Abstract:
INTRODUCTION:The biological mechanisms associated with an inadequate response to treatment with bisphosphonates are not well known. This study investigates the association between circulating levels of sclerostin and estradiol with an inadequate clinical outcome to bisphosphonate therapy in women with postmenopausal osteoporosis. METHODS:This case-control study is based on 120 Spanish women with postmenopausal osteoporosis being treated with oral bisphosphonates. Patients were classified as adequate responders (ARs, n=66, mean age 68.2±8 years) without incident fractures during 5 years of treatment, or inadequate responders (IRs, n=54, mean age 67±9 years), with incident fractures between 1 and 5 years of treatment. Bone mineral density (DXA), structural analysis of the proximal femur and structural/fractal analysis of the distal radius were assessed. Sclerostin concentrations were measured by ELISA and 17β-estradiol levels by radioimmunoassay based on ultrasensitive methods. RESULTS:In the ARs group, sclerostin serum levels were significantly lower (p=0.02) and estradiol concentrations significantly higher (p=0.023) than in the IRs group. A logistic regression analysis was performed, including as independent variables in the original model femoral fracture load, 25 hydroxyvitamin D, previus history of fragility fracture, sclerostin and estradiol. Only previous history of fragility fracture (OR 14.04, 95% CI 2.38-82.79, p=0.004) and sclerostin levels (OR 1.11, 95% CI 1.02-1.20, p=0.011), both adjusted by estradiol levels remained associated with IRs. Also, sclerostin concentrations were associated with the index of resistance to compression (IRC) in the fractal analysis of the distal radius, a parameter on bone microstructure. CONCLUSIONS:Sclerostin and estradiol levels are associated with the response to bisphosphonate therapy in women with postmenopausal osteoporosis.
journal_name
Maturitasjournal_title
Maturitasauthors
Morales-Santana S,Díez-Pérez A,Olmos JM,Nogués X,Sosa M,Díaz-Curiel M,Pérez-Castrillón JL,Pérez-Cano R,Torrijos A,Jodar E,Rio LD,Caeiro-Rey JR,Reyes-García R,García-Fontana B,González-Macías J,Muñoz-Torres Mdoi
10.1016/j.maturitas.2015.08.007subject
Has Abstractpub_date
2015-12-01 00:00:00pages
402-10issue
4eissn
0378-5122issn
1873-4111pii
S0378-5122(15)30042-6journal_volume
82pub_type
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