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Loop diuretics increase bone turnover and decrease BMD in osteopenic postmenopausal women: results from a randomized

Lars Rejnmark1, Peter Vestergaard, Lene Heickendorff

  • 1Department of Endocrinology and Metabolism C, Aarhus Sygehus, Aarhus University Hospital, Aarhus, Denmark. rejnmark@post6.tele.dk

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
|December 16, 2005
PubMed
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Loop diuretics like bumetanide significantly decrease bone mineral density (BMD) and affect bone turnover markers in postmenopausal women. These effects on bone metabolism may warrant further investigation into fracture risk.

Area of Science:

  • Endocrinology
  • Bone Metabolism
  • Pharmacology

Background:

  • Loop diuretics can impact bone health by increasing renal calcium excretion and altering parathyroid hormone (PTH) levels.
  • The study investigated the specific effects of bumetanide, a loop diuretic, on bone metabolism over one year.

Purpose of the Study:

  • To evaluate the impact of one-year bumetanide treatment on bone mineral density (BMD) and bone turnover markers.
  • To assess the reversibility of these effects after treatment cessation.

Main Methods:

  • A double-blind, randomized study involving 87 postmenopausal women with osteopenia.
  • Participants received either bumetanide (2 mg/day) or placebo, with calcium and vitamin D supplementation.
  • Measurements included BMD, calcitropic hormones, and biochemical bone markers at baseline, 1 year, and 6 months post-treatment.

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Main Results:

  • Bumetanide treatment led to increased urinary calcium and plasma PTH levels compared to placebo.
  • A significant decrease in BMD was observed in the bumetanide group at the total hip, ultradistal forearm, and whole body.
  • Biochemical markers of bone turnover were significantly lower in the placebo group than in the bumetanide group.

Conclusions:

  • Loop diuretic treatment negatively affects bone turnover and reduces BMD.
  • The observed effects on bone metabolism suggest a potential role for loop diuretics as a fracture risk factor, meriting further research.