Bone-Building Drug Strengthened Hips, Spines of Frail Women in Study

Frail, older women may only need a single dose of the osteoporosis drug Reclast to build bone strength, a new study suggests.

But greater bone density did not translate into fewer fractures among these high-risk women, who were living in nursing homes and assisted living facilities during the study, the researchers added.

“Two surprising findings emerged,” said study author Dr. Susan Greenspan, a professor of medicine at the University of Pittsburg.

The drug improved bone strength in the very old and frail as well as it did in younger and more robust seniors, but there was no association between increasing bone density and reducing fractures, she said.

“We first wanted to see if frail elders could even tolerate such treatment and whether it would improve bone density. However, we had expected to see a positive trend of fewer fractures. But if anything, there were more fractures in the treatment group,” Greenspan said, although “that could well be just a chance finding.”

The study was published online April 13 in the journal JAMA Internal Medicine.

Fracture in the elderly occur not only because the bones are weak, but also because people in this group are prone to falls writes Dr. Robert Lindsay, chief of the Osteoporosis Center at Helen Hayes Hospital in West Haverstraw, N.Y. in an accompanying editorial. “Both risks are high in this population. The study tells us that treating one side of the equation, bad bones, can only do so much when the risk of injury is high, because the patients studied were quite frail.”

Bone Marrow Hormone Influences Metabolism and Health

Until recently, scientists believed bone marrow had mostly a negative effect on health, but mounting evidence supports the idea that the fat tissue inside our bones – known as bone marrow adipose tissue – may be part of the body’s endocrine system.

In the journal Cell Metabolism, researchers from the University of Michigan explain how bone marrow adipose tissue is a significant source of the hormone adiponectin, which helps to break down fat and maintain sensitivity to insulin. The hormone has also been linked to reduced risk of various obesity-related diseases, including certain cancers, cardiovascular disease and type 2 diabetes.

Previous studies of bone marrow adipose tissue have primarily linked it to negative health consequences such as reduced bone mass, and raised risk of fractures and osteoporosis.

But in this study, where they looked at the role of bone marrow adipose tissue in patients having chemotherapy, or who have anorexia, the researchers found that under conditions where calories are restricted, the fat tissue may also do some good.

Senior author Ormond MacDougald, professor of internal medicine at U-M, says the findings are important because it appears bone marrow adipose tissue “may have positive, protective roles, and influence adaptive functions outside of the bone tissue, at least during calorie restriction.