Osteoporosis International

, Volume 23, Issue 4, pp 1235–1243

Long-term treatment with raloxifene, but not bisphosphonates, reduces circulating sclerostin levels in postmenopausal women

  • Y. E. Chung
  • S. H. Lee
  • S.-Y. Lee
  • S.-Y. Kim
  • H.-H. Kim
  • F. S. Mirza
  • S.-K. Lee
  • J. A. Lorenzo
  • G. S. Kim
  • J.-M. Koh
Original Article

DOI: 10.1007/s00198-011-1675-1

Cite this article as:
Chung, Y.E., Lee, S.H., Lee, SY. et al. Osteoporos Int (2012) 23: 1235. doi:10.1007/s00198-011-1675-1

Abstract

Summary

We determined whether suppression of sclerostin levels by estrogen treatment was mediated by anti-resorptive effect. Raloxifene, but not bisphosphonates, suppressed circulating sclerostin concentration, suggesting that sclerostin may mediate the action of estrogen on bone metabolism, independently of their anti-resorptive effects.

Introduction

Circulating sclerostin concentrations are higher in postmenopausal than in premenopausal women, and estrogen treatment suppresses sclerostin levels in both men and women. We determined whether anti-resorptives may suppress the circulating sclerostin levels.

Methods

We conducted a retrospective observational study. Eighty postmenopausal women were treated with raloxifene for 19.4 ± 7.7 months (n = 16), bisphosphonates for 19.2 ± 6.7 months (n = 32), or were untreated (n = 32) for 17.1 ± 4.6 months. Plasma sclerostin concentrations were measured before and after treatment.

Results

Plasma sclerostin levels after treatment were significantly lower in the raloxifene than in the control group (55.8 ± 23.4 pmol/l vs. 92.1 ± 50.4 pmol/l, p = 0.046), but were similar between the bisphosphonate and control groups. Relative to baseline, raloxifene treatment markedly reduced plasma sclerostin concentration (−40.7 ± 22.8%, p < 0.001), with respect to both control (−7.5 ± 29.1%) and bisphosphonate (−3.1 ± 35.2%) groups. Changes in bone-specific alkaline phosphatase and osteocalcin levels showed reverse associations with sclerostin concentration changes in the raloxifene (γ = −0.505, p = 0.017) and control (γ = −0.410, p = 0.020) groups.

Conclusions

Raloxifene, but not bisphosphonates, significantly suppressed circulating sclerostin concentration, suggesting that sclerostin may mediate the action of estrogen on bone metabolism, independently of their anti-resorptive effects.

Keywords

BisphosphonatesBone turnoverEstrogenRaloxifeneSclerostin

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • Y. E. Chung
    • 1
  • S. H. Lee
    • 2
  • S.-Y. Lee
    • 3
  • S.-Y. Kim
    • 4
  • H.-H. Kim
    • 5
  • F. S. Mirza
    • 6
  • S.-K. Lee
    • 6
  • J. A. Lorenzo
    • 6
  • G. S. Kim
    • 2
  • J.-M. Koh
    • 2
  1. 1.Department of Internal MedicineSeoul Veterans HospitalSeoulSouth Korea
  2. 2.Division of Endocrinology and Metabolism, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  3. 3.Asan Institute for Life SciencesSeoulSouth Korea
  4. 4.Department of Orthopedic Surgery, School of MedicineKyungpook National UniversityDaeguSouth Korea
  5. 5.Department of Cell and Developmental Biology, College of DentistrySeoul National UniversitySeoulSouth Korea
  6. 6.Division of EndocrinologyUniversity of Connecticut Health CenterFarmingtonUSA