title: Effects of intravenous zoledronate and ibandronate on carotid intima-media thickness, lipids and FGF-23 in postmenopausal osteoporotic women.
abstract: OBJECTIVE
  Osteoporosis and atherosclerosis are interconnected entities and share also some pathophysiological mechanisms. Moreover, recent literature data have supported the hypothesis that bisphosphonates (BPs) may have some antiatherogenic actions. This study aimed to evaluate the effects of one year with zoledronate or ibandronate given intravenously on lipid profile and on carotid artery intima-media thickness (CA-IMT).
  
  
  METHODS
  Sixty postmenopausal osteoporotic women (mean age: 66.6±7.8years) were randomly assigned to 1-year treatment with zoledronate 5mg i.v. annually or ibandronate 3mg i.v. every 3 months. In all patients at baseline and after 12months we measured CA-IMT, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), 25-hydroxyvitamin D (25OHD), bone alkaline phosphatase (B-ALP), type I collagen β carboxy telopeptide (βCTX), osteocalcin (OC), fibroblast growth factor 23 (FGF-23) and sclerostin.
  
  
  RESULTS
  The osteoporotic women treated with zoledronate showed a greater reduction in CA-IMT than those treated with ibandronate. HDL-C and HDL-C/LDL-C ratio showed a significant (p<0.01) increase in the 2 groups, whereas, LDL-C showed a reduction in the two groups which, however, reached statistical significance (p<0.05) only in the zoledronate group. FGF-23 serum levels showed a similar and significant decrease in both the women treated with zoledronate and in those treated with ibandronate. At the end of the study period sclerostin serum levels showed a higher increase in the patients treated with zoledronate than in those treated with ibandronate.
  
  
  CONCLUSIONS
  In osteoporotic women both zoledronate and ibandronate given intravenously resulted in an increase in HDL-C/LDL-C ratio and a reduction of CA-IMT which was significant only for zoledronate. Further prospective studies are needed to clarify whether the change in FGF-23 and sclerostin levels is a marker or a potential mechanism of the action of BPs at a vascular level.
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Italy. Electronic address: gonnelli@unisi.it.
authors.forename: S
authors.initials: S
authors.lastname: Gonnelli
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Caffarelli
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Tanzilli
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pondrelli
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Lucani
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
authors.forename: B M
authors.initials: BM
authors.lastname: Franci
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Nuti
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D059168:Carotid Intima-Media Thickness; D004164:Diphosphonates / Q000008:administration & dosage*; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D006801:Humans; D000077557:Ibandronic Acid; D007093:Imidazoles / Q000008:administration & dosage*; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; C000717427:FGF23 protein, human; D007093:Imidazoles; D008055:Lipids; D005346:Fibroblast Growth Factors; D000077211:Zoledronic Acid; D000089703:Fibroblast Growth Factor-23; D000077557:Ibandronic Acid
keywords: Carotid intima-media thickness; FGF-23; Ibandronate; Osteoporosis; Sclerostin; Zoledronate