Abstract
Although bone mineral density (BMD) measurement is the common method for the diagnosis of postmenopausal osteoporosis (PMO, bone turnover markers have been proposed as good indicators for monitoring the efficiency of antiresorptive treatment. We aim to evaluate course of bone turnover markers in the follow-up of treatment osteoporosis and compare the results of these markers with bone mineral densities. 47 postmenopausal patients were included in this study. The age average of the patients was 59.1±7.6 (48-81). Patients were divided into 5 groups depending on the type of the treatment: Calcium and vitamin D (8 patients); calcium, vitamin D and risendronate (10 patients); calcium, vitamin D and alendronate (10 patients); calcium, vitamin D and hormone replacement therapy (tibolone) (9 patients) and calcium, vitamin D and calcitonine (10 patients). Samples were taken from each group, prior to treatment and in the third and sixth months of the treatment. Bone mineral density measurements were carried out before the treatment and in the sixth month. The basal concentrations of bone turnover markers [serum Type I collagen C-telopeptide (CTX), N-mid-Osteocalcin (OC) and urinary deoxypridinoline (Dpd)] and Interleukin-1b (IL-1b) were compared to the values in the third and sixth month of the therapy and also to BMD.OC, CTX and Dpd are good markers for the evaluation the effectiveness antiresorptive therapy. The changes in CTX and OC seems to be reflect the changes in bone mass in the early period. However, the changes in Dpd levels come out later. HRT (tibolone) and biphosphonates especially risendronate are thought to be effective therapeutic approaches, because a significant decrease in bone turnover markers and an improvement in BMD – especially in lombar vertebra - were observed in the follow up of treatment. A good correlation found between the changes in levels of CTX and Dpd and changes in BMD during treatment, which suggest that these two markers would be useful for monitoring response to antiresorptive therapy. Keywords: Postmenopausal osteoporosis, bone turnover markers, serum Type I collagen C-telopeptide, N-mid-Osteocalcin, urinary deoxypridinoline, Interleukin-1b DOI: 10.7176/JHMN/80-14 Publication date: September 30 th 2020
Highlights
PMO is a disease characterised by low bone mineral denisty and microarchitecural impairment -as result of reduction in circulating estrogen causing an accelerated bone turnover and resorption- which lead to bone fragility and an increase risk of fractures
Bone mineral density (BMD) measurement is the most common method used for the diagnosis and the follow-up of the treament of osteoporosis (3)
Earlier information can be obtained when compared to bone mineral density measurement, so that they may be used to detect patients who do not respond to therapy (5,6)
Summary
PMO is a disease characterised by low bone mineral denisty and microarchitecural impairment -as result of reduction in circulating estrogen causing an accelerated bone turnover and resorption- which lead to bone fragility and an increase risk of fractures. It is a very serious health problem leading to significant morbidity, disability, mortality and decreased quality of life (1,2). For the evaluation of efficiency of the treatment of osteoporosis, bone formation and resorption markers are being used With these markers, earlier information can be obtained when compared to bone mineral density measurement, so that they may be used to detect patients who do not respond to therapy (5,6). The magnitude and the timing of reduction (within weeks) in the levels of bone turnover markers are thought to be their advantage when compared to BMD measurements by which slower changes and smaller magnitude are obtained (7)
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