Bone Loss after Heart Transplant: Effect of Alendronate, Etidronate, Calcitonin, and Calcium plus Vitamin D3

Gil-Fraguas, Lourdes; Guadalix, Sonsoles; Martínez, Guillermo; Vara, Jesús; Gómez-Sánchez, Miguel Ángel; Delgado, Juan; Cruz, Javier de la; Lora, David; Hawkins, Federico

doi:10.7182/pit2012969

Cited by 10 publications

(5 citation statements)

References 25 publications

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“…Besides, it is associated with periodontal disease and gingival inflammation in HT recipients which impair the nutritional intake [27]. The improvement of VD status after HT especially in the VD-and Ca-supplemented men was in line with a previous report by Gilfraguas et al [28]. Supplementation in addition to relief of hepatic congestion and improvement of general condition with more mobility and sunlight exposure were the causes of VD status improvement [29].…”

Section: Discussionsupporting

confidence: 81%

Impact of Vitamin D Supplementation on Bone Mineral Density and All-Cause Mortality in Heart Transplant Patients

et al. 2021

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Vitamin D (VD) deficiency is frequently reported in heart transplant (HT) recipients and routinely supplemented. However, the efficacy of VD supplementation on bone mineral density (BMD) and its association with all-cause mortality is underinvestigated. The VD levels and BMD were studied for two years, and the association of VD and BMD with all-cause mortality risk was investigated. Ninety-six HT patients (38.18 ± 12.10 years old; 74% men) were followed up during VD, Ca, and Mg supplementation. Anthropometric measurements, BMD by Dual-energy X-ray absorptiometry (DEXA) scan, VD concentrations, and related biochemical parameters were analyzed before, 1 year, and 2 years after HT. Despite significant improvement of VD3 and 25-hydroxy VD (25OHVD) levels especially in the men, BMD parameters were insignificantly changed. After 2 years, the all-cause mortality rate was 15.6%. High pretransplant levels of 25OHVD failed to improve the survival probability. Cox’s regression showed a 32.7% increased hazard ratio for each unit increase in body mass index (95% CI: 1.015–1.733, p = 0.038), in the VD-deficient group rather than in the VD-sufficient one. In conclusion, VD supplementation improves the biochemical status, especially in VD-deficient HT. However, its impact on the BMD and mortality was not as usually expected. Further investigation of the disturbed VD metabolism in HT is warranted.

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Section: Discussionsupporting

confidence: 81%

Impact of Vitamin D Supplementation on Bone Mineral Density and All-Cause Mortality in Heart Transplant Patients

et al. 2021

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“…The values of PINP found do not appear to be affected by the hepatopathy, since they do not correlate with parameters for hepatic function in this group of patients with hepatic insufficiency who have not yet received post-transplant immunosuppressive, or anti-resorptive, treatment. We do not know if either method would be sensitive enough to detect in a comparable way the changes in bone remodelling which occur after hepatic transplant 25 and with anti-osteoporotic treatment [22][23][24] . Garnero et al show that R-PINP, in comparison with manual RIA (intact PINP), detected an increase in bone remodelling in postmenopausal women and was sensitive enough to detect significant changes in bone remodelling induced by treatment with PTH 1-84 and with alendronate.…”

Section: Discussionmentioning

confidence: 99%

“…Changes in MBR may be useful in monitoring treatment of osteoporosis, confirming therapeutic compliance and evaluating the efficacy of treatment 8 . In those patients with terminal hepatic insufficiency after transplant the use of bisphosphonates is indicated [22][23][24] . The values of PINP found do not appear to be affected by the hepatopathy, since they do not correlate with parameters for hepatic function in this group of patients with hepatic insufficiency who have not yet received post-transplant immunosuppressive, or anti-resorptive, treatment.…”

Section: Discussionmentioning

confidence: 99%

PINP en pacientes con insuficiencia hepática: Comparación de dos métodos de medida y asociación con diferentes parámetros bioquímicos

