Effects of strontium ranelate administration on calcium metabolism in female patients with postmenopausal osteoporosis and primary hyperparathyroidism.
We investigated possible changes of parameters of calcium metabolism induced by strontium ranelate (SR). Twenty-three patients with postmenopausal osteoporosis (PO) and 14 with primary hyperparathyroidism (PHPT) were studied while taking 2 g/day of SR. Women with PO and 10 healthy age-matched control women were also daily supplemented with 1,000 mg calcium and 800 IU vitamin D. All subjects were studied at baseline and after 7 and 30 days; PO women and controls were also investigated at 180 and 360 days of treatment. Serum ionized calcium (iCa), phosphate (sP), magnesium, creatinine, 25-hydroxycholecalciferol (25[OH]D), 1,25-dihydroxycholecalciferol (1,25[OH](2)D), serum parathyroid hormone (PTH) were measured. In spot urine, we assessed calcium and phosphate over creatinine ratios (uCa/Cr, uP/Cr), calcium excretion (Ca ex) and renal phosphate threshold (TmP/GFR); in 24-h urine, calcium and magnesium over creatinine clearance ratios (CaCl/CrCl and MgCl/CrCl). In PO, SR administration was associated with a significant decrease of PTH and 1,25(OH)(2)D levels but an increase of sP (p < 0.001). SR also significantly increased Ca/Cr, Ca ex, and TmP/GFR in spot urine and CaCl/CrCl in both spot and 24-h urine (p = 0.004 to <0.001). In PHPT, SR significantly decreased iCa and increased sP, slightly modifying PTH, 25(OH)D, and 1,25(OH)(2)D values. Also in PHPT, Ca ex and CaCl/CrCl of spot and 24-h urine, as TmP/GFR, significantly increased (all p < 0.02). SR influenced the main parameters of calcium homeostasis, probably through the calcium-sensing receptor.
Unit of Internal Medicine, Casa Sollievo della Sofferenza Hospital, IRCCS, Viale dei Cappuccini snc, 71013, San Giovanni Rotondo, FG, Italy. venz.carnevale@libero.it
Vincenzo
V
Carnevale
Romano
R
Del Fiacco
Elisabetta
E
Romagnoli
Andrea
A
Fontana
Cristiana
C
Cipriani
Jessica
J
Pepe
Salvatore
S
Minisola
D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002112:Calcifediol / Q000097:blood; D002117:Calcitriol / Q000097:blood; D002118:Calcium / Q000097:blood / Q000378:metabolism* / Q000627:therapeutic use; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood / Q000378:metabolism; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000188:drug therapy*; D007477:Ions; D008274:Magnesium / Q000097:blood; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D013876:Thiophenes / Q000627:therapeutic use*; D013997:Time Factors; D014807:Vitamin D / Q000627:therapeutic use
D050071:Bone Density Conservation Agents; D007477:Ions; D009942:Organometallic Compounds; D010281:Parathyroid Hormone; D010710:Phosphates; D013876:Thiophenes; C081587:strontium ranelate; D014807:Vitamin D; D003404:Creatinine; D002117:Calcitriol; D008274:Magnesium; D002112:Calcifediol; D002118:Calcium