The effect of promethazine on bone is debated. We studied the effect of promethazine on bone and the mechanism of action involved by densitometric and histomorphometric measurements in female Wistar rats (100 days old, mean weight 25 +/- 20 g). A control group of 15 rats was not manipulated. An experimental group of 15 rats were ovariectomized (OVX) at 100 days of life and fed a diet supplemented with 4.8 mg/kg promethazine hydrochloride (OVX + Prom). The group that underwent OVX and a group of 15 rats that underwent sham ovariectomy (Sham-OVX) were not treated with promethazine. After 30 days, all the rats were killed. Their femur and 5th lumbar vertebra were dissected and cleaned of soft tissue. Femoral length and vertebral height were measured with a caliper and bones were weighed on a precision balance. The bone mineral content (BMC) and bone mineral density (BMD) of the whole right femurs and 5th lumbar vertebras were measured by dual-energy X-ray absorptiometry (DXA). Trabecular bone volume (Cn-BV-TV%), trabecular number (Tb-N mm(-1)), trabecular thickness (Tb-Th microm), and trabecular separation (Tb-Sp microm) were measured in the femurs by histomorphometric study of nondecalcified bone. Our results showed that promethazine significantly inhibited postovariectomy loss of bone mass (P < 0. 0001) by significantly reducing bone resorption, as shown by the smaller trabecular spaces observed in the treated OVX rats (P < 0. 0001).
Study design: A cross-sectional study. Objective: To clarify the existing controversy with regard to whether paraplegic patients suer a loss of bone mass in the upper limbs. Setting: Madrid, Spain. Methods: We evaluated bone mass by phalangeal ultrasonography in 35 male patients with paraplegia (mean age 49+12 years), and 25(OH)D3 and PTH to exclude the presence of osteomalacia and secondary hyperparathyroidism. Spasticity was evaluated according to the Ashworth scale. Patients were compared with a control group of 35 healthy male subjects (mean age 48+13 years). Results: The patients had lower 25(OH)D 3 levels and amplitude-dependent speed of sound (Ad-SOS) than controls (both P50.001), and higher PTH levels (P50.05). There was a statistically signi®cant negative association between PTH and 25(OH)D 3 levels (r=70.52, P50.0001, CI 70.73 to 70.22) and between 25(OH)D 3 and injury duration (r=0.34, P50.05, CI 70.60 to 70.01). There was no correlation between Ad-SOS values, levels of PTH or 25(OH)D 3 , and the injury duration. No signi®cant dierence in Ad-SOS values was found in patients grouped according to low-to-normal 25(OH)D 3 level or according to normal-to-high PTH level. There were no dierences in relation to muscle tone. Only alkaline phosphatase and tartrate-resistant acid phosphatase levels were higher in patients than in controls (both P50.001). Conclusion: Paraplegic patients had a loss of phalangeal bone mass that was unrelated to the levels of vitamin D or PTH, or to muscle tone, so it seems to be related to increased bone resorption rather than to de®cient bone formation.
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