Effects of Treatment With Risedronate and Alfacalcidol on Progression of Atherosclerosis in Postmenopausal Women With Type 2 Diabetes Mellitus Accompanied With Osteoporosis

Introduction: Accumulating evidence suggests that osteoporosis and cardiovascular disease have epidemiologic similarities. This study investigated the effects of treatment with risedronate and alfacalcidol on parameters of atherosclerosis in postmenopausal women with type 2 diabetes accompanied with osteoporosis. Methods: Thirteen Japanese type 2 diabetes postmenopausal women with newly diagnosed osteoporosis (osteoporosis group) and 13 age- and weight-matched diabetic women with normal bone mineral density (control group) were enrolled in this 1-year prospective study. Risedronate (2.5 mg/d) and alfacalcidol (1 mu g/d) were given to the osteoporosis group for a year. We measured parameters of atherosclerosis, such as ultrasonographically evaluated plaque score (PS) and abdominal aortic calcification score (AACS) calibrated by x-ray. Results: Patients with osteoporosis had significantly higher PS and AACS than control [mean (range) PS: 11.85 (0.00-27.50) versus 4.90 (0.00-10.90), P = 0.02 and AACS: 4.0 (0.0-14.0) versus 1.0 (0.0-7.0), P = 0.01]. After 1-year treatment, PS and AACS in the osteoporosis group were not statistically changed, whereas both parameters in the control group were significantly increased (P = 0.01 and P = 0.03, respectively). When percent changes in these parameters were compared between 2 groups, they were significantly different at any time points (at least P = 0.05). Conclusions: Atherosclerosis parameters in diabetic patients with osteoporosis were higher than those in patients without it. Combination therapy of risedronate with alfacalcidol might protect against progressive atherosclerosis.