Assessment of Urinary Bone Markers for Monitoring Treatment of Osteoporosis

Abstract Background: The usefulness of urinary markers of bone turnover in monitoring therapy depends on their within-person variability compared with their responses to therapy. The aim of this study was to assess the performance of two such markers on this basis. Methods: We measured variation, during a whole year, of cross-linked N-terminal telopeptide of collagen I (NTx) and urinary deoxypyridinoline (DPD) as ratios to creatinine concentration and after log-transformation of the ratios in untreated women stratified into three bone density classes, of which the lowest was osteoporotic. We also measured changes in bone mineral density at the lumbar spine (LSBMD) and hip (FNBMD) in untreated women with normal bones and in those with moderate osteopenia and calculated the reference change value (RCV; or least significant change) at P <0.05 for all of these measures. We made the same measurements on women treated with bisphosphonates, estrogen replacement (HRT), or calcium and examined their individual responses to treatment compared with RCV. Results: After 12 months on bisphosphonates, LSBMD changed more than RCV (2.55%) in 47% of women compared with 44% of those on HRT and 13% of those on calcium. Response of FNBMD was less. Log NTx (RCV= −28%) responded to bisphosphonates in 78%, regardless of BMD, but less often to HRT (67%). Log DPD (RCV= −30%) responded to bisphosphonates less frequently (31% at 12 months). Conclusions: NTx has advantages over DPD in monitoring therapy for osteoporosis when mailed urine samples are used.

Download Full-text

Biochemical Markers of Bone Turnover and Response of Bone Mineral Density to Intervention in Early Postmenopausal Women: An Experience in a Clinical Laboratory

Clinical Chemistry ◽

10.1093/clinchem/47.6.1083 ◽

2001 ◽

Vol 47 (6) ◽

pp. 1083-1088 ◽

Cited By ~ 30

Author(s):

La-or Chailurkit ◽

Boonsong Ongphiphadhanakul ◽

Noppawan Piaseu ◽

Sunee Saetung ◽

Rajata Rajatanavin

Keyword(s):

Bone Mineral Density ◽

Postmenopausal Women ◽

Biochemical Markers ◽

Bone Markers ◽

Response To Therapy ◽

Control Group ◽

Mineral Density ◽

Bone Resorption Markers ◽

Early Postmenopausal Women ◽

Markers Of Bone Turnover

Abstract Background: Markers of bone formation and resorption may be useful as early indicators of response to therapy. Our aim in this study was to investigate the use of bone markers for monitoring of intervention for bone loss in early postmenopausal women and to assess the relationships between these markers and changes in bone mineral density (BMD). Methods: Subjects were randomly assigned to the following groups: a control group; a group receiving calcium alone; groups receiving calcium plus low or conventional doses of conjugated equine estrogen; and groups receiving calcium plus low or conventional doses of calcitriol. At baseline and at 1 and 3 months after intervention, we measured serum intact osteocalcin, serum N-terminal midfragment osteocalcin, serum C-terminal telopeptide of type I collagen (CTx), urinary deoxypyridinoline cross-links, and urinary CTx. The BMD of the lumbar spine and the femoral neck was measured at baseline and after 1 and 2 years of intervention. Results: No marker changed significantly in the control group except urinary CTx, which increased at 3 months. Serum CTx decreased in all regimens at 1 or 3 months of intervention. In addition, the changes of all markers at 3 months were inversely associated with the change in the BMD of the lumbar spine at 1 or 2 years (r = −0.144 to −0.314), whereas only the changes of bone resorption markers at 3 months were inversely correlated with the changes in femoral BMD at 1 or 2 years (r = −0.143 to −0.366). Conclusions: Biochemical markers of bone turnover appear to be of use in assessing early response to therapy. Bone resorption markers, especially serum CTx, are better indicators than bone formation markers for estimating the response to intervention in early postmenopausal women. However, the early changes in bone markers were weakly related to the later changes in BMD.

