Department of Internal Medicine, University of Messina, 98125 Messina, Italy.
J Clin Endocrinol Metab. 2013 May;98(5):1911-5. doi: 10.1210/jc.2012-4039. Epub 2013 Apr 17.
Sclerostin is a circulating inhibitor of the Wnt-signaling pathway produced by osteocytes, which acts as a negative regulator of bone formation. Effects of zoledronic acid on sclerostin serum levels in postmenopausal osteoporosis are unknown.
The purpose of this study was to evaluate sclerostin serum levels after zoledronic acid administration and correlate variations with bone turnover markers.
We conducted a prospective intervention study in an ambulatory care setting.
Forty women (mean age 62.6 ± 4.9 years) with postmenopausal osteoporosis were enrolled in this study and randomized into 2 groups to receive zoledronic acid (5 mg) or placebo.
At baseline and then at 2, 7, 30, and 360 days after zoledronic acid or placebo administration, serum levels of sclerostin, bone-specific alkaline phosphatase (BSAP), as a bone formation marker, and serum C-telopeptide of type 1 collagen (CTX), as a bone resorption marker, were measured.
Sclerostin serum levels increased by day 2, reached a peak at day 7 (3-fold baseline, P < .001), and then decreased at day 30 and returned near to baseline after 360 days in the zoledronic acid group. Both CTX and BSAP were reduced, and a significant negative correlation was observed between the percentage changes of sclerostin and the variation in BSAP and CTX at all time points in the zoledronic acid group (P < .05). No changes were observed in the placebo group.
Our data demonstrate that zoledronic acid increases sclerostin serum levels and that sclerostin could play a role in coupling bone resorption to bone formation.
骨钙素是成骨细胞分泌的一种 Wnt 信号通路的循环抑制剂，作为骨形成的负调节剂。唑来膦酸对绝经后骨质疏松症患者骨钙素血清水平的影响尚不清楚。
本研究旨在评估唑来膦酸给药后骨钙素的血清水平，并将其变化与骨转换标志物相关联。
我们在门诊环境中进行了一项前瞻性干预研究。
40 名（平均年龄 62.6 ± 4.9 岁）绝经后骨质疏松症患者入组本研究，并随机分为 2 组，分别接受唑来膦酸（5mg）或安慰剂治疗。
在基线和唑来膦酸或安慰剂给药后 2、7、30 和 360 天，测量血清骨钙素、骨碱性磷酸酶（BSAP），作为骨形成标志物，以及血清Ⅰ型胶原 C 端肽（CTX），作为骨吸收标志物的水平。
骨钙素血清水平在第 2 天增加，在第 7 天达到峰值（基线的 3 倍，P <.001），然后在第 30 天下降，并在 360 天后接近基线。CTX 和 BSAP 均降低，唑来膦酸组在所有时间点均观察到骨钙素变化的百分比与 BSAP 和 CTX 变化之间存在显著负相关（P <.05）。安慰剂组无变化。
我们的数据表明，唑来膦酸增加了骨钙素的血清水平，而骨钙素可能在将骨吸收与骨形成偶联中发挥作用。
