Уважаемые пользователи!

Данный сайт содержит информацию для людей с медицинским образованием и специалистов здравоохранения.
Входя на сайт, Вы подтверждаете свое согласие с Условиями использования и Политикой конфиденциальности.

Dear visitor!
This site contains medical information for healthcare professionals.
You can go further, if you agree with Terms and Conditions and Privacy Policy on this site.



An open clinical trial evaluating effects of Pravastatin (P) 20 mg, Fluvastatin (F) 40 mg versus Calcium-D3 Nycomed Forte (1000 mg calcium and 800 ME cholecalciferol - CaD3 ) on bone metabolism, bone mineral density (BMD) and lipid metabolism have been conducted. We studied 80 osteopenic women from 60 to 80 years old, divided into three groups: 30 participants were treated by CaD3 during 12 months, at the same time 30 ones applied P, and 20 women were treated by L for the 6 months. All of the remedies showed similar influence on the spine BMD (the basal BMD remained intact). CaD3 and L were able to prevent proximal hip from BMD loss whereas patients treated P proceeded to lose bone mass (up to 1.3-1.5%). We have found that CaD3 provides an antiresorptive action (СТх became 27.2% lower and OC -4.1%), that P doesn't touch bone metabolism indices and dual action of L: it suppress a bone resorption (СТх was 14,1% reduce) and show an invigorative action on bone formation (ОК 25,5% raised). The CaD3 treatment was the less expensive, and the highest cost had P course. Our comparative study reveals that CaD3 is preferable in solitary osteoporosis prevention. However when osteopenia or validity OP risk factors coexist with dyslipidemia, type II particularly, use of L may be rational because of it's 6th month therapy had rather equal effect to one of year CaD3 consumption.







