The Effects of Ficus Carica Fruit on Bone Markers and Oestrogen Level of Post-Menopausal Osteoporotic Rats

@#Introduction: Post-menopausal osteoporosis is the most common type of osteoporosis, which occurs due to a deficiency of oestrogen following menopause. Considering the adverse effects of oestrogen replacement therapy, natural products may serve to replace the current conventional treatment. Ficus carica (FC) which is commonly known as fig may have a potential in treating post-menopausal osteoporosis due to their abundance of important minerals and bioactive compounds such as phenolic, flavonoid and anthocyanins. This study aimed to evaluate the effects of FC on bone metabolism of ovariectomized rats. Materials and Methods: Fifty-six female Spraque-Dawley rats were randomly divided into seven groups; SHAM operated (SHAM), ovariectomized control (OVX), ovariectomized + 64.5 µg/kg oestrogen (ERT), ovariectomized + 50 mg/kg aqueous extract of FC (AQ50), ovariectomized + 100 mg/kg aqueous extract of FC (AQ100), ovariectomized + 50 mg/kg raw FC (RW50), and ovariectomized + 100 mg/kg raw FC (RW100). After eight weeks of treatments, rats were euthanized and femurs were dissected out to measure bone osteocalcin, Ctelopeptide of type 1 collagen and bone estrogen level. Results: RW50 and RW100 showed an increasing trend in osteocalcin levels and also oestrogen level, but no significant difference between all groups. RW50 and RW100 also showed significantly reduced C-telopeptide of type 1 collagen levels compared to OVX group. Conclusion: These findings suggested that raw FC at the doses of 50 mg/kg and 100 mg/kg have potential to improve bone in treating post-menopausal osteoporosis. However, this need to be confirmed with higher doses.

Serum Procollagen Type I N-Terminal Propeptide and Osteocalcin Levels in Korean Children and Adolescents

PURPOSE: Bone markers can be useful for the diagnosis and treatment of skeletal diseases in children and adolescents. Owing to high skeletal growth velocity and rapid bone turnover, children and adolescents have higher bone marker levels than adults. Thus, a valid age- and sex-specific reference should be established for pediatric populations living in similar environments. We aimed to assess the associations of procollagen type I N-terminal propeptide (P1NP) and osteocalcin with age and sex in a group of healthy Korean children and adolescents. MATERIALS AND METHODS: The participants (290 boys and 290 girls, age range 0–18 years) were Korean outpatients. Serum P1NP and osteocalcin levels were measured in control materials and patient samples by electrochemiluminescence immunoassay using an automated Cobas e411 analyzer. RESULTS: Significant age-dependent variations in bone marker levels were observed in both sexes (p<0.001). The highest P1NP levels were observed during the first year of life; thereafter, levels decreased until puberty. There was no postnatal peak for osteocalcin; however, its levels remained higher than the adult reference range throughout childhood. Significant differences were observed between boys and girls (p<0.05), especially between the ages of 12 and 17 years. Cobas e411 results for P1NP showed satisfactory precision and linearity. CONCLUSION: We established reference data for P1NP and osteocalcin levels in healthy Korean children and adolescents, as the first and only study of these parameters in pre-adulthood in Korea. Cobas e411-quantified bone markers may be useful for determining bone metabolism indices.

Cellular zinc deficiency inhibits the mineralized nodule formation and downregulates bone-specific gene expression in osteoblastic MC3T3-E1 cells / 한국영양학회지

PURPOSE: Zinc (Zn) is an essential trace element for bone mineralization and osteoblast function. We examined the effects of Zn deficiency on osteoblast differentiation and mineralization in MC3T3-E1 cells. METHODS: Osteoblastic MC3T3-E1 cells were cultured at concentration of 1 to 15 µM ZnCl2 (Zn− or Zn+) for 5, 15 and 25 days up to the calcification period. Extracellular matrix mineralization was detected by staining Ca and P deposits using Alizarin Red and von Kossa stain respectively, and alkaline phosphatase (ALP) activity was detected by ALP staining and colorimetric method. RESULTS: Extracellular matrix mineralization was decreased in Zn deficiency over 5, 15, and 25 days. Similarly, staining of ALP activity as the sign of an osteoblast differentiation, was also decreased by Zn deficiency over the same period. Interestingly, the gene expression of bone-related markers (ALP, PTHR; parathyroid hormone receptor, OPN; osteopontin, OC; osteocalcin and COLI; collagen type I), and bone-specific transcription factor Runx2 were downregulated by Zn deficiency for 5 or 15 days, however, this was restored at 25 days. CONCLUSION: Our data suggests that Zn deficiency inhibits osteoblast differentiation by retarding bone marker gene expression and also inhibits bone mineralization by decreasing Ca/P deposition as well as ALP activity.

