Objective: This cohort study aimed to evaluate the protective effects of zoledronic acid (ZA) in lipidemia in postmenopausal women with osteoporosis.
Methods: A total of 668 postmenopausal women with osteoporosis were regularly followed up for 12 months between January 2018 and August 2021 in the department of endocrinology and the health examination center of the hospital. They were divided into group I and group II depending on lipid metabolism disorder; Group II received atorvastatin 20 mg/d orally. Groups I and II were divided into experimental group (ZA exposure) and control group (ZA nonexposure).
Results: In group I, which was the ZA exposure group, the level of low-density lipoprotein cholesterol (LDL-C) was significantly lower than that before ZA treatment (P = 0.017); in the ZA nonexposure group, the levels of LDL-C, total cholesterol (TC), and triglycerides (TG) significantly increased after 12 months of follow-up (P = 0.005, P < 0.001, and P = 0.001). At the baseline, no significant difference was found in blood lipid indicators between the ZA exposure and nonexposure groups (P > 0.05), but the levels of LDL-C and TC in the exposed group significantly decreased after 12 months of follow-up (P = 0.008 and P = 0.027). In group II, which was the ZA exposure group, the levels of LDL-C and TC were significantly lower than those before ZA treatment (P < 0.001 and P < 0.001). At the baseline, the ZA exposure and nonexposure groups had no significant difference in blood lipid indicators (P > 0.05), but the levels of LDL-C and TC significantly decreased in the exposed group after 12 months of follow-up (P < 0.001 and P = 0.003).
Conclusion: This cohort study found that ZA might exert a protective effect on lipid metabolism in postmenopausal women with osteoporosis. In postmenopausal women with lipid disorders suffering from osteoporosis, the treatment with ZA combined with atorvastatin significantly reduced the level of blood lipid compared with atorvastatin alone.
Keywords: Bisphosphonate; lipid metabolism; osteoporosis; postmenopausal women; zoledronic acid.