Serum homocysteine levels are affected by renal function during a 3-year period of minodronate therapy in female osteoporotic patients

  • Tsuyoshi Ohishi
  • Tomotada Fujita
  • Daisuke Suzuki
  • Tatsuya Nishida
  • Mitsuru Asukai
  • Yukihiro Matsuyama
Original Article


Serum homocysteine is a possible marker to indicate bone quality. However, it is not clear whether changes are seen in serum homocysteine levels with long-term bisphosphonate therapy. We aimed to investigate the factors affecting serum homocysteine levels during a 3-year period of monthly minodronate therapy in osteoporotic women, and to examine if the serum homocysteine levels could reflect some aspects of bone metabolism. The study included 43 patients (age 72.3 ± 7.0 years) undergoing treatment for osteoporosis for the first time (New group) and 35 patients (age 74.4 ± 8.2 years) who switched from alendronate or risedronate to minodronate (Switch group). Minodronate (50 mg/every 4 weeks) was administered for 36 months. Lumbar, femoral neck, and total hip bone mineral densities (BMD), and serum homocysteine levels were monitored at baseline and after 9, 18, 27, and 36 months of treatment. Lumbar BMD increased significantly in both groups (New group 11.4%, Switch group 6.2%). However, femoral neck and total hip BMDs increased only in the New group (femoral neck 3.6%, total hip 4.1%). Serum homocysteine levels increased significantly at 18 and 27 months in all subjects. Multiple linear regression analysis revealed that changes in homocysteine levels during 18, 27, and 36 months significantly correlated with changes in creatinine clearance during the same corresponding periods (18 months: B = − 0.472, p = 0.003; 27 months: B = − 0.375, p = 0.021; 36 months: B = − 0.445, p = 0.012). Thus, serum homocysteine levels possibly reflect renal function instead of bone metabolism during minodronate therapy.


Bisphosphonate Bone mineral density Homocysteine Minodronate Osteoporosis 



The authors would like to thank Yoshiaki Ito, Yasuyuki Takabayashi, and Yasuhide Suzuki, who are laboratory technicians at Enshu Hospital, for their assistance with blood sample preparation.

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest. The authors are responsible for the content and writing of the paper.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Tsuyoshi Ohishi
    • 1
  • Tomotada Fujita
    • 1
  • Daisuke Suzuki
    • 1
  • Tatsuya Nishida
    • 1
  • Mitsuru Asukai
    • 1
  • Yukihiro Matsuyama
    • 2
  1. 1.Department of Orthopedic SurgeryEnshu HospitalHamamatsuJapan
  2. 2.Department of Orthopedic SurgeryHamamatsu University School of MedicineHamamatsuJapan

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