Effects of Alendronate Sodium on Bone Mineral Density and Bone Marker in Prostate Cancer Elderly Pa-tients after Medical Castration Therapy / 中国药房

OBJECTIVE:To explore the effects of alendronate sodium on bone mineral density (BMD) and bone marker in prostate cancer elderly patients after medical castration therapy. METHODS:In perspective study,84 elderly patients undergoing medical castration therapy were selected and divided into treatment group(45 cases)and control group(39 cases)according to ran-dom number table. Control group received medical castration therapy+Calcium carbonate D3 tablets,1 tablet,po,qn;treatment group was additionally given Alendronate sodium tablets 70 mg,po,once a week,1 week after routine treatment,on the basis of control group. Treatment course of 2 groups lasted for 12 months. The levels of 25-OH-D,testosterone,BMD and bone marker were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:3 cases of treatment group and 1 case of control group dropped out of the study. Before treatment,there was no statistical significance in above indexes between 2 groups (P>0.05). After treatment,25-OH-D levels of 2 groups were increased slightly,but there was no statistical significance(P>0.05);tes-tosterone level of 2 groups were decreased significantly compared to before treatment,with statistical significance (P0.05). CONCLUSIONS:Alendronate sodium can prevent bone loss and reduce the rate of bone turnover in elderly patients with prostate cancer receiving medical castration therapy.

Bone turnover increases during supervised treadmill walking in Thai postmenopausal women

INTRODUCTION: Treadmill walking is a cheap and attainable form of exercise, which carries a low injury risk and confers other health benefit. The aim of this study is to investigate the effects of 3-month treadmill walking on biochemical bone markers in Thai postmenopausal women. MATERIAL AND METHODS: Thai postmenopausal women participated in a 3-month supervised treadmill walking program. The program consisted of treadmill walking, the intensity of which was 55-70% of maximal heart rate, with duration of 30 min per day, at a frequency of 3 days a week. Crosslinked C-terminal telopeptides of type I collagen (CTX-I) and N-terminal propeptides of type I procollagen (PINP) level were measured at baseline and at 1 week after 3-month training. RESULTS: Eighteen women completed the training program. The average age of patients was 59.39 ± 4.18 years. The average period after menopause was 9.28 ± 6.52 years. CTX-I and PINP levels at baseline were 0.43 ± 0.14 and 52.15 ± 13.43 ng/ml. CTX-I and PINP levels after 3-month training were 0.80 ± 0.26 and 66.77 ± 22.82 ng/ml. Bone resorption and formation markers were significantly increased after treadmill walking (p < 0.01). CONCLUSIONS: Bone turnover increases after 3-month supervised treadmill walking in Thai postmenopausal women.

Effect of Danhong injection on serum levels of bone markers and healing time in postoperative patients with tibial fractures / 中国生化药物杂志

Objective To analyse effect of Danhong injection on serum levels of bone markers and healing time in postoperative patients with tibial fractures.Methods 52 patients who were diagnosed with tibial fractures in our hospital were collected and randomly divided into control group and experimental group.All patients were treated with intramedullary nailing.After the operation, on the basis of routine treatment, patients in control group were treated with ossotide injection 50 mg, dissolved in 250 mL 0.9% sodium chloride solution, one times per day.Patients in experimental group was treated with Danhong injection 20 mL, dissolved in 250 mL 0.9% sodium chloride solution, one times per day.14 days for one period of treatment, two groups were treated for two cycles.After the treatment,the serum levels of bone Gla-protein (BGP), carboxyterminal propeptide of typeⅠprocollagen (PICP), bone alkaline phosphatase (BALP) and the racture healing time were detected in all patients.Results Compared with control group post-treatment, the serum BGP and PICP levels were higher in experimental group (P<0.05);the serum BALP level was higher in experimental group (P<0.05); the average fracture healing time of the patients in experimental group was shorter (P<0.05).Conclusion Danhong injection can significantly increase the serum BGP, PICP and BALP level in postoperative patients with tibial fractures, shorten fracture healing time.

