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Health See other Health Articles Title: Phosphate and alendronate make stronger bones NEW YORK (Reuters Health) Feb 07 - Phosphate or alendronate given in combination with standard growth hormone replacement (GHR) leads to a greater improvement in bone mineral density (BMD) in adults with growth hormone deficiency, UK researchers report in a January 20th online paper in the Journal of Clinical Endocrinology & Metabolism. Dr. H. D. White and colleagues at the University of Liverpool note that the condition is associated with osteoporosis, and occurs as the result of reduced sensitivity of the bone and kidney to the effect of PTH. Overall prevalence is reportedly between 2 and 3 per 10,000. The researchers note that GHR and alendronate is a first-line osteoporosis treatment at their center. Standard practice in the UK is to offer GHR to all patients with severe GH deficiency. Serum phosphate is a regulator of PTH secretion and also may be of value. To examine these alternatives, the researchers studied 44 patients. Those who were previously naive to GH were randomized to receive GH replacement alone or with alendronate or phosphate. Patients already receiving GHR continued with that treatment alone or in combination with alendronate or phosphate. After a year, patients receiving phosphate had significantly greater increases in nephrogenous cAMP (a marker of renal PTH activity) than those on GH alone. There was also a significantly greater increase in BMD. BMD was also significantly improved but to a lesser extent in the alendronate combination group. Type-I collagen beta C-telopeptide (a marker of bone resorption) also decreased to a greater extent in this group than in those receiving GH alone. "Phosphate appears to exert its effect by increasing PTH target-organ action, whereas alendronate acts primarily through reduction in bone resorption," say the investigators. They add that the condition may serve as a model for age-related osteoporosis but further investigation into the use of phosphate therapy in primary osteoporosis is necessary. J Clin Endocrinol Metab. Posted online January 20, 2010. Abstract
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Alendronate is an osteoporosis drug:
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