Guadalix

Martínez-Conde

Díaz-Guerra

et al. 2013

Rev Osteoporos Metab Miner

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Introduction: N-terminal propeptide of type 1 collagen (PINP) is a marker for bone formation. Blood PINP is found in trimeric and monomeric forms. There are two automated methods for its determination. R-PINP (Roche Diagnostics) determines both forms (Total PINP). IDS-PINP (IDS iSYS N-Mid ® Vitro) determines the trimeric part (Intact PINP). Objective: To compare the two methods. Material and method: 81 patients (64 men and 17 women, average age of 53 ± 8 years) with terminal hepatic insufficiency were recruited. Creatinine, PTH, 25-OH-vitamin D, beta-crosslaps (β-CTX), desoxypyridinoline (Dpyr), hepatic function and PINP with both methods, were measured. Bone mineral density (BMD) was measured (Hologic ® , QDR 4500) in the lumbar spine and femoral neck. The comparison between the two methods was carried out using a Bland-Altman and Passing'Bablok analysis. Results: R-PINP showed higher values than IDS-PINP (85.03 ± 56.67 vs. 55.22 ± 32.81 ng/mL, p<0,001). The correlation between the two methods was r= 0.81 (p<0.01) and the Passing-Bablok regression analysis Y = 0.570 [0.475-0.669] X + 7.724 [2.130-12.542]. Conclusion: There is a good correlation between the two methods in patients with hepatic insufficiency, although not proportional or interchangeable.

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“…Hemos realizado una comparación de la administración de alendronato, etidronato, calcitonina y vitamina D3, en pacientes con TxH. El alendronato, se confirmó como el más potente antirresortivo y frenador de la pérdida ósea frente a los otros (45). Otros estudios con ibandronato, ácido zolendrónico y pamidronato,en diferentes TxO han demostrado también eficacia en la prevención de la pérdida ósea (46).…”

Section: ) B Glucocorticoidesunclassified

Postransplantation metabolic bone disease

Hawkins-Carranza¹,

López-Álvarez²,

Valero-Samuy³

et al. 2020

an. ranm

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Resumen La osteoporosis puede ser una complicación importante del trasplante de órganos (TxO), que puede llevar a menor calidad de vida y mayor riesgo de fracturas. El objetivo ha sido revisar el estado actual de este riesgo, en base a nuestra experiencia en relación, a la fisiopatología y tratamiento. Después del TxO, los esteroides son el agente más nocivo sobre el remodelado óseo, con pérdida ósea importante en los primeros meses y una tendencia posterior a la recuperación en algunos, pero a persistir en otros. Junto a los esteroides, la ciclosporina y otros inmunosupresores, pueden contribuir al deterioro del remodelado óseo. El tratamiento actual, es objeto de estudios y ensayos clínicos, siendo los bisfosfonatos los agentes más utilizados. De entre ellos hay más experiencia con el alendronato, risedronato y últimamente con el ácido zolendronico. Su eficacia es similar, y los efectos secundarios deben vigilarse durante su administración. Finalmente, la administración de calcio y vitamina D es recomendable, dado el frecuente déficit de esta vitamina en estos pacientes acentuada por los esteroides.

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Bone Loss after Heart Transplant: Effect of Alendronate, Etidronate, Calcitonin, and Calcium plus Vitamin D3

Abstract: Alendronate therapy in heart transplant recipients was associated with a significant increase in bone mineral density in the lumbar spine and less bone loss at the hip.

Cited by 10 publications

References 25 publications

Impact of Vitamin D Supplementation on Bone Mineral Density and All-Cause Mortality in Heart Transplant Patients

Impact of Vitamin D Supplementation on Bone Mineral Density and All-Cause Mortality in Heart Transplant Patients

PINP en pacientes con insuficiencia hepática: Comparación de dos métodos de medida y asociación con diferentes parámetros bioquímicos

Postransplantation metabolic bone disease

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