Effects of a safflower tea supplement on antioxidative status and bone markers in postmenopausal women

We conducted this study to examine the effects of safflower seed granular tea containing physiologically active polyphenols on antioxidative activities and bone metabolism. Forty postmenopausal women ages 49 to 64-years were recruited from Daegu and Gyeongbuk and were randomly assigned to either a safflower tea supplement (Saf-tea) group (n = 27) or a placebo group (n = 13). The Saf-tea group received 20 g of safflower seed granule tea per day containing a 13% ethanol extract of defatted safflower seeds, whereas the placebo group received a similar type of tea that lacked the ethanol extract. No significant changes in nutrient intake for either the placebo or Saf-tea groups were observed before or after the study period, except vitamin A intake increased after 6 months in the Saf-tea group. Dietary phytoestrogen intakes were similar in the Saf-tea group (60.3 mg) and placebo group (52.5 mg). Significant increases in plasma genistein and enterolactone were observed in the Saf-tea group. After 6 months of supplementation, serum levels of antioxidant vitamins such as alpha-tocopherol and ascorbic acid increased significantly, and TBARS levels decreased in the Saf-tea group compared to the placebo group. Serum osteocalcin levels were reduced (P < 0.05) in the Saf-tea group after 6 months, whereas serum osteocalcin did not change in the placebo group. Urinary deoxypyridinoline/creatinine excretion was not different between the two groups at baseline, and did not change in either group after 6 months. Bone mineral density decreased significantly in the placebo group (P < 0.01) but not in the supplemented group. It was concluded that polyphenols (72 mg/day), including serotonin derivatives, in the Saf-tea had both antioxidant and potential bone protecting effects in postmenopausal women without liver toxicity.

Relationship between serum leptin level and bone mineral density and bone markers in postmenopausal women / 대한산부인과학회지

OBJECTIVE: This study was performed to prove the relationship between serum leptin level and bone mineral density of lumbar spine, femur neck and bone markers in postmenopausal Korean women. METHODS: We measured serum leptin, serum osteocalcin, urine deoxypyridinoline levels and bone mineral density of lumbar spine, femur neck in 88 premenopausal and 118 postmenopausal women who visited St. Vincent Hospital of Catholic University of Korea from March 1st, 2007 to December 31th, 2007. RESULTS: Statistically significant correlation was shown between serum leptin level and body mass index (BMI) in both premenopausal (r= 0.343, P<0.0001) and postmenopausal women (r=0.360, P<0.0001). And no significant correlation was observed between serum leptin level and bone mineral density (BMD) of lumbar spine and femur neck in premenopausal women (r=0.013, P=0.107 and r=0.004, P=0.425, respectively), but in postmenopausal women, there was a positive correlation between serum leptin and lumbar spinal BMD (r=0.085, P=0.02). But after the adjustment with age and BMI, the serum leptin and BMD of lumbar spine did not showed a significantly correlation in the same group (r=0.088, P=0.939). Also, no significant correlations were observed between serum leptin level and serum osteocalcin and urine deoxypyridinoline in premenopausal (r=0.004, P=0.566 and r=0.002, P=0.707, respectively) and postmenopausal women (r=0.026, P=0.096 and r=0.000, P=0.933, respectively). CONCLUSIONS: In our study, there is no significant correlation between serum leptin level and bone mineral density and bone markers in premenopausal and postmenopausal Korean women. Our own data would suggest that leptin has both negative and positive effects in bone mass regulation. Furthermore, larger clinical studies are necessary to clarify leptin's role to assess the contribution of the central and peripheral role of leptin in the overall maintenance of bone turnover.

The Relationship of Subclinical Hypothyroidism with Bone Mineral Density and Biochemical Bone Markers in Postmenopausal Women

