The Predictive Value of Biochemical Markers of Bone Turnover for Bone Mineral Density In Early Postmenopausal Women Treated with Hormone Replacement or Calcium Supplementation--Author's Response

1998 ◽  
Vol 83 (3) ◽  
pp. 1045-1046
Author(s):  
C. J. Rosen
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Predictive Value ◽  
Biochemical Markers ◽  
Calcium Supplementation ◽  
Hormone Replacement ◽  
Mineral Density ◽  
Early Postmenopausal Women ◽  
Markers Of Bone Turnover

scholarly journals The Predictive Value of Biochemical Markers of Bone Turnover for Bone Mineral Density in Early Postmenopausal Women Treated with Hormone Replacement or Calcium Supplementation1

1997 ◽  
Vol 82 (6) ◽  
pp. 1904-1910 ◽  
Author(s):  
Clifford J. Rosen ◽  
Charles H. Chesnut ◽  
Nancy J. S. Mallinak
Keyword(s):  
Bone Mineral Density ◽  
Bone Formation ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Biochemical Markers ◽  
Hormone Replacement ◽  
Mineral Density ◽  
Percent Change ◽  
Early Postmenopausal Women ◽  
Markers Of Bone Formation

Abstract To compare the relative sensitivity and specificity of bone turnover indexes for bone loss or gain in early postmenopausal women, we performed a multicenter trial in 236 menopausal women (mean age, 51 yr), who were randomized to hormone replacement therapy (HRT) or calcium supplementation (CS; 500 mg/day) for 1 yr. Two markers of bone formation, osteocalcin (OC) and bone alkaline phosphatase (BSAP), and two markers of bone resorption, urinary N-telopeptide (NTx) and urinary free deoxypyridinoline (fDpd), as well as spine and femoral neck bone mineral density (BMD) were measured at baseline and 3, 6, and 12 months after treatment. Women receiving HRT (n = 105) showed a significant increase in spine BMD (+2.5%; P < 0.0001) and hip BMD (+1.0%; P = 0.02) compared to women receiving CS, who showed a decline at both sites (−1.1%; P < 0.01). All four markers showed time-dependent decreases in women receiving HRT (P < 0.001) and no change in women receiving CS alone. When baseline indexes of turnover were stratified by quartile, there was a significantly greater increase in BMD among those with the highest NTx, OC, and BSAP levels compared to that in those with the lowest NTx, OC, and BSAP levels (P < 0.05). The highest quartile for percent change from baseline to 6 months in fDpd, BSAP, and NTx was also associated with the greatest change in spine BMD at 1 yr. Receiver operator characteristic curves for percent change from baseline to 6 months in an individual marker to 1 yr change in BMD during HRT revealed that the percent change in NTx provided the greatest discrimination between gain and loss of BMD. When subjects receiving HRT were compared by their positive or negative skeletal response at 1 yr and their baseline turnover marker, initial NTx values were significantly higher in those that gained bone than in those that lost bone (P = 0.0002). CS women in the highest quartile for NTx at baseline had significantly greater decreases in spine BMD than subjects with the lowest NTx values (P < 0.005), although this was not true for fDpd (P < 0.20). In conclusion, for early postmenopausal women there are differential responses of biochemical markers to HRT and CS. Baseline urinary NTx and serum OC were the most sensitive predictors of change in spine BMD after 1 yr of either HRT or CS. Similarly, the percent change in NTx and OC from baseline to 6 months best predicted bone gain or loss. We conclude that markers of bone formation and resorption can be used clinically to predict future BMD in early postmenopausal women.

Bone Mineral Density and Biochemical Markers of Bone Turnover in Peri- and Postmenopausal Women

2000 ◽  
Vol 66 (4) ◽  
pp. 263-267 ◽  
Author(s):  
V. De Leo ◽  
A. Ditto ◽  
A. la Marca ◽  
D. Lanzetta ◽  
C. Massafra ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Biochemical Markers ◽  
Mineral Density ◽  
Markers Of Bone Turnover

scholarly journals Biochemical Markers of Bone Turnover and Response of Bone Mineral Density to Intervention in Early Postmenopausal Women: An Experience in a Clinical Laboratory

2001 ◽  
Vol 47 (6) ◽  
pp. 1083-1088 ◽  
Author(s):  
La-or Chailurkit ◽  
Boonsong Ongphiphadhanakul ◽  
Noppawan Piaseu ◽  
Sunee Saetung ◽  
Rajata Rajatanavin
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Biochemical Markers ◽  
Bone Markers ◽  
Response To Therapy ◽  
Control Group ◽  
Mineral Density ◽  
Bone Resorption Markers ◽  
Early Postmenopausal Women ◽  
Markers Of Bone Turnover

Abstract Background: Markers of bone formation and resorption may be useful as early indicators of response to therapy. Our aim in this study was to investigate the use of bone markers for monitoring of intervention for bone loss in early postmenopausal women and to assess the relationships between these markers and changes in bone mineral density (BMD). Methods: Subjects were randomly assigned to the following groups: a control group; a group receiving calcium alone; groups receiving calcium plus low or conventional doses of conjugated equine estrogen; and groups receiving calcium plus low or conventional doses of calcitriol. At baseline and at 1 and 3 months after intervention, we measured serum intact osteocalcin, serum N-terminal midfragment osteocalcin, serum C-terminal telopeptide of type I collagen (CTx), urinary deoxypyridinoline cross-links, and urinary CTx. The BMD of the lumbar spine and the femoral neck was measured at baseline and after 1 and 2 years of intervention. Results: No marker changed significantly in the control group except urinary CTx, which increased at 3 months. Serum CTx decreased in all regimens at 1 or 3 months of intervention. In addition, the changes of all markers at 3 months were inversely associated with the change in the BMD of the lumbar spine at 1 or 2 years (r = −0.144 to −0.314), whereas only the changes of bone resorption markers at 3 months were inversely correlated with the changes in femoral BMD at 1 or 2 years (r = −0.143 to −0.366). Conclusions: Biochemical markers of bone turnover appear to be of use in assessing early response to therapy. Bone resorption markers, especially serum CTx, are better indicators than bone formation markers for estimating the response to intervention in early postmenopausal women. However, the early changes in bone markers were weakly related to the later changes in BMD.

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