Risedronate or Exercise for Lean Mass Preservation During Menopause: Secondary Analysis of a Randomized Controlled...

Area of Science:

• Menopause research
• Exercise physiology
• Pharmacology

Background:

• Menopause transition involves hormonal shifts causing body composition changes like fat gain and lean mass loss.
• Weight-bearing and resistance exercise are recommended for lean mass maintenance but have low uptake.
• Bisphosphonates show preclinical promise in preventing lean mass loss.

Purpose of the Study:

• To investigate if bisphosphonate therapy can mitigate lean mass loss post-menopause.
• To compare the efficacy of bisphosphonate therapy against weight-bearing exercise in preserving lean mass.

Main Methods:

• The Heartland Osteoporosis Prevention Study randomized 276 osteopenic, postmenopausal women into bisphosphonate, exercise, or control groups for one year.
• Dual energy X-ray absorptiometry (DXA) measured body composition (lean mass, fat mass) at baseline and 12 months.
• Intent-to-treat and per-protocol analyses, including weight change adjustment, were used.

Main Results:

• Both risedronate and exercise groups showed greater lean mass gains than the control group over 12 months.
• Adherence rates were 89% for risedronate and 64% for exercise.
• After adjusting for weight change, the difference in lean mass between the risedronate and control groups was not statistically significant.

Conclusions:

• Both oral risedronate and weight-bearing exercise may reduce lean mass loss during the menopause transition compared to no intervention.
• The lean mass-sparing effect of risedronate might be influenced by overall weight changes.