title: Effect of vitamin D therapy on bone turnover markers in postmenopausal women with osteoporosis and osteopenia.
abstract: OBJECTIVE
  To (1) assess the rate of reduction in bone turnover with vitamin D and bisphosphonate therapies and (2) evaluate the clinical utility of bone-specific alkaline phosphatase (BSAP) in monitoring treatment response.
  
  
  METHODS
  We retrospectively reviewed medical records of patients with newly diagnosed osteopenia and osteoporosis from 2002 to 2009 at Loyola University Medical Center. A cohort of postmenopausal women with hip or spine T-scores of less than -1, normal serum creatinine, and no prior vitamin D or bisphosphonate therapy was divided into vitamin D-deficient (n = 29) and vitamin D-sufficient (n = 13) groups. Vitamin D-deficient patients received high-dose vitamin D, whereas vitamin D-sufficient patients received orally administered bisphosphonates. BSAP levels at baseline and 1 year were compared.
  
  
  RESULTS
  Vitamin D therapy in the group with vitamin D deficiency led to a 26.7% decrease in BSAP (P<.01). Bisphosphonate therapy in the vitamin D-sufficient group led to a 32.7% decrease in BSAP (P = .01). The magnitude of BSAP change in the 2 study groups (6.74 ± 6.48 μg/L and 8.72 ± 9.94 μg/L) did not differ significantly (P = .45).
  
  
  CONCLUSIONS
  The results of this study suggest that correction of vitamin D deficiency in patients with osteopenia and osteoporosis can lead to a decrease in bone turnover as measured by BSAP and that the magnitude of this reduction is similar to that achieved with orally administered bisphosphonates.
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, Loyola University Medical Center, Maywood, Illinois 60153, USA.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Tanzy
authors.forename: Pauline M
authors.initials: PM
authors.lastname: Camacho
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001851:Bone Diseases, Metabolic / Q000097:blood* / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D001862:Bone Resorption / Q000517:prevention & control*; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D015331:Cohort Studies; D004164:Diphosphonates / Q000627:therapeutic use*; D016903:Drug Monitoring; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood* / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D017698:Postmenopause; D012189:Retrospective Studies; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014807:Vitamin D; D000469:Alkaline Phosphatase