Nancy Waltman1, Kevin A Kupzyk2, Laura E Flores3, Lynn R Mack4, Joan M Lappe5, Laura D Bilek3. 1. College of Nursing, University of Nebraska Medical Center, 550 N 19th, Street, Suite 350E, Lincoln, NE, 6850-0620, USA. nwaltman@unmc.edu. 2. Center for Nursing Science, University of Nebraska Medical Center, 4101 Dewey Avenue, Omaha, NE, 68198-5330, USA. 3. College of Allied Health Professions, 984000 Nebraska Medical Center, Omaha, NE, 68198-4000, USA. 4. Diabetes, Endocrinology, & Metabolism, Nebraska Medicine, Omaha, NE, 68198-4130, USA. 5. Creighton Osteoporosis Research Center, 601 North 30th, Omaha, NE, 68131, USA.
Abstract
PURPOSE: This randomized controlled trial compared changes in bone mineral density (BMD) and bone turnover in postmenopausal women with low bone mass randomized to 12 months of either risedronate, exercise, or a control group. METHODS: Two hundred seventy-six women with low bone mass, within 6 years of menopause, were included in analysis. Treatment groups were 12 months of (a) calcium and vitamin D supplements (CaD) (control), (b) risedronate + CaD (risedronate), or (c) bone-loading exercises + CaD (exercise). BMD and serum markers for bone formation (Alkphase B) and resorption (Serum Ntx) were analyzed at baseline, 6, and 12 months. RESULTS: Using hierarchical linear modeling, a group by time interaction was found for BMD at the spine, indicating a greater improvement in the risedronate group compared to exercise (p ≤ .010) or control groups (p ≤ .001). At 12 months, for women prescribed risedronate, changes in BMD at the spine, hip, and femoral neck from baseline were + 1.9%, + 0.9%, and + .09%; in exercise group women, + 0.2%, + 0.5%, and - 0.4%; and in control group women, - 0.7%, + 0.5%, and - 0.5%. There were also significant differences in reductions in Alkphase B (RvsE, p < .001, RvsC, p < .001) and Serum Ntx (RvsE, p = .004, RvsC, p = .007) in risedronate women compared to exercise and control groups. For risedronate, 12-month changes in Alkphase B and Serum Ntx were - 20.3% and - 19.0%; for exercise, - 6.7% and - 7.0%; and for control, - 6.3% and - 9.0%. CONCLUSION: Postmenopausal women with low bone mass should obtain adequate calcium and vitamin D and participate in bone-loading exercises. Additional use of BPs will increase BMD, especially at the spine.
PURPOSE: This randomized controlled trial compared changes in bone mineral density (BMD) and bone turnover in postmenopausal women with low bone mass randomized to 12 months of either risedronate, exercise, or a control group. METHODS: Two hundred seventy-six women with low bone mass, within 6 years of menopause, were included in analysis. Treatment groups were 12 months of (a) calcium and vitamin D supplements (CaD) (control), (b) risedronate + CaD (risedronate), or (c) bone-loading exercises + CaD (exercise). BMD and serum markers for bone formation (Alkphase B) and resorption (Serum Ntx) were analyzed at baseline, 6, and 12 months. RESULTS: Using hierarchical linear modeling, a group by time interaction was found for BMD at the spine, indicating a greater improvement in the risedronate group compared to exercise (p ≤ .010) or control groups (p ≤ .001). At 12 months, for women prescribed risedronate, changes in BMD at the spine, hip, and femoral neck from baseline were + 1.9%, + 0.9%, and + .09%; in exercise group women, + 0.2%, + 0.5%, and - 0.4%; and in control group women, - 0.7%, + 0.5%, and - 0.5%. There were also significant differences in reductions in Alkphase B (RvsE, p < .001, RvsC, p < .001) and Serum Ntx (RvsE, p = .004, RvsC, p = .007) in risedronate women compared to exercise and control groups. For risedronate, 12-month changes in Alkphase B and Serum Ntx were - 20.3% and - 19.0%; for exercise, - 6.7% and - 7.0%; and for control, - 6.3% and - 9.0%. CONCLUSION: Postmenopausal women with low bone mass should obtain adequate calcium and vitamin D and participate in bone-loading exercises. Additional use of BPs will increase BMD, especially at the spine.
Authors: Nancy L Waltman; Kara M Smith; Kevin A Kupzyk; Joan M Lappe; Lynn R Mack; Laura D Bilek Journal: Nurs Res Date: 2019 Jul/Aug Impact factor: 2.381
Authors: N L Waltman; J J Twiss; C D Ott; G J Gross; A M Lindsey; T E Moore; K Berg; K Kupzyk Journal: Osteoporos Int Date: 2009-10-03 Impact factor: 4.507
Authors: J A Kanis; D Hans; C Cooper; S Baim; J P Bilezikian; N Binkley; J A Cauley; J E Compston; B Dawson-Hughes; G El-Hajj Fuleihan; H Johansson; W D Leslie; E M Lewiecki; M Luckey; A Oden; S E Papapoulos; C Poiana; R Rizzoli; D A Wahl; E V McCloskey Journal: Osteoporos Int Date: 2011-07-21 Impact factor: 4.507
Authors: Laura D Bilek; Nancy L Waltman; Joan M Lappe; Kevin A Kupzyk; Lynn R Mack; Diane M Cullen; Kris Berg; Meghan Langel; Melissa Meisinger; Ashlee Portelli-Trinidad; Molly Lang Journal: BMC Womens Health Date: 2016-08-30 Impact factor: 2.809