Objective: To investigate the effect of Jianpi Bushen (JPBS) formula on aromatase inhibitor (AI)-associated bone loss after menopause.
Methods: Six-month-old female rats were randomly divided into 6 groups: a sham group, an ovariectomized (OVX) group, an OVX treated with exemestane and 3 OVX groups each treated with a different dose of JPBS formula. Bone mineral density (BMD) at the lumbar vertebrae, histology, bone markers and serum levels of estrogen were assessed. Furthermore, a cohort study was conducted in 130 postmenopausal women with breast cancer that had undergone treatment with AIs. The subjects were given JPBS + caltrate D or caltrate D only, administered orally. BMD at the lumbar vertebrae and femoral neck and bone markers were evaluated in both control and herbal treatment groups at baseline and 12 months.
Results: Experimental results indicated that a high dose of JPBS significantly increased the trabecular bone area percentage (Tb.Ar %) and broadened the trabecular thickness (Tb.Th). The JPBS formula enriched the carboxyterrninal propeptide of type ipmcollagen and increased serum estrogen level significantly. The clinical investigation revealed that bone loss was decreased in the group treated with JPBS vs control (BMD T score at lumbar vertebrae, 3.9% increased vs 14.58% decreased, respectively, P = 0.004 and BMD T score on femoral neck, 1.8% decreased vs 22.45% decreased, respectively, P = 0.008). Besides, JPBS formula elevated N- middle osteocalcin and decreased type I collagen cross-linked C-terminal telopeptide.
Conclusion: JPBS formula prevented aromatase-inhibitor-associated bone loss after menopause by inhibiting bone resorption and promoting bone formation.
Keywords: Aromatase inhibitors; Menopause; Bone resorption; Jianpi Bushen formula; Osteogenesis.