Association between Vitamin D and Calcium Level and BMD Alteration in Post-Menopausal Osteoporosis Patients Treated with Bisphosphonate Therapy for at Least 1 Year in Saiful Anwar Hospital Malang

Hamzah Hamzah, Thomas Erwin Christian Junus Huwae, Chodidjah Chodidjah

Abstract


Post-menopausal osteoporosis is a degenerative disease among post-menopausal women. In Indonesia, women over 50 years old get post-menopausal osteoporosis.The therapy should be comprehensive and continous. Bisphosphonate therapy is one of the most preferable therapeutic option for maintaining bone density. Calcium and vitamin D have a role in increasing osteoblastic activity. The objective of this study was to describe the vitamin D and calcium in bone mineral density (BMD) of hip and spine in postmenopausal woman with biphosphonat therapy. This study is a cross-sectional, observational analytic. The subject were female patients with post-menopausal osteoporosis treated in clinic of RSUD dr. Saiful Anwar Malang, who had received routine bisphosphonate for at least 1 year. The method was collecting the patient data, who received oral and injectie bisphosphonate therapy, serial BMD test,hip and spine, vitamin D and calcium level in serum test. Total sample 25 participan, the association between BMD change (Δ BMD), vitamin D and calcium level, were analyzed.with Chi Square test then continued using Spearman correlation test. Vitamin D levels in Δ BMD Spine in participants was less <30 ng/ml, mean 16.8+6.95 14 respondents (56%), and 6 respondens (24%) 10.05+5.28, normal vitamin D levels were 5 respondents (20%) mean 34.16+5.10. Vitamin D levels in Δ BMD Hip in participants was less <30 ng/ml, mean 15.19+7.7 12 respondents (48%), and 8 respondens (32%) 12.30+5.57, normal vitamin D levels were 5 respondents (20%) 33.66+5.40. Calcium levels in BMD spine 9.60+0.45, 14 respondents (56%), and 11 respondens (44%) 9.59+0.52. There is a significant and moderate relationship between vitamin D levels with Δ BMD spine (p=0.009, r=0.564) and Hip (p=0.039, r= 0.480) T Blood calcium levels with Δ BMD changes unrelated (normal). There is a significant association between vitamin D levels spine and Hip Δ BMD. Blood calcium levels with Δ BMD changes unrelated.


Keywords: Osteoporosis, Bisphosphonate, Vitamin D levels, Calcium levels.


Full Text:

PDF

References


Cairoli, E., Eller-Vainicher, C., Ulivieri, F.M., Zhukouskaya, V.V., Palmieri, S., Morelli, V., Beck-Peccoz, P., and Chiodini, I., 2014, Factors Associated with bisphosphonates treatment failure in post menopausal women with primary Osteoporosis, Osteoporosis International, 25, 1401-1410. CrossRef

Colin, E.M., 2002, Studies on the interaction between the estrogen and vitamin D endocrine system. Rotterdam: Department of Internal Medicine of the Erasmus MC.

Croucher, P.I., and Apperley, J.F., 1998, Bone disease in multiple myeloma, Br J Haematol, 103(4), 902-910. CrossRef

Eastell, R., O’Neil, T.W., Hofbauer, L.C., Langdahl, B., Reid, I.R., Gold, D.T., and Cummings, S.R., 2016, Postmenopausal Osteoporosis, Nat Rev Dis Primers, 2, 16069. CrossRef

Feldman, D., Krishnan, A.V., Swami, S., Giovannucci, E., and Feldman, B.J., 2014, The role of vitamin D in reducing cancer risk and progression, Nat. Rev. Cancer, 14(5), 342–357. CrossRef

Florencio-Silva, R., Sasso, G.R.D.S., Sasso-Cerri, E., Simoes, M.J., and Cerri, P.S., 2015, Biology of Bone Tissue: Structure, Function, and Factors that Influence Bone Cells, BioMed Research International, 2015, 1-17. CrossRef

Grey, A., and Reid, I.R., 2006, Differences between the bisphosphonates for the prevention and treatment of osteoporosis, Ther Clin Risk Manag., 2(1), 77-86. Link

Hania, H.M., Occurrence of Osteoporosis Among Menopausal Women in Gaza Strip. 2008. PhD Thesis. Islamic University-Gaza.

