The effects of bisphosphonates on inflammatory markers and atherosclerosis

Abstract

Aims: Atherosclerosis and osteoporosis are prevalent conditions associated with significant morbidity and mortality worldwide. Evidence of literature suggests that bisphosphonates (BP) may play a role in inhibiting atherogenesis. The pathophysiological mechanisms underlying both atherosclerosis and osteoporosis share similarities, and numerous studies have shown an association between osteoporosis and cardiovascular events. This study aims to evaluate the effects of oral BP therapy on vascular inflammatory markers and carotid intima-media thickness (CIMT), a surrogate marker of atherosclerosis, in osteoporotic patients. Methods: The study included 28 osteoporotic patients (study group) and 28 osteopenic patients (control group). BP therapy (alendronate 70 mg/week, risedronate 35 mg/week) was administered to the study group in a randomized controlled way. The patients of the both groups received daily supplements of calcium (1000 mg) and vitamin D (880 IU). Baseline and 12-month follow-up measurements included height, weight, body-mass index (BMI), high-sensitivity C-reactive protein (hs-CRP), homocysteine levels, CIMT, and bone mineral density (BMD). Results: At the 12-month follow-up, hs-CRP levels decreased significantly in the study group, while they increased slightly in the control group (p=0.032). Similarly, homocysteine levels showed a significant reduction in the study group compared to the control group (p=0.002). No significant change in CIMT was observed between the two groups over the study period. Conclusion: Our findings suggest that while oral BPs may influence certain vascular inflammatory markers, such as hs-CRP and homocysteine but they do not have a significant effect on CIMT. BPs may exert anti-atherosclerotic effects through the mevalonate pathway, but the results of this study warrant further investigation with larger sample sizes to confirm the broader implications of BPs in atherosclerosis management.

Keywords

• Atherosclerosis
• bisphosphonates
• vascular inflammatory markers

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