title: Vitamin D and bone mineral density changes in postmenopausal women treated with strontium ranelate.
abstract: OBJECTIVE
  Vitamin D deficiency is widespread and often reported in subjects treated for osteoporosis. Optimal vitamin D repletion was previously shown to maximize the efficacy of anti-resorptive agents. To date, no information exists about the role of vitamin D in the response to strontium ranelate (SrR) treatment. The aim of our study was to investigate the BMD response to SrR in accordance with change of vitamin D status.
  
  
  METHODS
  A retrospective analysis of 108 women receiving SrR for postmenopausal osteoporosis was carried out. Women were treated with SrR (2 g/day), with cholecalciferol (25,000 IU biweekly) and calcium carbonate as appropriate. Lumbar spine and femoral neck BMD, bone formation markers (BGP, ALP), resorption marker (OH-PRO) and serum 25(OH)D were measured at baseline after 18-months. All participants were divided into two groups according to the median variation of 25(OH)D over the observation period.
  
  
  RESULTS
  SrR was associated with improvement of BMD at lumbar spine (p < 0.0001) and to a non significant variation at femoral neck (p = 0.2). Only subjects with Δ25(OH)D > 6.14 %, reported a significant BMD gain at femoral neck (p = 0.03). Change of BMD at femoral neck was positively associated with modification of ALP (r = 0.28, p = 0.01). This association was not maintained when considering only women with Δ25(OH)D < 6.14 % (r = 0.28, p = 0.09). At a multiple regression analysis, ALP change was the only predictor of femoral neck BMD modification (β 0.13; SE 0.05; p = 0.01).
  
  
  CONCLUSIONS
  Improvement of vitamin D status was associated with enhancement of BMD response to SrR in women with postmenopausal osteoporosis, in particular, at femoral neck.
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, A.O.U. Policlinico "G. Martino" Via C. Valeria, 98125, Messina, Italy, catalanoa@unime.it.
authors.forename: A
authors.initials: A
authors.lastname: Catalano
authors.forename: N
authors.initials: N
authors.lastname: Morabito
authors.forename: A
authors.initials: A
authors.lastname: Di Stefano
authors.forename: E
authors.initials: E
authors.lastname: Morini
authors.forename: G
authors.initials: G
authors.lastname: Basile
authors.forename: B
authors.initials: B
authors.lastname: Faraci
authors.forename: S
authors.initials: S
authors.lastname: Loddo
authors.forename: R
authors.initials: R
authors.lastname: Ientile
authors.forename: A
authors.initials: A
authors.lastname: Lasco
mesh_terms: D000368:Aged; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D017698:Postmenopause / Q000187:drug effects / Q000502:physiology; D012189:Retrospective Studies; D013876:Thiophenes / Q000494:pharmacology / Q000627:therapeutic use*; D014807:Vitamin D / Q000097:blood*
chemical_list: D050071:Bone Density Conservation Agents; D013876:Thiophenes; C081587:strontium ranelate; D014807:Vitamin D