Harmanjit, S., Manoj, G., and Jasbir, S., 2013, Osteoporosis: Current Management Guidelines, Indian Journal of Clinical Practice, 23(12), 842-850.

Horikawa, A., Miyakoshi, N., Shimada, Y., Sugimura, Y., and Kodama, H., 2015, Comparative Study between intravenous and oral alendronate administration for the treatment of Osteoporosis, SpingerPlus, 4, 675. CrossRef

Indonesian Ministry of Health, 2015, Data and Conditions of Osteoporosis Disease in Indonesia, Indonesian Ministry of Health data and information center, Jakarta. Link

Jeremiah, M.P., Unwin, B.K., Greenawald, M.H., and Casiano, V.E., 2015, Diagnosis and Management of Osteoporosis, American Family Physician, 962(4), 216-268.

Kennedy, P., Jain, A., Srinivasan, R., and Chaudhry, S., 2007, Calcium Homeostasis and Osteoporosis, N Engl J Med., 357(3), 266-281.

Kinoshita, M., Ishijima, M., Kaneko, H., Liu, L., Nagao, M., Sadatsuki, R., et al., 2019, The increase in bone mineral density by bisphosphonate with active vitamin D analog is associated with the serum calcium level within the reference interval in postmenopausal osteoporosis, Mod Rheumatol, 29(1), 157-164. CrossRef

Lin, X., Xiong, D., Peng, Y-Q., Sheng, Z-F., Wu, X-Y., Wu, X-P., et al., 2015, Epidemiology and Management of Osteoporosis in The People’s Republic of China: Current Perspectives, Clinical Intervention in Aging, 10, 1017-1033. CrossRef

Malaysian Osteoporosis Society, 2012, Clinical Guidance on Management of Osteoporosis, Malaysian Osteoporosis Society.

Maraka, S., and Kennel, K.A., 2015, Biphosphonate for The Prevention and Treatment of Osteoporosis, British Medical Journal, 351, h3783. CrossRef

Mary, E.E., 2015, Prevention and Management of Osteoporosis, JPSW, 1(2), 48-52.

Mithal, A., Dhingra, V., and Lau, E., 2009, The Asian Audit: Epidemiology, Costs, and Burden of Osteoporosis in Asia 2009, International Osteoporosis Foundation, 56-57. CrossRef

Mundy, G.R., 2002, Metastasis to bone: causes, consequences and therapeutic opportunities, Nat Rev Cancer, 2(8), 584-593. CrossRef

National Medicines Information Centre, 2013, Update on Osteoporosis, NMIC Bulletin Update on Osteoporosis, 19(2).

Pawel, S., and Mary, L.B., 2011, Vertebral Fracture Initiative, International Osteoporosis Foundation.

Reszka, A.A., and Rodan, G.A., 2003, Mechanism of action of bisphosphonates, Current osteoporosis reports, 1(2), 45-52. CrossRef

Rosol, T.J., Chew, D.J., Nagode, L.A., and Capen, C.C., 2008, Patophysiology of calcium metabolism, Vet Clin Pathol., 24(2), 49-63. CrossRef

Roodman, G.D., 2010, Pathogenesis of myeloma bone disease, J Cell Biochem, 109, 283-291. CrossRef

Taha, A., Al-Taki, M., and Taha, T., 2015, Vitamin D revisited: impact on osteoporosis, Women Health Open J., 1(2), 48-52. CrossRef

Watts, N.B., and Diab, D.L., 2010, Long Term Use of Biphosphonates in Osteoporosis, The Journal of Clinical Endocrinology and Metabolism, 95(4), 1555-1565. CrossRef




DOI: http://dx.doi.org/10.14499/indonesianjcanchemoprev12iss3pp123-129

Copyright (c) 2022 Hamzah Hamzah, Erwin HT, Chodidjah Chodidjah

Indexed by:

               

               

      

 

Indonesian Society for Cancer Chemoprevention