title: Treatment with teriparatide might be associated with cardiometabolic changes in postmenopausal severe osteoporotic women.
abstract: Parathormone (PTH) has been suggested to affect the cardiovascular system. Teriparatide (TPT), the hormonally active 1-34 fragment of PTH, provides an anabolic treatment for osteoporosis. The aim of the present study was to evaluate the cardiometabolic effects of 18-month treatment with 20 μg/ die teriparatide subcutaneosly. Fourteen women with postmenopausal severe osteoporosis treated with once-daily sc 20 μg TPT (67.6 ± 2.5 years; BMI 27.7 ± 1.0 kg/m²) and 24 age- and BMI-matched severe osteoporotic women treated with iv yearly 5 mg zoledronate (ZLN) were evaluated at baseline and at 12-18 months of treatment for anthropometric measures, calcium, glucose and lipid metabolic parameters, and assessment of cardiac geometry by conventional echocardiography. TPT was effective in increasing mean lumbar spine bone mineral density with no clinically relevant changes in calcium metabolism parameters. TPT patients experienced an increase of BMI (27.7 ± 1.0 at baseline vs 29.0 ± 1.0 kg/m² at last evaluation, P=0.005) and mean whole body fat percentage (37.0 ± 2.1 vs 40.3 ± 1.9%, P=0.05), associated with increased serum leptin levels (17.3 ± 2.1 vs 22.9 ± 3.0 ng/ml; P=0.049). Glucose and lipid parameters were not affected by TPT as well as by ZLN treatment. Furthermore, TPT was associated with a decrease in systolic blood pressure; a decrease in the fractional shortening (41.2 ± 2.3 vs 36.9 ± 1.2; P=0.05) and an increase in the relative wall thickness (0.39 ± 0.01 vs 0.48 ± 0.01 mm; P=0.002), suggestive for concentric cardiac remodeling, was detected by echocardiographic monitoring. These changes could not be detected in bone active drug-free age- and metabolic-matched controls. In conclusion, long-term TPT therapy might affect cardiometabolic and cardiac geometry parameters in severe osteoporotic women, though changes are not clinically relevant.
authors.affiliation: Endocrinology Unit, IRCCS Policlinico San Donato, San Donato M.se, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Passeri
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Dozio
authors.affiliation: Endocrinology Unit, IRCCS Policlinico San Donato, San Donato M.se, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mendola
authors.affiliation: Clinical Chemistry Laboratory, IRCCS Policlinico San Donato, San Donato M.se, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Costa
authors.affiliation: Heart Failure Unit, IRCCS Policlinico San Donato, San Donato M.se, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bandera
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; UOC SMEL-1 Clinical Pathology, IRCCS Policlinico San Donato, San Donato M.se, Milan, Italy.
authors.forename: M M
authors.initials: MM
authors.lastname: Corsi Romanelli
authors.affiliation: Endocrinology Unit, IRCCS Policlinico San Donato, San Donato M.se, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Corbetta
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002118:Calcium / Q000378:metabolism; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006321:Heart / Q000187:drug effects; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D019379:Teriparatide / Q000009:adverse effects / Q000627:therapeutic use*; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D019379:Teriparatide; D000077211:Zoledronic Acid; D002118:Calcium