Quantitative ultrasound and densitometric measurements and laboratory variables in patients on long-term acenocoumarol therapy.

The aim of the study was to establish whether chronic use of acenocomarol affects bone metabolism. Eighty-two males [41 treated with acenocumarol (mean therapy duration of 6.0+/-6.4 years) and 41 age-matched controls] were studied. Skeletal assessment included densitometric measurements at ultradistal forearm and calcaneus and ultrasound examination of hand phalanges and laboratory measurements included serum total calcium, phosphates, bone alkaline phosphatase (bAlp) and C-terminal telo peptide of type I collagen (ICTP). Densitometric and ultrasound variables did not differ significantly between patients and controls. Mean dose and duration of acenocumarol treatment did not affect skeletal and laboratory variables. Bone turnover was depressed, and bAlp and telopeptide were significantly lower in patients than in controls (10.0+/-7 vs. 23.0+/14 U/l, p<0.05, and 1.6+/-1.3 vs. 3.1+/-1.3 microg/l, respectively). In conclusion, despite of the lack of changes in skeletal status, male subjects on long-term acenocumarol therapy may be at high risk for fracture due to disturbances in bone turnover.