Horm Metab Res 2009; 41(11): 846-850
DOI: 10.1055/s-0029-1233491
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

The Effect of Zoledronic Acid on Serum Dickkopf-1, Osteoprotegerin, and RANKL in Patients with Paget's Disease of Bone

S. A. Polyzos1 , A. D. Anastasilakis2 , Z. Efstathiadou1 , M. Kita1 , I. Litsas1 , A. Avramidis1 , G. Arsos3 , E. Moralidis3 , S. Gerou4 , V. Pavlidou 4 , A. Papatheodorou5 , E. Terpos5
  • 1Department of Endocrinology, Ippokration General Hospital, Thessaloniki, Greece
  • 2Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece
  • 3Department of Nuclear Medicine, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece
  • 4Laboratories “Analysis”, Thessaloniki, Greece
  • 5Department of Medical Research, 251 General Airforce Hospital, Athens, Greece
Further Information

Publication History

received 27.02.2009

accepted 30.06.2009

Publication Date:
10 August 2009 (eFirst)


Overexpression of dickkopf (DKK)-1 in pagetic osteoblast cultures resulted in stimulation of osteoclast proliferation and inhibition of osteoblast growth. The aim of this study was to evaluate for the first time in Paget's disease of bone (PDB): 1) the serum levels of DKK1; 2) the association of DKK-1 with receptor activator of nuclear factor kappa B (RANKL) and osteoprotegerin (OPG); and 3) the effect of zoledronic acid (ZOL) on serum DKK-1, RANKL, and OPG. The study was conducted as a prospective open-label cohort study. Eleven patients with PDB (median age 60 years) were recruited. Twelve age- gender- and body mass index (BMI)-matched healthy individuals were used as controls at baseline. Blood samples were obtained before treatment (baseline) and after 3, 6, 12, and 18 months following ZOL infusion in patients with PDB. Patients with PDB had significantly higher RANKL (p=0.002), OPG (p=0.001), and bone markers (total alkaline phosphatase and C-terminal cross-linking telopeptide of type I collagen) compared with controls at baseline. There was no difference between groups in DKK-1 at baseline. Bone markers were both significantly decreased after therapy. Serum OPG, RANKL, RANKL:OPG ratio, and DKK-1 remained unaffected throughout the study. No correlations were found between OPG, RANKL, RANKL:OPG ratio, and DKK-1 at baseline nor between their changes during the study. Although both OPG and RANKL were increased in patients with PDB, ZOL had no effect on their serum levels. Serum DKK-1 was neither increased in patients with PDB nor related to OPG and RANKL, and was unaffected by ZOL.



S. A. Polyzos

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Email: stergios@endo.gr