ECTS2016 Poster Presentations Osteoporosis: treatment (40 abstracts)
The upper two third of the reference interval of the serum calcium level is required for the optimal increase in lumbar bone mineral density by bisphosphonate and active vitamin D3 analogue for osteoporosis
Mayuko Kinoshita , Muneaki Ishijima , Haruka Kaneko , Liu Lizu , Ryo Sadatsuki , Shinnnosuke Hada , Anwar Yusup , Hitoshi Arita , Jun Shiozawa , Makoto Yamanaka , Yuko Sakamoto , Hidetoshi Nojiri & Kazuo Kaneko
Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Background: It is important to increase bone mineral density (BMD) by the treatment with bisphosphonates (BPs), as lower BMD has been revealed to be one of the risk factors for the subsequent fragility fracture in patients with osteoporosis treated with BPs.
Methods: The two independent populations of the patients with postmenopausal osteoporosis who were treated for 2y by BPs with active vitamin D analogue (aVD) were enrolled in Study 1 (n=93) and Study 2, (n=99) in this retrospective study. The most appropriate cut-off level of serum Ca (sCa) for optimal increase in LS-BMD by the combined therapy for six months was calculated using Akaike’s information criterion (AIC).
Results: In Study 1, the lumbar spine (LS)-BMD of the patients was significantly increased by the combined therapy for 2y (P<0.001, 5.4%). A multiple regression analysis revealed that the sCa was the factor that was significantly associated with the increase in LS -BMD for 2 years (R2:0.088, P=0.02). The sCa of 9.3 mg/dl, which was the borderline between the lower and middle tertiles of its reference range, was found to be a cut-off levels for the optimal increase in %LS-BMD by the treatment. When the patients were divided into two groups by sCa of 9.3 mg/ml, the %LS-BMD of the every 6 month-treatment was significantly different between these two groups (0.8% vs 1.8%, P=0.038). Neither hypercalcemia nor hypercalcium urea were observed during 2y of the treatment of the patients in both Group 1 and 2. Same results were observed in Study 2.
Conclusion: The present study revealed for the first time that, even though within the reference range of sCa, the upper two third of sCa level is required to optimal increase in LS-BMD by BP with aVD in patients with postmenopausal osteoporosis.
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Bone Abstracts
ISSN 2052-1219 (online)
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