Korean J Bone Metab > Volume 8(2); 2001 > Article
Korean Journal of Bone Metabolism 2001;8(2):131-145.
Clinical Usefulness of Biochemical Markers of Bone Turnover for Early Prediction the Response of Treatment in Patients with Postmenopausal Osteoporosis
폐경 후 골다공증 환자에서 치료 반응의 조기 예측을 위한 생화학적 골표지자의 임상적 유용성
김상완,권성희,신찬수,박경수,김성연,조보연,이홍규
서울대학교 의과대학 내과학교실
Abstract
Objective
s: This study was to see whether a early reduction in biochemical markers of bone turnover could predict the increment of bone mineral density after long-term treatment with antiresoptive agent to postmenopausal women.
Methods
We reviewed the medical records of 107 women with postmenopausal osteoporosis who visited to Seoul National University from February 1997 to April 2001. Seventy nine women of them were treated with conjugated estrogen 0.625 mg and continuous or cyclic medoxyprogesterone 2.5~10 mg per day and twenty eight patients were treated with alendronate 10 mg per day or etidronate 400 mg per day with on-14 days and off-75 days. Bone mineral density (BMD) was measured at baseline and 12th month and biochemical bone markers; serum osteocalcin or urine type I collagen N-telopeptide or urine deoxypyridinoline, were measured at baseline, 3rd or 6th month after antiresorptive treatment.
Results
Both serum osteocalcin and urine type I collagen N-telopeptide were decreased significantly at 3rd and 6th month, and urine deoxypyridinoline were decreased significantly at 6th month in total patients. At 12th month, BMD was significantly increased at lumbar spine, femur neck, femur trochanter and Ward's triangle. In total patients, reduction of type I collagen N-telopeptide at 3rd and 6th month and osteocalcin at 6th month after treatment significantly correlated with increment of BMD at 12th month after treatment in lumbar spine, femur neck, femur trochanter and Ward's triangle. In women treated with estrogen, there were significant correlation between reduction of type I collagen Ntelopeptide at 3rd month and increment of BMD in femur neck (n=36, r=-0.550, p<0.01) and Ward's triangle (n=34, r=-0.378, p<0.05), and between osteocalcin at 6th month and Ward's triangle (n=38, r=-0.343, p<0.05). In women treated with bisphosphonate, there were significant negative correlation between changes of type I collagen N-telopeptide at 3rd month and c
Key Words: Biochemical markers of bone turnover, Bone mineral density, Type I collagen N-telopeptide, Antiresorptive treatment


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