ORIGINAL PAPER
Effects of antiresorptive agents on body composition: a case-control retrospective study.
| 1 | Department of Medical Sciences, Surgery, and Neurosciences, Rheumatology Unit, University of Siena, Italy |
CORRESPONDING AUTHOR
Submission date: 2022-09-24
Final revision date: 2022-11-21
Acceptance date: 2022-11-26
Online publication date: 2023-01-24
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Osteoporosis is the most represented metabolic bone disease and is characterized by the reduction of bone mineral density (BMD), exposing patients to high fracture risk and disability. Bisphosphonates (BPs) are the main compounds exploited in treatment of osteoporosis and significantly reduce fracture risk. Sarcopenia is the pathological reduction of muscle masses and strength, and many studies highlighted its co-existence in patients with impaired bone mass. Indeed, the pathological reduction of lean tissue has been linked to a higher risk of falls and, consequently, fractures and disability. Moreover, the pathological reduction of lean tissue seems to share many pathological mechanisms with impaired bone strength and structure; thus, in this context, we decided to conduct a retrospective case-control study aimed at evaluating the effects of BPs on lean mass and body composition.
Material and methods:
We enrolled postmenopausal women from our metabolic bone diseases outpatient clinic who underwent at least two consecutive dual-energy X-ray absorptiometry (DXA) examinations concomitantly to the beginning of an antiresorptive agent. The body composition of patients and controls was compared by fat masses, lean masses and android-to-gynoid ratio (A/G ratio).
Results:
A total of 64 female subjects were considered for the study: 41 starting a BP and 23 without treatment were used as control. The fat masses and lean masses appeared to be unaffected by BPs. Conversely, A/G ratio was lower in BPs group after 18 months of therapy compared to baseline (p<0,05). From the stratification based on the single BP we failed to highlight any significant difference between the tested variables.
Conclusions:
Bisphosphonates treatment did not modify lean tissues, however a significant reduction of A/G ratio in BP group was documented. Thus the BPs seems to act on patients body composition and extra-skeletal tissues but larger prospective studies are needed to evaluate whether these modifications have clinical relevance.
Osteoporosis is the most represented metabolic bone disease and is characterized by the reduction of bone mineral density (BMD), exposing patients to high fracture risk and disability. Bisphosphonates (BPs) are the main compounds exploited in treatment of osteoporosis and significantly reduce fracture risk. Sarcopenia is the pathological reduction of muscle masses and strength, and many studies highlighted its co-existence in patients with impaired bone mass. Indeed, the pathological reduction of lean tissue has been linked to a higher risk of falls and, consequently, fractures and disability. Moreover, the pathological reduction of lean tissue seems to share many pathological mechanisms with impaired bone strength and structure; thus, in this context, we decided to conduct a retrospective case-control study aimed at evaluating the effects of BPs on lean mass and body composition.
Material and methods:
We enrolled postmenopausal women from our metabolic bone diseases outpatient clinic who underwent at least two consecutive dual-energy X-ray absorptiometry (DXA) examinations concomitantly to the beginning of an antiresorptive agent. The body composition of patients and controls was compared by fat masses, lean masses and android-to-gynoid ratio (A/G ratio).
Results:
A total of 64 female subjects were considered for the study: 41 starting a BP and 23 without treatment were used as control. The fat masses and lean masses appeared to be unaffected by BPs. Conversely, A/G ratio was lower in BPs group after 18 months of therapy compared to baseline (p<0,05). From the stratification based on the single BP we failed to highlight any significant difference between the tested variables.
Conclusions:
Bisphosphonates treatment did not modify lean tissues, however a significant reduction of A/G ratio in BP group was documented. Thus the BPs seems to act on patients body composition and extra-skeletal tissues but larger prospective studies are needed to evaluate whether these modifications have clinical relevance.
REFERENCES (12)
1.
Rizer MK. Osteoporosis. Prim Care 2006; 33: 943–951, DOI: 10.1016/j.pop.2006.09.004.
2.
Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019; 48: 16–31, DOI: 10.1093/ageing/afy169.
3.
Verschueren S, Gielen E, O’Neill TW, et al. Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men. Osteoporos Int 2013; 24: 87–98, DOI: 10.1007/s00198-012-2057-z.
4.
Molfino A, Amabile MI, Rossi Fanelli F, Muscaritoli M. Novel therapeutic options for cachexia and sarcopenia. Expert Opin Biol Ther 2016; 16: 1239–1244, DOI: 10.1080/14712598.2016.1208168.
5.
Baumgartner RN, Wayne SJ, Waters DL, et al. Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res 2004; 12: 1995–2004, DOI: 10.1038/oby.2004.250.
6.
El Miedany Y. FRAX : re-adjust or re-think. Arch Osteoporos 2020; 15: 150, DOI: 10.1007/s11657-020-00827-z.
7.
Dhillon RJ, Hasni S. Pathogenesis and management of sarcopenia. Clin Geriatr Med 2017; 33: 17–26, DOI: 10.1016/j.cger.2016.08.002.
8.
Tagliaferri C, Wittrant Y, Davicco MJ, et al. Muscle and bone, two interconnected tissues. Ageing Res Rev 2015; 21: 55–70, DOI: 10.1016/j.arr.2015.03.002.
9.
Børsheim E, Herndon DN, Hawkins HK, et al. Pamidronate attenuates muscle loss after pediatric burn injury. J Bone Miner Res 2014; 29: 1369–1372, DOI: 10.1002/jbmr.2162.
10.
Drake MT, Clarke BL, Khosla S. Bisphosphonates: mechanism of action and role in clinical practice. Mayo Clin Proc 2008; 83: 1032–1045, DOI: 10.4065/83.9.1032.
11.
Flodin L, Cederholm T, Saäf M, et al. Effects of protein-rich nutritional supplementation and bisphosphonates on body composition, handgrip strength and health-related quality of life after hip fracture: a 12-month randomized controlled study. BMC Geriatr 2015; 15: 149, DOI: 10.1186/s12877-015-0144-7.
12.
Panagiotakou A, Yavropoulou M, Nasiri-Ansari N, et al. Extra-skeletal effects of bisphosphonates. Metabolism 2020; 110: 154264, DOI: 10.1016/j.metabol.2020.154264.
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
RELATED ARTICLE
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.