scholarly journals Transdermal Nitroglycerin Therapy May Not Prevent Early Postmenopausal Bone Loss

2009 ◽  
Vol 94 (9) ◽  
pp. 3356-3364 ◽  
Author(s):  
Sunil J. Wimalawansa ◽  
Julia P. Grimes ◽  
Alan C. Wilson ◽  
Donald R. Hoover

Context: Osteoporosis is common among postmenopausal women; animal studies and human pilot studies support the concept of nitric oxide (NO) donors reducing bone mineral density loss. Objective: The objective of the study was to evaluate whether NO donor, nitroglycerin, prevents postmenopausal bone loss. Design: This was a 3-yr randomized, double blinded, single-center, placebo-controlled clinical trial. Setting: The single-center study was conducted at the University of Medicine and Dentistry-Robert Wood Johnson Medical School (New Brunswick, NJ). Participants: Participants included 186 postmenopausal women aged 40–65 yr, with lumbar bone mineral density (BMD) T-scores of 0 to −2.5. Intervention: Women, stratified by lumbar T-score (<−1.50 and ≥−1.50) and years since menopause (≤5 and >5 yr), were randomized to receive nitroglycerin ointment (22.5 mg as Nitro-Bid) or placebo ointment received daily for 3 yr. Both groups took 630 mg daily calcium plus 400 IU vitamin D supplements. Measurements: BMD was measured at 6 months and annually by dual-energy x-ray absorptiometry. Percent change in lumbar vertebrae BMD was the primary outcome. Hip BMD, total body bone mineral content, and height were secondary outcomes. Results: After 36 months of therapy, changes of −2.1% in the active group (n = 88) and −2.5% in the placebo group (n = 82) in lumbar spine BMD were seen (P = 0.59; 95% confidence interval −1.001, 1.975). Secondary outcomes also did not differ by intervention arm. The active group reported more headaches compared with the placebo group (57 vs. 14%, P < 0.001). Other adverse and serious adverse events were not different. Conclusions: BMD changes did not substantially differ between postmenopausal women who received the dose of nitroglycerin tested, in comparison with a placebo. Once-daily dosing with 22.5 mg of transdermal-administered nitroglycerin was not effective (compliance adjusted dose was only ∼16 mg/d); a sub-therapeutic dose. No substantial bone mineral density changes were observed between postmenopausal women receiving once-daily 22.5 mg of transdermal nitroglycerin, compared to calcium plus vitamin D (compliance adjusted dose = 16 mg/day).

2018 ◽  
Vol 2 (2) ◽  
pp. 148-153
Author(s):  
Kazuki Fujimoto ◽  
Kazuhide Inage ◽  
Toru Toyoguchi ◽  
Yawara Eguchi ◽  
Sumihisa Orita ◽  
...  

2019 ◽  
Vol 12 (2) ◽  
pp. 44-49
Author(s):  
AKM Shaheen Ahmed ◽  
Wasim Md Mohosin Ul Haque ◽  
Khwaja Nazim Uddin ◽  
Fadlul Azim Abrar ◽  
Farhana Afroz ◽  
...  

Background and objectives: Low vitamin D is a global problem in all age groups as is osteoporosis in postmenopausal women. The present study was carried out in an urban hospital to assess serum 25-hydroxyvitamin D [25(OH)D] level and bone mineral density (BMD) in postmenopausal women (PMW) and to evaluate correlation between serum 25(OH)D levels and BMD. Methods: A single center cross-sectional study was conducted among 133 apparently healthy PMW aged 45 years and above with the history of complete cessation of menstruation over a period of more than 1 year. Serum 25(OH)D, BMD and serum intact parathyroid hormone (iPTH) were determined. Patients having both vitamin D and BMD values were analyzed for correlations. Similarly, correlation of vitamin D, iPTH and BMD were determined. Results: Among the study population, 63 (47.4%) had deficient (<20 ng/ml), 46 (34.6%) had insufficient (20-30ng/ml) and 24(18%) had sufficient (30-100ng/ml) levels of serum 25(OH)D. Among the 121 patients whose BMD was done, 52 (43.0%) and 60 (49.6%) had osteoporosis and osteopenia respectively. Serum iPTH levels were normal in 34 (89.5%) patients. The proportion of osteopenia and osteoporosis in vitamin D deficient group were 44.1% and 50.8% and in insufficient group 47.5 and 45.0%, respectively. Age had significant negative correlation with BMD value (r=-0.246, p=.005) and significant positive correlation with serum iPTH (r=0.358, p=.024). There was no statistically significant influence of serum 25(OH)D or iPTH on occurrence of osteoporosis (P=0.322 and P=0.592 respectively). Conclusion: A large proportion of postmenopausal women had low vitamin D levels and as well as osteopenia and osteoporosis. Low vitamin D level coexisted with low BMD. However, there was no correlation between serum 25(OH)D levels and BMD status. IMC J Med Sci 2018; 12(2): 44-49


Bone ◽  
2009 ◽  
Vol 44 ◽  
pp. S398 ◽  
Author(s):  
C. Poiana ◽  
M. Carsote ◽  
E. Neacsu ◽  
C. Barbu ◽  
A. Gruia ◽  
...  

Bone ◽  
2001 ◽  
Vol 29 (3) ◽  
pp. 310
Author(s):  
M.J Pozzo ◽  
M.P Lozano Bullrich ◽  
P Pagano ◽  
H Claus-Hermberg

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