Download Full-text

The effect of 1-year transdermal estrogen replacement therapy on bone mineral density and biochemical markers of bone turnover in osteopenic postmenopausal systemic lupus erythematosus patients: a randomized, double-blind, placebo-controlled trial

Osteoporosis International ◽

10.1007/s00198-003-1553-6 ◽

2004 ◽

Vol 15 (5) ◽

pp. 396-404 ◽

Cited By ~ 17

Author(s):

P. Bettembuk ◽

H. P. Bhattoa ◽

A. Balogh ◽

G. Szegedi ◽

E. Kiss

Keyword(s):

Lupus Erythematosus ◽

Biochemical Markers ◽

Estrogen Replacement Therapy ◽

Controlled Trial ◽

Estrogen Replacement ◽

Mineral Density ◽

Double Blind ◽

Double Blind Placebo ◽

Markers Of Bone Turnover ◽

Transdermal Estrogen

Download Full-text

To help practitioner: monitoring treatment of osteoporosis in study of bone mineral density on different axial densitometers

Medical alphabet ◽

10.33667/2078-5631-2019-2-37(412)-22-28 ◽

2020 ◽

Vol 2 (37) ◽

pp. 22-28

Author(s):

O. A. Nikitinskaya ◽

N. V. Toroptsova

Keyword(s):

Preventive Measures ◽

Initial Assessment ◽

Correction Factors ◽

Mineral Density ◽

Simple Method ◽

Treatment Of Osteoporosis ◽

X Ray ◽

T Score ◽

Bone Densitometer ◽

Monitoring Treatment

Dual-energy X-ray absorptiometry is recognized as the ‘gold standard’ for the diagnosis of osteoporosis. This method is used not only for the initial assessment of the state of the IPC, but also for further monitoring of treatment or preventive measures. It allows you to compare the data of a patient with successive measurements during a long observation. However, it is impossible to evaluate the results of studies in dynamics on devices of different manufacturers without standardizing indicators or introducing correction factors. A simple method for recalculating the T-score obtained on a Dexxum 3 apparatus (OsteoSys, South Korea) is presented in order to compare it with a similar indicator of a bone densitometer Lunar Prodigy (GE Healthcare, USA).

Download Full-text

Comparison of Alendronate and Intranasal Calcitonin for Treatment of Osteoporosis in Postmenopausal Women*

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.85.5.6606 ◽

2000 ◽

Vol 85 (5) ◽

pp. 1783-1788 ◽

Cited By ~ 9

Author(s):

Robert W. Downs Jr. ◽

Norman H. Bell ◽

Mark P. Ettinger ◽

Brian W. Walsh ◽

Murray J. Favus ◽

...

Keyword(s):

Lumbar Spine ◽

Femoral Neck ◽

Bone Turnover ◽

Postmenopausal Women ◽

Mineral Density ◽

Open Label ◽

Treatment Of Osteoporosis ◽

Specific Alkaline Phosphatase ◽

Bone Specific Alkaline Phosphatase ◽

Markers Of Bone Turnover

Abstract This study compared the effects of oral alendronate and intranasal calcitonin for treatment of osteoporosis in postmenopausal women. Women at least 5 yr postmenopause (n = 299) were randomized to either 10 mg alendronate, matching alendronate placebo, or open-label intranasal calcitonin 200 IU daily for 12 months. Hip and spine bone mineral density (BMD) and markers of bone turnover were measured, and safety and tolerability were assessed. Alendronate produced greater increases in BMD than calcitonin at 12 months at the lumbar spine (5.16% vs. 1.18%; P < 0.001), trochanter (4.73% vs. 0.47%; P < 0.001), and femoral neck (2.78% vs. 0.58%; P< 0.001). Changes in BMD with calcitonin were greater than with placebo at the femoral neck, but were not different from placebo at either the trochanter or lumbar spine. Greater decreases in bone turnover were seen with alendronate than with calcitonin (serum bone-specific alkaline phosphatase, 43% vs. 9%, P < 0.001; urinary N-telopeptide, 62% vs. 11%, P < 0.001). Similar percentages of patients in each group reported an adverse experience during the study. We conclude that, in postmenopausal women with osteoporosis, 12 months of therapy with alendronate produced significantly greater increases in BMD of the hip and spine and greater decreases in bone turnover than intranasal calcitonin.