BACKGROUND: It is well recognized that thyroid hormone stimulates bone turnover, increasing bone resorption, thus affecting bone mineral density, but few data are available on untreated subclinical hypothyroidism. The aim of this study was to examine whether bone mineral density is increased in postmenopausal subclinical hypothyroidism patients compared with postmenopausal normal thyroid function women, and to evaluate the relationship between thyroid hormones (TSH, FT(4)) and bone mineral density or various biochemical markers of bone metabolism. METHODS: This was a cross sectional study of 132 postmenopausal women aged from 51 to 70 who undertook health screening program in Pundang CHA general hospital from 1996 to 2001. They were divided into two groups; subclinical hypothyroidism group (n=52) and normal thyroid function group (n=80) matched by age. RESULTS: The total bone mineral density was significantly increased in the subclinical hypothyroid group than in the normal group (P<0.05). The serum osteocalcin was lower in the subclinical hypothyroidism group (P<0.05), but neither the alkaline phosphatase nor the deoxypyridinoline showed any significance. For all participants in this study, TSH, but not FT(4), exhibited significant correlation with the total bone mineral density (r=0.188, P<0.05), and with the osteocalcin (r=-0.191, P<0.05). Multiple regression analysis identified the TSH as an independent predictor of the total bone mineral density (beta=0.0410; P< 0.05). CONCLUSION: This study indicated that subclinical hypothyroidism is one of the factors which can elevate bone mineral density in postmenopausal women.

The Increment of Bone Density in Patients with Spinal Cord Injury after Alendronate Therapy

OBJECTIVE: The aim of this study was to investigate the changes of bone mineral density (BMD) according to the postinjury duration, walking ability, and to assess the effect of oral alendronate therapy on BMD and biochemical markers in patients with spinal cord injury. METHOD: Forty-eight subjects with spinal cord injury were enrolled. One tablet of Alend(R) (10 mg of sodium alendronate) was administered daily for 6 months. After this, all subjects received placebo for 6 months as the same manner. The baseline quantitative assessments of BMD and biochemical bone markers, serum osteocalcin and C-terminal telopeptide of type I collagen (ICTP), were performed before the administration of drug. The follow up assessments were performed at 6 and 12 months after drug and placebo administration. RESULTS: The patients treated with oral alendronate showed significantly higher BMD of femur compared with baseline (p <0.05). Also, ICTP showed significant reduction after alendronate therapy. BMD change rate of alendronate therapy was higher in functional ambulation group compared with wheelchair ambulation group. BMD change rate of alendronate therapy was higher than that of placebo administration. CONCLUSION: Alendronate therapy may be useful in prevention of loss of BMD after spinal cord injury.

Effects of Pamidronate Treatment on Osteogenesis Imperfecta / 대한내분비학회지

BACKGROUND: Osteogenesis imperfecta (OI) is a congenital disorder of type I collagen, with variable phenotypes, due to increased bone fragility and low bone mass. Previous pharmacological treatments for OI have been attempted with calcitonin and growth hormone but with little beneficial effects. Recently, Glorieux reported the beneficial effects of bisphosphonates in OI. METHODS: In this study, the effects of pamidronate treatment were evaluated in 9 patients with OI. All patients received intravenous pamidronate infusions, which was dose adjusted according to the patients' age. The outcome measures included the biochemical bone markers; serum alkaline phosphatase, urine deoxy-pyridinoline, urine Ca/Cr ratio, and bone mineral density (BMD). RESULTS: Serum alkaline phosphatase, urine deoxypyridinoline, and urine Ca/Cr ratio were slightly decreased after 1 year of therapy, although these changes were not statistically significant. The BMDs of the lumbar spine and proximal femur were significantly increased after 1-year of pamidronate treatment. No fractures were reported during the 1 year treatment periods. CONCLUSION: Pamidronate treatment had an effect on the BMD in osteogenesis imperfecta, probably due to decreasing bone resorption

The Effects of Alendronate in Bone Metabolism of Primary Osteoporosis / 대한내분비학회지

BACKGROUND: To evaluate the effects of alendronate in preventing bone loss at the spine and hip in Korean cases of primary osteoporosis, we treated 138 patients with 10 mg of alendronate daily. Of the 138 patients treated, 50 were treated for one complete year, and at their final visit, measurements were taken to assess the completed outcome of the reatment, and the results from this small group were compared with those of the rest. The way this has been written causes ambiguity concerning exactly who was being studied. Check that my rewrite of this section conveys correctly the group that was studied, and how. METHODS: The serum levels of calcium(Ca) and phosphorous(P), total alkaline phosphatase(ALP), the urine calcium creatinine ratio(Uca/cr) and urine deoxypyridinoline(DPD) were measured before, during, and after the 1 year treatment period. The bone mineral densities(BMDs) at the spine and hip were also measured before and after the treatment period. New clinical fractures and side effects, were evaluated during the treatment period. RESULTS: The total serum ALP and urine DPD were decreased significantly, after the treatment period, by 38.3 and 40.5% respectively. The bone mineral density at the spine and hip were significantly increased after 1 year, by 6.7 and 2.0%, respectively. Of the 50 subjects who had completed a full year of treatment, only 4(8%) had developed new clinical fractures. Of the 138 patients who had been treated, 8(5.8%) discontinued the medication due to side effects. Of these, 7 had gastrointestinal symptoms, and 1 had skin eruption. CONCLUSION: Alendronate significantly decreased the total serum ALP and urine DPD and significantly increased spine and hip bone mineral density. Alendronate 10mg was effective in preventing bone loss in Korean cases of primary osteoporosis.

