Effect of alendronate on bone mineral density and bone turnover markers in post-gastrectomy osteoporotic patients.
Alendronate decreases the urinary levels of cross-linked N-terminal telopeptides of type I collagen (NTX; about 45% at 3 months) and serum levels of alkaline phosphatase (ALP; about 27% at 24 months), leading to an increase in lumbar spine bone mineral density (BMD; about 9% at 24 months) in postmenopausal Japanese women with osteoporosis. However, the effectiveness of oral bisphosphonates on osteoporosis remains to be established in patients who have undergone a gastrectomy. The objective of the present case series study was to examine the effect of alendronate on BMD and bone turnover markers in post-gastrectomy osteoporotic patients. Sixteen patients (3 men and 13 postmenopausal women) with osteoporosis, who had undergone a gastrectomy (mean age: 69.1 years), were recruited in our outpatient clinic. All the patients were treated with alendronate (5 mg daily or 35 mg weekly) for 24 months. The effects of alendronate on lumbar spine (women) or total hip (men) BMD and urinary NTX and serum ALP levels were examined. A total or partial gastrectomy had been performed for eight patients each. The mean duration after surgery was 16.0 years. With alendronate therapy, urinary NTX levels significantly decreased at 3 months (-27.0%). Serum ALP levels decreased (-12.1%) and lumbar spine BMD increased (+5.2%), but total hip BMD did not significantly change (+0.6%) at 24 months. No severe adverse events were observed, and alendronate therapy was well tolerated. These results suggest that alendronate mildly increases lumbar spine BMD by mildly reducing bone turnover in osteoporotic patients after a gastrectomy.
Iwamoto
Jun
J
Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. jiwamoto@sc.itc.keio.ac.jp
Uzawa
Mitsuyoshi
M
Sato
Yoshihiro
Y
Takeda
Tsuyoshi
T
Matsumoto
Hideo
H
D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000009:adverse effects / Q000627:therapeutic use*; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016723:Bone Remodeling / Q000187:drug effects*; D001842:Bone and Bones / Q000737:chemistry / Q000000981:diagnostic imaging / Q000187:drug effects; D003094:Collagen / Q000652:urine; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D010352:Patient Dropouts; D011859:Radiography; D012727:Sex Characteristics; D013223:Statistics as Topic
D015415:Biomarkers; D050071:Bone Density Conservation Agents; C461299:urinary N-telopeptide of type I collagen, human; D003094:Collagen; D000469:Alkaline Phosphatase; D019386:Alendronate
J Bone Miner Metab. 2001;19(6):331-7
11685647
Hum Nutr Clin Nutr. 1986 Jul;40(4):301-8
3744890
Arq Gastroenterol. 2001 Apr-Jun;38(2):129-31
11793943
Osteoporos Int. 1999;10(3):183-92
10525709
Bone. 1999 May;24(5 Suppl):73S-79S
10321934
J Bone Miner Metab. 2005;23(2):97-104
15750686
Expert Opin Pharmacother. 2007 Nov;8(16):2743-56
17956196
World J Gastroenterol. 2007 Dec 28;13(48):6492-7
18161918
J Clin Endocrinol Metab. 2001 Mar;86(3):1212-21
11238511
J Bone Miner Metab. 2005;23(5):382-8
16133688
J Pharm Sci. 1994 Dec;83(12):1741-6
7891304
J Gastroenterol Hepatol. 1992 Nov-Dec;7(6):639-45
1486191
Clin Interv Aging. 2008;3(3):483-9
18982918
J Bone Miner Metab. 2007;25(5):302-9
17704995
Clin Pharmacokinet. 1999 May;36(5):315-28
10384857
J Orthop Sci. 2003;8(5):717-20
14557940
Curr Med Res Opin. 2006 May;22(5):919-28
16709313
Clin Calcium. 2003 Nov;13(11):1399-404
15775224
Clin Pharmacol Ther. 1995 Sep;58(3):288-98
7554702
Nutrition. 1999 Sep;15(9):677-82
10467612
Am J Med. 1996 Nov;101(5):488-501
8948272