Introduction
cognitive impairment, fracture, CVD
OSTEOPOROTIC FRACTURE, CARDIOVASCULAR DISEASE, CVD, MALIGNANT TUMORS, LOW BONE MINERAL DENSITY, DISEASES
Life expectancy has increased worldwide, and this situation has enhanced the susceptibility to involutional diseases, such as cardiovascular disease (CVD), osteoporotic fractures, malignant tumors, and cognitive impairment. These morbid conditions account for a significant socio-economic burden, especially in an aging society. Many epidemiological studies have indicated a positive link between CVD and osteoporotic fracture or low bone mineral density (BMD) and high low-density lipoprotein cholesterol (LDL-C) or total cholesterol level [Nitrogen-containing bisphosphonates (N-BPs) inhibit the mevalonate pathway, which is the main target metabolic process of statins, and this inhibitory effect is responsible for the inhibition of bone resorption [Adami et alHowever, until now, there have been no robust data that suggest an osteoporotic drug that has a more beneficial effect on cholesterol metabolism, thereby having additional health benefits. Therefore, it may be important to investigate which class of bone resorption inhibitor has a stronger cholesterol-lowering effect and whether the effect on the cholesterol metabolism is associated with fracture risk reduction or not.The aim of the present study was to clarify the relationship between the baseline cholesterol level and incident fracture rate under N-BP and SERM. In addition, we investigated the effects of N-BP and SERM on serum cholesterol levels using a randomized open-label prospective study design [