Download Full-text

Markers of Bone Turnover for Monitoring Treatment of Osteoporosis with Antiresorptive Drugs

Osteoporosis International ◽

10.1007/s001980070007 ◽

2000 ◽

Vol 11 (0) ◽

pp. S66-S76 ◽

Cited By ~ 83

Author(s):

P. D. Delmas

Keyword(s):

Bone Turnover ◽

Treatment Of Osteoporosis ◽

Markers Of Bone Turnover ◽

Antiresorptive Drugs ◽

Monitoring Treatment

Download Full-text

AB0033 Association of c ? reactive protein with bone mineral density and biochemical markers of bone turnover in osteoporosis patients with rheumatoid arthritis

10.1136/annrheumdis-2001.938 ◽

2001 ◽

Author(s):

DA Gukasyan ◽

EL Nasonov ◽

RM Balabanova ◽

AV Smirnov

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Turnover ◽

Bone Mineral ◽

Biochemical Markers ◽

C Reactive Protein ◽

Mineral Density ◽

Reactive Protein ◽

Markers Of Bone Turnover

Download Full-text

Estrogen replacement may be an alternative to surgery for the treatment of osteoporosis in primary hyperparathyroidism (PHPT)

Bone ◽

10.1016/8756-3282(95)90476-x ◽

1995 ◽

Vol 16 (3) ◽

pp. 406

Author(s):

T. Diamond ◽

S. Levy ◽

C. Magarey ◽

R. Smart

Keyword(s):

Primary Hyperparathyroidism ◽

Estrogen Replacement ◽

Treatment Of Osteoporosis

Download Full-text

Compromised Volumetric Bone Density and Microarchitecture in men with Congenital Hypogonadotropic Hypogonadism

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab169 ◽

2021 ◽

Author(s):

Agnès Ostertag ◽

Georgios E Papadakis ◽

Corinne Collet ◽

Severine Trabado ◽

Luigi Maione ◽

...

Keyword(s):

Bone Markers ◽

Bone Structure ◽

Hypogonadotropic Hypogonadism ◽

Quantitative Computed Tomography ◽

Hormonal Treatment ◽

Mineral Density ◽

Trabecular Microarchitecture ◽

Trabecular Thickness ◽

Congenital Hypogonadotropic Hypogonadism

Abstract Context Men with Congenital Hypogonadotropic Hypogonadism (CHH) and Kallmann syndrome (KS) have both low circulating testosterone and estradiol levels. Whether bone structure is affected remains unknown. Objective To characterize bone geometry, volumetric density and microarchitecture in CHH/KS. Design Cross-sectional study. Setting One tertiary academic French center. Patients and Controls 51 genotyped CHH/KS patients and 40 healthy volunteers were included. Ninety-eight percent of CHH/KS men had received testosterone and/or combined gonadotropins. Intervention(s) High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT), Dual X-ray absorptiometry (DXA) and measurement of serum bone markers. Main Outcome Volumetric bone mineral density (vBMD), cortical and trabecular microarchitecture. Results CHH and controls did not differ for age, BMI, vitamin D and PTH levels. Despite long-term hormonal treatment (10.8 ± 6.8 years), DXA showed lower areal BMD in CHH/KS at lumbar spine, total hip, femoral neck and distal radius. Consistent with persistently higher serum bone markers, HR-pQCT revealed lower cortical and trabecular vBMD as well as cortical thickness at the tibia and the radius. CHH/KS men had altered trabecular microarchitecture with a predominant decrease of trabecular thickness. Moreover, CHH/KS men exhibited lower cortical bone area, whereas total and trabecular areas were higher only at the tibia. Earlier treatment onset (before the age of 19 years) conferred a significant advantage for trabecular bone volume/tissue volume and trabecular vBMD at the tibia. Conclusion Both vBMD and bone microarchitecture remain impaired in CHH/KS men despite long-term hormonal treatment. Treatment initiation during adolescence is associated with enhanced trabecular outcomes, highlighting the importance of early diagnosis.

Download Full-text