ECTS2016 Poster Presentations Osteoporosis: treatment (40 abstracts)
Impact of 3-year vitamin D and calcium supplementation on mineral and organic matrix formation of trabecular bone in postmenopausal osteoporosis
E P Paschalis 1 , S Gamsjaeger 1 , N Hassler 1 , A Fahrleitner-Pammer 2 , H Dobnig 3 , J J Stepan 4 , E F Eriksen 5 & K Klaushofer 1
1Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospita, Vienna, Austria; 2Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria; 3Schilddrüsen Endokrinologie Osteoporose Institut Dobnig GmbH, Graz, Austria; 4Institute of Rheumatology, and Charles University Faculty of Medicine, Prague, Czech Republic; 5Department of Endocrinology, Morbid obesity and Preventive Medicine, Oslo University Hospital and University of Oslo, Oslo, Norway.
Clinical trials involving drug therapies for postmenopausal osteoporosis typically compare effects of the active drug combined with vitamin D (vit D) and calcium (Ca) vs vit D and Ca supplementation on its own. Bone strength is estimated based on the amount of bone, frequently expressed as bone mineral density determined by dual X-ray absorptiometry, and quality of bone, hardly measured in clinical practice.
The purpose of the present study was to compare bone material composition properties at actively bone forming (based on fluorescent labels) trabecular surfaces between two independent, age-matched groups: treatment-naïve postmenopausal osteoporosis patients with various level of vit D and Ca supplementation according to the routine clinical practice (TN; controlled vit D and Ca supplementation for up to 3 months) and patients who participated in the placebo arm of the prospective HORIZON clinical trial for zoledronic acid and received adequate vit D and Ca supplementation for 3 years (PLC). We analyzed by Raman microspectroscopy iliac crest biopsy samples by ANOVA for: the mineral/matrix ratio (MM); nanoporosity (a surrogate for tissue water content); the mineral maturity/crystallinity (MMC); the glycosaminoglycan (GAG) content; and the pyridinoline (Pyd) content. The results indicate significant differences between the two groups in all monitored parameters even after adjustment for tissue age. Specifically, the PLC group exhibited lower MM (−53%, P<0.0001) and GAGs (−90%, P<0.0001), and higher nanoporosity (+89%, P<0.01), MMC (+5%, P<0.001), and Pyd (+62%, P<0.0001) values compared to TN.
Given that major clinical trials in osteoporosis involve comparison between active drugs supplemented with adequate dose of vit D plus Ca, and adequate dose of vit D plus Ca, the difference in forming bone quality between these two groups of patients may underestimate the difference between patients on adequate osteoporosis therapies and treatment naive patients from the clinical practice.
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Bone Abstracts
ISSN 2052-1219 (online)
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