The Role of Bone Turnover Markers in the Follow up of the Treatment of Osteoporosis

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