[The role of bone metabolic markers in qualification for treatment of osteoporosis. Results of POMOST study].
BACKGROUND
Increased bone turnover markers (BTM) level is consider as independent risk factor of bone fracture. However, it was not used in 10-year probability of bone fracture method (FRAX) proposed by WHO, which helps in qualification of patients for pharmacological treatment of osteoporosis. The aim of the study was to evaluate the usefulness of BTM in qualification for pharmacological treatment of osteoporosis.


METHODS
The study was performed in 152 subjects (20 men and 132 women) referred to Krajowe Centrum Osteoporozy. One-hundred thirty two of them were qualified for pharmacological treatment and 20 for prophylaxis on the basis of qualitative method. The following BTM were examined in all patients: of bone formation - N-terminal propeptide of procolagen type I (PINP) and N-mid osteocalcin (OC) and of bone resorption - C-terminal cross-linked telopeptide of collagen type I (CTx).


RESULTS
The values over that considered as independent fracture risk (in women only, no data for men) were found in 39 women with PINP, 39 with OC and 41 with CTx. Part of women had decreased serum BTM (10 women 3 BTM and 35 with 1 at least). There were not significant differences in serum BTM depending on the presence of clinical fracture risk factors: osteoporotic fracture in past, osteoporotic hip fracture in parents, chronic treatment with glucocorticosteroids and qualification for pharmacological treatment on the basis of qualitative and FRAX method. There was no significant difference in the presence of fracture risk factors depending on increased or decreased serum BTM.


CONCLUSIONS
Results of the study did not show the practical use of BTM in qualification for pharmacological treatment of osteoporosis.
Przedlacki
Jerzy
J
Krajowe Centrum Osteoporozy, Warszawa.
Bartoszewicz
Zbigniew
Z
Ksiezopolska-Orłowska
Krystyna
K
Kondracka
Agnieszka
A
Grodzki
Artur
A
Bartuszek
Tomasz
T
Bartuszek
Dorota
D
Swirski
Andrzej
A
Loth
Ewa
E
Musiał
Jan
J
Luczak
Elzbieta
E
Teter
Paweł
P
Lasiewicki
Andrzej
A
Walkiewicz
Andrzej
A
Drozdowska-Rusinowicz
Iwona
I
D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism*; D015897:Comorbidity; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000517:prevention & control; D005938:Glucocorticoids / Q000627:therapeutic use; D006620:Hip Fractures / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism*; D011044:Poland / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods
D015415:Biomarkers; D005938:Glucocorticoids