Effects of Estrogen Receptor Polymorphisms on Bone Markers and Serum Lipid Levels / 대한진단검사의학회지

BACKGROUND: In post-menopausal women, osteoporosis and cardiovascular diseases which are partly due to estrogen deficiency, occur more common than in pre-menopause women. Estrogen action is supposed to be mediated by an estrogen receptor (ER) and two polymorphisms of the ER gene in particular, Pvu II and Xba I, have been described for several years for genetic association studies. Authors have investigated the frequencies and patterns of the ER gene polymorphisms and their association with bone markers and lipid levels. METHODS: For 121 women who visited the health promotion center of Kyungpook National University Hospital, the ER gene polymorphisms were determined by the Pvu II and Xba I restriction enzymes following polymerase chain reaction. RESULTS: The distributions of ER Pvu II and Xba I restriction fragment length polymorphisms were as follows: PP 15.7%, Pp 47.9%, pp 36.4% and XX 5.8%, Xx 31.4%, xx 62.8%, respectively. And in a combination of two polymorphisms, ppxx was the most common, followed by PpXx, Ppxx, PPXx, PPXX and PPxx in that order. No significant genotypic differences were found in bone mineral density, bone markers and menopausal status. LDL cholesterol and triglyceride levels were significantly different by genotypes in premenopausal women (P<0.05). CONCLUSIONS: The results suggest that ER polymorphisms might be associated with LDL cholesterol and triglyceride levels. Further evaluation in a larger population would be helpful to determine the effects of ER polymorphisms on lipid metabolism and therapeutic trial for cardiovascular diseases in women.

Changes of bone mineral density after 2-yrs treatment with HRT and alendronate in osteoporotic Korean women

BACKGROUND: Alendronate is one of the anti-resorptive drugs for the treatment of osteoporosis and results in a decrease of bone turnover. HRT is also known to decrease the bone turnover. Combination therapy with HRT and alendronate has made significant increase of BMD in postmenopausal women. But there were no available long-term results about combination therapy of HRT and alendronate on Korean osteoporotic women. METHODS: Eighty postmenopausal women with osteoporosis who visited the Climacteric clinic in Samsung Cheil Hospital & Women's Health Care Center from Apil to July 1999 were subjects. Randomized open labeled case control study was made. We evaluated 37 postmenopausal osteoporotic Korean women who were treated for 2 years after enrollment. Subjects in Group I were treated with HRT only, and group II had HRT with alendronate 10 mg daily. Subjects also were measured BMD at lumbar spine and markers of bone turnover before, one and two year after treatment. RESULTS: Common reasons for dropouts were side effects of HRT such as breast tenderness, irregular vaginal bleeding, economic problems, long distance from clinic etc. BMD in lumbar spine was increased 10.1% in the first year, and 12.0% in the second year in subjects treated with HRT and alendronate. But in HRT only group BMD increased to 6.4% in the first year and 7.8% at second year. Markers of bone turnover were decreased significantly in both groups compared with baseline value, but the percent changes of markers after 1 year and 2 years between the two groups were not significant. CONCLUSION: This study demonstrated that, in postmenopausal Korean women with osteoporosis, 2 years of combination therapy with HRT and alendronate resulted in a significant and sustained increase in spinal BMD than HRT only group.

