Clinical significance of alendronate in postmenopausal type 2 diabetes mellitus.

OBJECTIVES To examine early changes in biochemical markers of bone turnover and bone mineral density (BMD) in a clinical trial of anti-resorptive agent alendronate versus alfacalcidol in postmenopausal women with type 2 diabetes mellitus. METHODS 12 subjects (mean age; 73.1 +/- 6.3 yrs, duration of diabetes; 13.2 +/- 3.7 yrs) were administered alendronate sodium (5 mg/day) and 12 subjects (mean age; 70.7 +/- 7.8 yrs, duration of diabetes; 12.8 +/- 2.0 yrs) were administered alfacalcidol (0.5 microg/day) for 12 months. Urinary N-telopeptide cross-linked collagen type I (NTx), one of biochemical markers, and radial bone mineral density (BMD) were measured as a marker of bone turnover. RESULTS After 12 months, urinary NTx did not change in women with alfacalcidol treatment, however urinary NTx significantly decreased after alendronate treatment. The BMD significantly decreased by 3.33% (p<0.05) in women with alfacalcidol treatment, while the BMD did not decrease in women with alendronate treatment. CONCLUSION Alendronate that produces reduction in urinary NTx and inhibition of decrease in BMD may have a clinical significance to reduce the risk of bone fracture in postmenopausal type 2 diabetic women.