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Title: Circulating sclerostin and estradiol levels are associated with inadequate response to bisphosphonates in postmenopausal women with osteoporosis
Authors: Morales-Santana, Sonia
Díez-Pérez, Adolfo
Olmos, José M.
Nogués, Xavier
Sosa, Manuel 
Díaz-Curiel, Manuel
Pérez-Castrillón, José L.
Pérez-Cano, Ramón
Torrijos, Antonio
Jodar, Esteban
Rio, Luis Del
Caeiro-Rey, José R.
Reyes-García, Rebeca
García-Fontana, Beatriz
González-Macías, Jesús
Muñoz-Torres, Manuel
UNESCO Clasification: 32 Ciencias médicas
320108 Ginecología
320107 Geriatría
Keywords: Van-Buchem-Disease
Serum Sclerostin
Hip Fracture, et al
Issue Date: 2015
Journal: Maturitas 
Abstract: Introduction: The biological mechanisms associated with an inadequate response to treatment with bisphosphonates are not well known. This study investigates the association between circulating levels of sclerostin and estradiol with an inadequate clinical outcome to bisphosphonate therapy in women with postmenopausal osteoporosis.Methods: This case-control study is based on 120 Spanish women with postmenopausal osteoporosis being treated with oral bisphosphonates. Patients were classified as adequate responders (ARs, n = 66, mean age 68.2 +/- 8 years) without incident fractures during 5 years of treatment, or inadequate responders (IRs, n = 54, mean age 67 +/- 9 years), with incident fractures between Ti and 5 years of treatment. Bone mineral density (DXA), structural analysis of the proximal femur and structural/fractal analysis of the distal radius were assessed. Sclerostin concentrations were measured by ELISA and 17 beta-estradiol levels by radioimmunoassay based on ultrasensitive methods.Results: In the ARs group, sclerostin serum levels were significantly lower (p = 0.02) and estradiol concentrations significantly higher (p = 0.023) than in the IRs group. A logistic regression analysis was performed, including as independent variables in the original model femoral fracture load, 25 hydroxyvitamin D, previus history of fragility fracture, sclerostin and estradiol. Only previous history of fragility fracture (OR 14.04,95% CI 2.38-82.79, p = 0.004) and sclerostin levels (OR 1.11,95% Cl 1.02-1.20, p = 0.011), both adjusted by estradiol levels remained associated with IRs. Also, sclerostin concentrations were associated with the index of resistance to compression (IRC) in the fractal analysis of the distal radius, a parameter on bone microstructure.Conclusions: Sclerostin and estradiol levels are associated with the response to bisphosphonate therapy in women with postmenopausal osteoporosis.
ISSN: 0378-5122
DOI: 10.1016/j.maturitas.2015.08.007
Source: Maturitas[ISSN 0378-5122],v. 82, p. 402-410 (Dicembre 2015)
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