Bone mineral density in patients using aromatase inhibitors: a clinical, nutritional, and quality of life assessment.

Abstract

The use of aromatase inhibitors (AIs) leads to an imbalance in bone remodeling and can cause osteoporosis. This study aimed to identify clinical, periodontal, nutritional, and biochemical determinants of bone mineral density (BMD) changes in patients using AIs. The sample consisted of 40 women using AIs and 32 controls. BMD was assessed by dual X-ray absorptiometry (DXA). Data on nutritional, anthropometric, oral and periodontal status, and oral health-related quality of life (OHRQoL) were collected. Cytokines and adipokines were quantified in saliva and serum. Thirty-nine of the 72 women had low BMD, with a similar distribution in the control and AIs groups. BMD was lower in older women using AIs (p = 0.009) and in smokers (p = 0.034). Anthropometric assessment demonstrated that women with low BMD who used AIs had lower weight (p = 0.028). Although the frequency of periodontitis was similar in all groups, higher IL-6 (p = 0.004), IL-1β (p = 0.002), and IL-33 (p = 0.006) levels were associated with poor periodontal status. Women who used AIs were 1.18 times more likely to report better OHRQoL than controls. While advanced age, smoking, and lower weight are factors associated with low BMD, the use of antiresorptive agents was a protective factor for maintaining BMD in women using AIs.