The possible protective role of glucosamine versus zoledronic acid on osteopenic effect of pantoprazole in adult male albino rats

Background Osteopenia is an asymptomatic condition till fragility fractures occur and may be linked to prolonged use of pantoprazole. Aim To determine osteopenic effect of long-term use of pantoprazole and study the possible protective role of glucosamine versus zoledronic acid on this effect in adult male albino rats. Patient and methods A total of 60 rats were divided equally into six groups; group I subdivided equally into IA received no treatment and IB received normal saline. Group II received glucosamine. Group III received zoledronic acid. Group IV received pantoprazole. Group V received pantoprazole and glucosamine. Group VI received pantoprazole and zoledronic acid. After 12 weeks, the left femurs were subjected to radiography and measured bone mineral density from the proximal end (neck). The right proximal ends of femurs were processed for histological, immunohistochemical, and scanning electron microscopic studies. Results Groups V and VI showed restoration of normal trabecular histology with a highly significant increase in trabecular thickness and a highly significant decrease in inter-trabecular spaces and mean area% of osteopontin compared with group IV. However, it seemed that group V had a more anabolic effect revealed by significant increase in bone mineral density, Z-score, and mean area% of osteocalcin compared with group VI. Conclusion Long-term use of pantoprazole led to osteopenia. Concomitant use of either glucosamine or zoledronic acid with pantoprazole reduced the severity of trabecular damage induced by pantoprazole. However, it seemed that glucosamine exerted a more anabolic effect than zoledronic acid.