  1. Лесняк Ю.Ф., Лесняк О.М. Анализ минимизации и эффективности затрат на профилактику остеопороза препаратами кальция и витамина D // Росс. сем. врач. 2004. 1: 22-27.
  2. Насонов Е.Л. Дефицит кальция и витамина D: новые факты и гипотезы (обзор литературы) // Остеопороз и остеопатии. 1998. No 3. C. 42-47.
  3. Насонов Е.Л. Перспективы применения статинов в ревматологии // РМЖ. 2003. No 23 (195). Т. 11. С.1273-1276.
  4. Рожинская Л.Я., Л.К. Дзеранова, Е.И. Марова, Н.И. Сазонова, Б.П. Мищенко, Г.С. Колесникова, Н.И. Сергеева. Применение кальция и витамина D для профилактики остеопороза у женщин в постменопаузе // Остеопороз и остеопатии. 2001. No1. С. 29-33.
  5. Скрипникова И.А. Взаимосвязь генерализованного остеопороза и сердечно-сосудистых заболеваний, обусловленных атеросклерозом у женщин постменопаузального периода // Остеопороз и остеопатии. 2001. No 3. С. 27-33.
  6. Шварц Г.Я. Препараты витамина D // Лекарственные средства для лечения и профилактики остеопороза. М., Медицинское Информационное Агенство (МИА), 2002 г.
  7. Шварц Г.Я. Статины и формирование кости. //Остеопороз и остеопатии. 2003. No 3. С. 17-20.
  8. American association of endocrinologists (AACE) medical guidelines for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003 // Endocrine Practice, 2003, vol. 9, No 6, p. 544-564.
  9. Bjarnason N.H., Riis B.J., Christiansen C. The effect of fluvastatin on parameters of bone remodeling. // Osteoporos Int. 2001. V. 12(5). P. 380-384.
  10. Brown J.P., Josse R.G. 2002 Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada // CMAJ, 2002, 167 (10 suppl), pp. S1-S34.
  11. Chapuy M.C., Arlot M.E., Delmas P.D. et al. Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women.// Br. Med. J. 1994. v.308, p. 1081-1082.
  12. Compston J.E. The role vitamin D and Calcium supplementation in the prevention of osteoporosis fractures in the elderly // Clin. Endocrinology. 1995. v. 43, p. 393-405.
  13. Cooper C. and Barret-Connor E. Epidemiology of osteoporosis. In: Osteoporosis '96. Proceedings of the 1996 World Congress on Osteoporosis. Amsterdam, the Nitherlands, 18-23 May, 1996. Eds S.E. Papapoulos, P. Lips., H.A.P. Pols, C.C. Johnston and P.D. Delmas. International Congress Series 1118, Excerpta Medica. Amsterdam, 1996. P. 75-79.
  14. Dawson-Hughes B., Harris S.S., Krall E.A., Dallal G.E.- Effect of calcium and vitamin D supplementation on bone density in mеn and women 65 years age or older. // N. Engl.Med. J., 1997. Vol. 337. P. 670-676.
  15. Garrett I.R., Gutierrez, Mundy G.R. Statins and bone formation // Curr. Pharm. Design. 2001. V. 7. P. 715 - 736.
  16. Greenspan S.L., Parker S.A., Ferguson L. et al.: Early changes in biochemical markers on bone turnover predict the long-term response to alendronate therapy in representative elderly women: a randomized clinical trial. // J. Bone Mineral Research, 1998; Vol. 13: 143-1438.
  17. LaCroix A. Z., Cauley J.A., Pettinger M. et al. Statin use, clinical fracture, and bone density in postmenopausal women: results from the Women's Health Initiative Observational Study. // Ann Intern Med. 2003 Jul 15 - Vol.139(2). P. 97-104.
  18. Luckman S.P., Hughes D.E., Coxon F.P. et al. Nitrogen-containing bisphosphonates inhibit the mevalonate pathway and prevent post-translational prenylation of GNP-binding proteins, including Ras // J. Bone Miner. Res. 1998. Vol. 13. P. 581- 589
  19. Martin T.J. and Dempster D.W. Bone structure and cellular activity. In: Osteoporosis, edited by J.C. Stevenson and R. Lindsay. Chapman & Hall Medical, London, 1998, p. 1-28.
  20. McClung M., Kiel D., Lindsay R. et al. A 12-Month, dose-response study of atorvastatin effects on bone in postmenopausal women. // JBMR - January 2004. Vol. 19. Num. 1. P. 11-17.
  21. Morii H., Ohashi Y., Taketani Y., Fukunaga M., Nakamura T., Itabashi A., Sarkar S., Harper K.. Effect of raloxifene on bone mineral density and biochemical markers of bone turnover in Japanese postmenopausal women with osteoporosis: results from a randomized placebo-controlled trial. Osteoporos Int. 2003 Oct;14(10):793-800.
  22. Mostaza J.M., De la Piedra C., Curiel M.D., Pena R., Lahoz C. Pravastatin therapy increases procollagen I N-terminal propeptide (PINP), a marker of bone formation in post-menopausal women. // Clin Chim Acta. 2001 Jun. V. 308 (1-2). P. 133-137.
  23. Mundy G., Garrett R., Harris S. et al. Stimulation of bone formation in vitro and in rodents by statins. // Science. 1999. V.286. P. 1946-1949.
  24. New evidence connecting cardiovascular disease and osteoporosis. NIAMS NHLBI Working Group 1999. Bethesda, Meriland. www.nhlbi.nih.gov./meetings/ workshop/bnhrtsm.htm
  25. Nieves J.W., Komar L., Cosman F., Lindsay R. Benefit of calcium to antiresorbtive therapy // Am. J. Clin. Nutr., 1998. Vol. 67, P. 18-24.
  26. Pasco J.A., Kotowicz M.A., Henry M.J. Statin use, bone mineral density, and fracture risk: Geelong Osteoporosis Study // Arch Intern Med. 2002 Mar 11 V. 162(5). P. 537-540.
  27. Reid I.R., Hague W., Emberson J. Effect of pravastatin on frequency of fracture in the LIPID study: secondary analysis of a randomised controlled trial. Long-term Intervention with Pravastatin in Ischaemic Disease. // Lancet. - 2001 - Feb. 17. V. 357(9255). P. 509-512.
  28. Rejnmark L., Buus N.H., Vestergaard P. Effects of simvastatin on bone turnover and BMD: a 1-year randomized controlled trial in postmenopausal osteopenic women.// JBMR. May 2004. Vol. 19. Num. 5, P. 737-744.
  29. Stein E.A., Farnier M., Waldstreicher J., Mercuri M. Simvastatin Effects of statins on biomarkers of bone metabolism: a randomised trial // Nutr Metab Cardiovasc Dis. 2001 Apr - Vol. 11(2). P. 84-87.
  30. Van Beek E., Lowik C., Van der Pluijm G., Papapoulos S. The role of geranylgeranylation in bone resorption and its suppression by bisphosphonates in fetal bone explants in vitro: A clue to the mechanism of action of nitrogen-containing bisphosphonates // J. Bone Miner. Res. 1999. V. 14. P. 722-729.


Abstract - 393

PDF (Russian) - 216



Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.