title: Traditional and novel bone remodeling markers in premenopausal and postmenopausal women.
abstract: BACKGROUND
  Bone turnover markers (BTMs) may identify changes in bone remodeling within a relatively short time interval before changes in bone mineral density can be detected. New markers such as osteoprotegerin, receptor activator of nuclear factor-κB ligand, and sclerostin have emerged, but there is little information about their potential use in clinical practice.
  
  
  OBJECTIVE
  The aim of this study was to analyze the ability of several BTMs to predict bone loss in pre- and postmenopausal women and to monitor the efficacy of treatment in osteoporotic women.
  
  
  METHODS
  We performed an observational prospective study in pre- and postmenopausal ambulatory women (n = 72 and n = 152, respectively).
  
  
  METHODS
  Postmenopausal women with osteoporosis (n = 18) were treated with risedronate and calcium. Women filled out a questionnaire and underwent bone mineral density measurement using dual-energy x-ray absorptiometry at the time of enrollment and after 1 year of follow-up. BTMs were measured at baseline, at 6 months, and after 1 year.
  
  
  RESULTS
  Increased levels of N-terminal propeptide of type 1 procollagen (P1NP) and β-type I collagen telopeptides (CTXs) were associated with low bone mineral density in the premenopausal (P = .02 and P = .04, respectively) and postmenopausal (P = .03 and P = .02) groups. The best analytical performance to diagnose osteoporosis was for β-CTX, osteocalcin, and P1NP, with areas under the curve of 0.70 (P = .005), 0.64 (P = .048), and 0.71 (P = .003). A significant decrease was found in P1NP, osteocalcin, tartrate-resistant acid phosphatase-5b, β-CTX, and bone alkaline phosphatase after 1 year of treatment (all P < .05).
  
  
  CONCLUSIONS
  Our data suggest that measurement of β-CTX and P1NP shows adequate analytical performance and could potentially be included in algorithms for the screening of osteoporosis. Furthermore, these two markers, along with osteocalcin and tartrate-resistant acid phosphatase-5b, are useful to monitor the response to risedronate.
authors.affiliation: PhD, Servicio de Bioquímica, Clínica Universidad de Navarra, Avda Pío XII 36, 31008 Pamplona, Spain. nvaro@unav.es.
authors.forename: Sonsoles
authors.initials: S
authors.lastname: Botella
authors.forename: Patricia
authors.initials: P
authors.lastname: Restituto
authors.forename: Ignacio
authors.initials: I
authors.lastname: Monreal
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Colina
authors.forename: Amparo
authors.initials: A
authors.lastname: Calleja
authors.forename: Nerea
authors.initials: N
authors.lastname: Varo
mesh_terms: D000135:Acid Phosphatase / Q000097:blood; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology; D016723:Bone Remodeling / Q000502:physiology*; D024042:Collagen Type I / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D015663:Osteoporosis, Postmenopausal / Q000097:blood* / Q000175:diagnosis*; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D017698:Postmenopause / Q000378:metabolism*; D011237:Predictive Value of Tests; D017697:Premenopause / Q000378:metabolism*; D011347:Procollagen / Q000097:blood; D011446:Prospective Studies; D012372:ROC Curve; D000071681:Tartrate-Resistant Acid Phosphatase
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D007527:Isoenzymes; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C042813:procollagen type I carboxy terminal peptide; D015675:Osteocalcin; D000469:Alkaline Phosphatase; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase