Early changes in biochemical markers of bone turnover predict bone mineral density response to antiresorptive therapy in Korean postmenopausal women with osteoporosis.
Biochemical markers of bone turnover have been suggested to be useful in monitoring the efficacy of antiresorptive therapy. In this study, we investigated the predictive value of bone turnover markers to determine short-term response in bone mineral density (BMD) and to identify nonresponders in 138 postmenopausal women (mean age 58 years) with osteoporosis given with either hormone thearpy (HT) or alendronate. Urinary type I collagen N-telopeptide (NTx) and serum osteocalcin (OC) at baseline, 3, and 6 months after treatment as well as spine and femoral neck BMD at baseline and 12 months were measured. Significant decreases in both NTx and OC were evident in women on treatment with antiresorptive agents as early as 3 months (p<0.01). Percent change of NTx at 3 months correlated with the percent change of spinal BMD at 12 months of treatment. When bone turnover markers were stratified by tertiles, the average rate of lumbar spine BMD gain increased significantly with increasing tertiles of baseline value (p<0.05) and percent change (p<0.05) of urinary NTx at 3 month of treatment. In terms of BMD response, urinary NTx at 3 months decreased significantly more in BMD responders group than in nonresponders group. Logistic regression analysis demonstrated that percent change of NTx at 3 months is an independent predictor to identify BMD nonresponders, defined as those whose BMD gain remained within the precision error range of dual energy X-ray absorptiometer (DXA). We conclude that biochemical markers of bone turnover, especially percent change in urinary NTx levels, can be used to determine BMD response to antiresorptive therapy in Korean postmenopausal women with osteoporosis.
Kim
Sang Wan
SW
Department of Internal Medicine, Seoul National University College of Medicine, Seoul.
Park
Do Joon
DJ
Park
Kyong Soo
KS
Kim
Seong Yeon
SY
Cho
Bo Youn
BY
Lee
Hong Kyu
HK
Shin
Chan Soo
CS
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000494:pharmacology / Q000627:therapeutic use; D015415:Biomarkers; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001862:Bone Resorption / Q000188:drug therapy*; D001842:Bone and Bones / Q000378:metabolism*; D003094:Collagen / Q000652:urine*; D024042:Collagen Type I; D004967:Estrogens / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005272:Femur Neck / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008137:Longitudinal Studies; D008525:Medroxyprogesterone / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood*; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D010455:Peptides / Q000652:urine*; D013131:Spine / Q000187:drug effects / Q000503:physiopathology; D013997:Time Factors
D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D004967:Estrogens; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin; D003094:Collagen; D008525:Medroxyprogesterone; D019386:Alendronate