Serum homocysteine, folate and vitamin B12 in patients with Paget's disease of bone: the effect of zoledronic acid.
High serum homocysteine (HCY) and indirectly deficiency of folate and/or vitamin B(12) stimulate bone resorption and adversely affect collagen cross-linking. The aim of this study was the evaluation of serum levels of HCY, folate and vitamin B(12) in patients with Paget's disease of bone (PDB) and the effect of zoledronic acid (ZOL) on their serum levels. Nine consecutive patients with polyostotic PDB (median age 66 years) received a single 5-mg ZOL infusion. Blood samples for HCY, folate, vitamin B(12), 25-hydroxyvitamin D (25-OH-D), total serum alkaline phosphatase (TSAP), bone-specific serum alkaline phosphatase (BSAP) and C-terminal cross-linking telopeptide of type I collagen (CTX) were obtained at baseline and 3, 6 and 12 months after ZOL infusion. Twelve age-, gender- and BMI-matched healthy individuals were recruited for the control group at baseline assessment. Patients with PDB had significantly higher serum HCY (p = 0.028), folate (p < 0.001) and bone markers [TSAP (p < 0.001), BSAP (p < 0.001) and CTX (p < 0.001)] compared with the control group at baseline. In the pagetic group, serum HCY significantly decreased 3 months after ZOL infusion and remained essentially unchanged up to the end of the study (p = 0.005). Serum vitamin B(12) and folate remained unaffected throughout the study. Our data suggest that serum HCY levels are increased in patients with PDB. A single ZOL infusion results in a decrease in HCY levels that might represent another mechanism for the reduction of the activity of PDB achieved by ZOL.
Department of Endocrinology, Ippokration General Hospital, Thessaloniki, Greece. stergios@endo.gr
Stergios A
SA
Polyzos
Athanasios D
AD
Anastasilakis
Zoe
Z
Efstathiadou
Ioannis
I
Litsas
Marina
M
Kita
Athanasios
A
Panagiotou
Athanasios
A
Papatheodorou
Georgios
G
Arsos
Efstratios
E
Moralidis
Georgios
G
Barmpalios
Efthimia
E
Zafeiriadou
Efthimia
E
Triantafillidou
Eleni
E
Makrigiannaki
Evangelos
E
Terpos
D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D050071:Bone Density Conservation Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000097:blood*; D016723:Bone Remodeling / Q000187:drug effects; D002112:Calcifediol / Q000097:blood; D015331:Cohort Studies; D024042:Collagen Type I / Q000097:blood; D004164:Diphosphonates / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology* / Q000627:therapeutic use; D007527:Isoenzymes / Q000097:blood; D008297:Male; D010145:Paget Disease, Extramammary / Q000097:blood* / Q000188:drug therapy; D010455:Peptides / Q000097:blood; D010865:Pilot Projects; D013997:Time Factors; D014805:Vitamin B 12 / Q000097:blood*; D000077211:Zoledronic Acid
D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D004164:Diphosphonates; D007093:Imidazoles; D007527:Isoenzymes; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D006710:Homocysteine; D015652:25-Hydroxyvitamin D 2; D000077211:Zoledronic Acid; D005492:Folic Acid; D000469:Alkaline Phosphatase; D014805:Vitamin B 12; D002112:Calcifediol