Nitrogen-Bisphosphonate Therapy Is Linked to Compromised Coenzyme Q10 and Vitamin E Status in Postmenopausal Women

Kalyan, Shirin, Huebbe, Patricia, Esatbeyoglu, Tuba, Niklowitz, Petra, Cote, Helene C. F., Rimbach, Gerald and Kabelitz, Dieter (2014) Nitrogen-Bisphosphonate Therapy Is Linked to Compromised Coenzyme Q10 and Vitamin E Status in Postmenopausal Women Journal of Clinical Endocrinology & Metabolism, 99 (4). pp. 1307-1313.

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Background: Nitrogen-bisphosphonates (N-BPs) are the most widely used drugs for bone fragility disorders. Long-term or high-dose N-BP use is associated with unusual serious side effects such as osteonecrosis of the jaw, musculoskeletal pain, and atypical fractures of long bones. It has escaped notice that the pathway N-BPs block is central for the endogenous synthesis of coenzyme Q10, an integralenzymeof the mitochondrial respiratory chain and an important lipid-soluble antioxidant. Our objective was to assess the coenzyme Q10 and antioxidant status in relation to N-BP exposure in women with postmenopausal osteoporosis. Methods: Seventy-one postmenopausal women (age, 73.5 +/- 5.5 y) with osteoporosis and no other malignancy were included in this cross-sectional study. Seventeen were treatment naive, 27 were on oral N-BP, and 27 were on iv N-BP. Results: Vitamin E gamma-tocopherol levels (mu mol/mL) were significantly reduced in N-BP users [oral, H(2) = 18.5, P = .02; iv, H(2) = 25.2, P < .001; mean rank comparisons after Kruskal-Wallis test). Length of time (days) of N-BP exposure, but not age, was inversely associated with the coenzyme Q10/cholesterol ratio (mu mol/mol) (beta = -0.27; P = .025), which was particularly low for those on iv N-BP (mean difference = -35.0 +/- 16.9; 95% confidence interval, -65.2 to -4.9; P = .02). Conclusion: The degree of N-BP exposure appears related to compromised coenzyme Q10 status and vitamin E gamma-tocopherol levels in postmenopausalwomenwith osteoporosis. This phenomenon may link to certain adverse N-BP-associated effects. Confirmation of this would suggest that therapeutic supplementation could prevent or reverse certain complications of long-term N-BP therapy for at-risk individuals.

Document Type: Article
Additional Information: Times Cited: 0 Kabelitz, Dieter/A-2757-2010 0
Research affiliation: Kiel University > Kiel Marine Science
OceanRep > The Future Ocean - Cluster of Excellence
Kiel University
Refereed: Yes
ISSN: 0021-972X
Projects: Future Ocean
Date Deposited: 30 Mar 2015 12:27
Last Modified: 27 Mar 2018 12:25

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