Bisphosphonates are the first-choice treatment of osteoporosis and Paget’s disease of bone. Among the bisphosphonates, the non-amino-bisphosphonates, such as clodronic acid, are intracellular converted into toxic analogues of ATP and induce cellular apoptosis whereas the amino-bisphosphonates, such as zoledronic acid, inhibit the farnesyl-diphosphate-synthase, an enzyme of the mevalonate pathway. This pathway regulates cholesterol and glucose homeostasis and is a target for statins. In this retrospective cohort study, we evaluated the effects of an intravenous infusion of zoledronic acid (5 mg) or clodronic acid (1500 mg) on blood lipid (i.e. total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol and triglycerides) and glucose levels in patients with osteoporosis and Paget’s disease of bone. All patients were evaluated before, 1 and 6 months after bisphosphonate treatment. Pagetic and osteoporotic patients treated with zoledronic acid showed a significant reduction in glucose and atherogenic lipids during follow-up whereas these phenomena were not observed after clodronic treatment. The effect on circulating lipid levels was similar in naïve and re-treated Pagetic patients. Zoledronic acid treatment was associated with a reduction in blood glucose and atherogenic lipids in patients with metabolic bone disorders. The extent of change was similar to that obtained with the regular assumption of a low-intensity statin. Further studies are warranted to better evaluate the clinical implications of these observations.

双膦酸盐是治疗骨质疏松症和佩吉特骨病的首选药物。在双膦酸盐中，非氨基双膦酸盐，如氯膦酸，在细胞内转化为 ATP 的毒性类似物并诱导细胞凋亡，而氨基双膦酸盐，如唑来膦酸，抑制法呢基二磷酸合酶，一种酶甲羟戊酸途径。该途径调节胆固醇和葡萄糖稳态，是他汀类药物的靶点。在这项回顾性队列研究中，我们评估了静脉输注唑来膦酸（5 mg）或氯膦酸（1500 mg）对血脂（即总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和骨质疏松症和佩吉特骨病患者的甘油三酯）和葡萄糖水平。所有患者均在双膦酸盐治疗前、1 个月和 6 个月后进行评估。用唑来膦酸治疗的 Pagetic 和骨质疏松症患者在随访期间显示出葡萄糖和致动脉粥样硬化脂质的显着降低，而在氯膦酸治疗后未观察到这些现象。初治和重新治疗的 Pagetic 患者对循环血脂水平的影响相似。唑来膦酸治疗与代谢性骨病患者的血糖和致动脉粥样硬化脂质降低有关。变化的程度与使用低强度他汀类药物的常规假设获得的变化程度相似。需要进一步研究以更好地评估这些观察结果的临床意义。用唑来膦酸治疗的 Pagetic 和骨质疏松症患者在随访期间显示出葡萄糖和致动脉粥样硬化脂质的显着降低，而在氯膦酸治疗后未观察到这些现象。初治和重新治疗的 Pagetic 患者对循环血脂水平的影响相似。唑来膦酸治疗与代谢性骨病患者的血糖和致动脉粥样硬化脂质降低有关。变化的程度与使用低强度他汀类药物的常规假设获得的变化程度相似。需要进一步研究以更好地评估这些观察结果的临床意义。用唑来膦酸治疗的 Pagetic 和骨质疏松症患者在随访期间显示出葡萄糖和致动脉粥样硬化脂质的显着降低，而在氯膦酸治疗后未观察到这些现象。初治和重新治疗的 Pagetic 患者对循环血脂水平的影响相似。唑来膦酸治疗与代谢性骨病患者的血糖和致动脉粥样硬化脂质降低有关。变化的程度与使用低强度他汀类药物的常规假设获得的变化程度相似。需要进一步研究以更好地评估这些观察结果的临床意义。初治和重新治疗的 Pagetic 患者对循环血脂水平的影响相似。唑来膦酸治疗与代谢性骨病患者的血糖和致动脉粥样硬化脂质降低有关。变化的程度与使用低强度他汀类药物的常规假设获得的变化程度相似。需要进一步研究以更好地评估这些观察结果的临床意义。初治和重新治疗的 Pagetic 患者对循环血脂水平的影响相似。唑来膦酸治疗与代谢性骨病患者的血糖和致动脉粥样硬化脂质降低有关。变化的程度与使用低强度他汀类药物的常规假设获得的变化程度相似。需要进一步研究以更好地评估这些观察结果的临床意义。