Effects of anti-osteoporosis therapy on plasma aldosterone and renin.

Objective: This study aimed to investigate the effect of anti-osteoporosis therapy on plasma aldosterone concentration (PAC), plasma renin concentration (PRC) and the aldosterone/renin ratio (ARR) in patients with postmenopausal osteoporosis. Methods: In 60 patients with postmenopausal osteoporosis, bone mineral density (BMD), PAC and PRC were measured before and after treatment with alendronate (70 mg/week, n=22) or recombinant human parathyroid hormone (20 mu g/day, n=35) for 48 weeks. Results: PAC was negatively correlated with the T-score of lumbar spine BMD and femoral neck BMD (lumbar r=-0.386, pr=-0.262, p<0.05). With the improvement in lumbar BMD after anti-osteoporosis treatment (T-score -3.4 +/- 0.5 vs. -3.1 +/- 0.4, p<0.0001), PAC decreased from 182.8 +/- 53.2 to 143.7 +/- 68.6 pg/mL (p<0.0001), PRC increased from 7.8 +/- 11.6 to 39.2 +/- 50.0 mu IU/mL (p<0.0001) and the ARR decreased from 74.8 +/- 75.2 to 13.1 +/- 17.1 pg/mu IU (p<0.0001). At baseline, 58% (35/60) of the patients had an ARR >37 pg/mu IU, and the proportion decreased to 8% (5/57) after treatment. Conclusion: Treatment with alendronate or parathyroid hormone causes decreased PAC and increased PRC, resulting in a decreased ARR in postmenopausal women with osteoporosis.