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Vitamin D and bone mineral density changes in postmenopausal women treated with strontium ranelate

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Abstract

Objective

Vitamin D deficiency is widespread and often reported in subjects treated for osteoporosis. Optimal vitamin D repletion was previously shown to maximize the efficacy of anti-resorptive agents. To date, no information exists about the role of vitamin D in the response to strontium ranelate (SrR) treatment. The aim of our study was to investigate the BMD response to SrR in accordance with change of vitamin D status.

Methods

A retrospective analysis of 108 women receiving SrR for postmenopausal osteoporosis was carried out. Women were treated with SrR (2 g/day), with cholecalciferol (25,000 IU biweekly) and calcium carbonate as appropriate. Lumbar spine and femoral neck BMD, bone formation markers (BGP, ALP), resorption marker (OH-PRO) and serum 25(OH)D were measured at baseline after 18-months. All participants were divided into two groups according to the median variation of 25(OH)D over the observation period.

Results

SrR was associated with improvement of BMD at lumbar spine (p < 0.0001) and to a non significant variation at femoral neck (p = 0.2). Only subjects with Δ25(OH)D > 6.14 %, reported a significant BMD gain at femoral neck (p = 0.03). Change of BMD at femoral neck was positively associated with modification of ALP (r = 0.28, p = 0.01). This association was not maintained when considering only women with Δ25(OH)D < 6.14 % (r = 0.28, p = 0.09). At a multiple regression analysis, ALP change was the only predictor of femoral neck BMD modification (β 0.13; SE 0.05; p = 0.01).

Conclusion

Improvement of vitamin D status was associated with enhancement of BMD response to SrR in women with postmenopausal osteoporosis, in particular, at femoral neck.

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Conflict of interest

Antonino Catalano, Nunziata Morabito, Antonina Di Stefano, Elisabetta Morini, Giorgio Basile, Bianca Faraci, Saverio Loddo, Riccardo Ientile and Antonino Lasco have no conflicts of interest.

Ethical standard

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

For this type of study, formal informed consent was not required.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, University Hospital of Messina, A.O.U. Policlinico “G. Martino” Via C. Valeria, 98125, Messina, Italy

    A. Catalano, N. Morabito, A. Di Stefano, E. Morini, G. Basile, B. Faraci, S. Loddo & A. Lasco

  2. Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital of Messina, Messina, Italy

    R. Ientile

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  1. A. Catalano
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  2. N. Morabito
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Correspondence to A. Catalano.

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Catalano, A., Morabito, N., Di Stefano, A. et al. Vitamin D and bone mineral density changes in postmenopausal women treated with strontium ranelate. J Endocrinol Invest 38, 859–863 (2015). https://doi.org/10.1007/s40618-015-0299-2

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  • DOI: https://doi.org/10.1007/s40618-015-0299-2

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