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Postmenopozal Osteoporozlu Olgularda Bifosfonat Tedavisinin Kan Lipid Parametreleri Üzerine Etkisi The Effect of Bisphosphonate Treatment on Blood Lipid Parameters in Patients with Postmenopausal Osteoporosis

Postmenopozal Osteoporozlu Olgularda Bifosfonat Tedavisinin Kan Lipid Parametreleri Üzerine Etkisi The Effect of Bisphosphonate Treatment on Blood Lip

Postmenopozal Osteoporozlu Olgularda Bifosfonat Tedavisinin Kan Lipid Parametreleri Üzerine Etkisi The Effect of Bisphosphonate Treatment on Blood Lipid Parameters in Patients with Postmenopausal Osteoporosis  
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Bifosfonatlar günümüzde osteoporoz ve Paget hastal›¤› gibi metabolik kemik hastal›klar›n›n tedavisinde yayg›n ola- rak kullan›lan ilaç grubudur. Kesin etki mekanizmalar› bilin- memekle birlikte özellikle amin grubu içeren bifosfonatlar›n (aminobifosfonat) mevalonat yolunu inhibe ederek osteok- last aktivasyonunu azaltt›¤› gösterilmifltir. Kolesterol sente- zinin de mevalonate yoluyla olmas›, bu grup ilaçlar›n koles- terol metabolizmas›n› da etkileyebileceini düflündürmek- tedir. Bu çal›flmada, osteoporoz tan›s› konularak tedavi amac›yla aminobifosfonat bafllan›lan olgularda kan lipid parametrelerindeki deifliklikler araflt›r›lm›flt›r. Bu amaçla çal›flmaya toplam 50 osteoporotik postmeno- pozal hasta al›nm›fl olup, 25 hastaya (ort.yafl:54±9 y›l) alendronat sodyum (70mg/hafta), 25 hastaya da (ort.yafl:55±8 y›l) risedronat sodyum (35mg/hafta) bafl- lanm›flt›r. Ölçümler bafllang›çta ve 6 ayl›k tedavi sonras›n- da yap›lm›flt›r. Kan lipid parametreleri olarak; total koles- terol (T-kol), yüksek dansiteli kolesterol (HDL-kol), düflük dansiteli kolesterol (LDL-kol), trigliserid, apolipoprotein A (Apo-A), apolipoprotein B (Apo-B), lipoprotein (a) (Lip a) ve kemik döngüsünü gösteren parametreler olarak da; serumda total alkalen fosfataz (TAP), kemik-spesifik alka- len fosfataz (BAP), osteokalsin (OCL) ve idrarda deoksi- piridinolin (DPD) düzeyleri deerlendirmeye al›nm›flt›r. Alt› ayl›k tedavi sonras›nda her 2 grupta biyokimyasal olarak ölçülen kemik döngüsüne ait parametrelerde an- laml› deifliklikler olmas›na karfl›n (p<0,05), gerek alendronat gerekse de risedronat tedavisinin lipid para- metreleri üzerine herhangi anlaml› bir etkisinin olmad›¤› gözlenmifltir (p>0,05). Sonuçlar›m›z orta süreli oral aminobifosfonat tedavisinin kan lipid profili üzerine etki- sinin olmad›¤›n› düflündürmüfltür. A Annaahhttaarr kkeelliimmeelleerr:: Aminobifosfonat, kolesterol, lipid pa- rametreleri, lipoproteinler SUMMARY Bisphosphonates are currently the most preferred class of drugs used for the treatment of metabolic bone dise- ase such as osteoporosis and Paget's disease. Altho- ugh their exact mechanism has not been identified, the compounds containing amino group (amino bisphosp- honates) were shown to decrease osteoclast activation by inhibiting mevalonate pathway. Because mevalonate pathway is essential in production of cholesterol, these compounds could also interfere with cholesterol synthe- sis. In the present study, the effects of aminobisphosp- honates on lipid parameters in subjects who were diag- nosed as osteoporosis were investigated. For this re- ason, 50 postmenopausal osteoporotic subjects were included in the study and 25 of them (mean age:54±9 years) received alendronate sodium (70mg/week) and the remaining 25 subjects (mean age:55±8 years) were given risedronate sodium (35mg/week). Blood samples were analyzed at baseline and at the end of sixth months. Total cholesterol, high density cholesterol (HDL-chol), low density cholesterol (LDL-chol), triglyce- ride, apolipoprotein A (Apo-A), apolipoprotein B (Apo-B) and lipoprotein (a) (Lip a) were investigated as lipid pa- rameters. Total alkaline phophatase (TAP), bone-speci- fic alkaline phophatase (BAP), osteocalcine (OCL) and urine deoxyprydolin (DPD) levels were assessed as bo- ne remodeling markers. After six month treatment period, while significant chan- ges were observed in bone remodeling parameters (p<0.05), no significant changes were found in all me- asured lipid parameters (p>0.05). Our results suggest that moderate-term oral aminobisfosphonate treatment has no significant effect on blood lipid parameters. K Keeyy wwoorrddss:: Aminobisphosphonates, cholesterol, lipid parameters, lipoproteins
Published in 2005.
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