Changes of Bone Mineral Density and Biochemical Bone Markers during Perimenopausal Period for Healthy Women: Retrospective Cohort Study

BACKGROUND: Although it is well known that bone mineral density (BMD) loss occurs after menopausal transition, there are only few previous studies that describe differences of BMD and biochemical bone markers in women of pre- and postmenopausal periods. The purpose of this study was to find factors that contribute to loss of BMD after menopause and to show changes of BMD and biochemical bone markers during pre- and postmenopausal periods by retrospective cohort study. METHODS: This retrospective cohort study was performed from Jan. 1995 to Jan. 2001 at a health promotion center. Twenty one healthy perimenopausal women were enrolled. BMD and biochemical bone markers were checked more than two times during the study period. Changes of BMD and biochemical bone markers between pre- and postmenopausal state were compared by paired t-test. Pearson correlation and multiple regression were performed to find the contributing factors to loss of BMD after menopause. RESULTS: Postmenopausal BMD (164.65 36.34 mg/cm3) was significantly decreased to 16.49 16.91 mg/cm3 (P<0.001) as compared with premenopausal BMD (181.14 40.81 mg/cm3). In biochemical bone markers only urine deoxypyridinoline had a significant difference (3.30 3.97 nMDP/mMcre, P<0.05) Only premenopausal BMD contributed to decreasing rate of BMD between the two states and the loss of BMD after menopause (P<0.05). CONCLUSION: In perimenopausal healthy women, postmenopausal BMD was significantly decreased as compared with premenopausal BMD. And only premenopausal BMD was shown to be a contributing factor to decreasing rate of BMD between the two states and the loss of BMD after menopause. It suggests that premenopausal BMD is important in predicting postmenopausal osteoporosis and efforts to prevent loss of BMD before menopause can prevent progress of postmenopausal osteoporosis.

Relationship between vitamin D receptor gene polymorphism, and bone mineral density in postmenopausal Korean women / 대한산부인과학회잡지

OBJECTIVE: To investigate the relationship between vitamin D receptor (VDR) gene polymorphisms and bone mineral density (BMD) in postmenopausal Korean women, and to evaluate if VDR gene polymorphisms are associated with serum levels of 1,25 (OH)2 vitamin D3 and bone turnover markers METHODS: The BsmI, TaqI, ApaI, and FokI polymorphisms were analyzed by restriction fragment length polymorphism in 443 postmenopausal Korean women. Serum CrossLaps (CTX), bone alkaline phosphatase (BAP), osteocalcin and 1,25 (OH)2 vitamin D3 levels were measured by enzyme linked immunosorbent assay and immmunoassay and BMD at the lumbar spine and proximal femur by dual energy X-ray absorptiometry. RESULTS: BMD at the femoral neck and Ward' triangle in women with the Bb, and Tt genotype (uppercase letters signifying the absence and lowercase letters the presence of the restriction site) was lower than that in women with the bb, and tt genotype respectively. Haplotype analysis showed that BbTt genotype had lower BMD at all skeletal sites than bbtt genotype. No significant association between adjusted BMD at any skeletal site and the FokI or ApaI genotypes was observed. There were no significant associations between the adjusted levels of the bone markers and 1,25 (OH)2 vitamin D3 and single or combined genotypes. CONCLUSION: The VDR gene BsmI, and TaqI polymorphisms are genetic factors which may affect BMD at the lumbar spine and proximal femur in postmenopausal Korean women, but does not affect serum levels of 1,25 (OH)2 vitamin D3 and bone turnover markers.

A Comparison of the effect of Synthetic Hormone Replacement therapy on Bone Mineral Density and Biochemical markers of Bone metabolism / 대한산부인과학회잡지

OBJECTIVE: To determine the effect of hormone replacement therapy on bone mineral density and biochemical marker of bone metabolism in postmenopausal women receiving hormone replacement therapy. METHOD: We have treated two groups of menopausal women for 4 years; Group 1 received Conjugated Equine Estrogen 0.625 mg (Premarin(R)); Group 2 received Cyclic combined therapy, estrogen and progestin, (Premarin(R) 0.625 mg per day, Provera(R) 10mg per day for 12days), Group 1 was hysterectomized women, received Conjugated Equine Estrogen 0.625 mg per day. We compared the change of bone marker, osteocalcin and bone mineral density during therapy. RESULT: The data demonstrated a beneficial effect in bone marker, osteocalcin decreased in two groups from the baseline values. And hormone replacement therapy shows the beneficial effect in bone mineral densities. Spine BMD increased in two groups by 3.67%, 3.04% after 4years. Femur BMD increased in two groups by 5.34%, 5.25% from the initial value after 4 years. CONCLUSION: Our study results suggest that single estrogen therapy and cyclic combined therapy have benificial effect on increased BMD and decreased bone marker, osteocalcin. Their effects were not signigicantly different between two groups.

The Usefulness of Biochemical Markers of Bone turnover for Bone Mineral Density in Early Postmenopausal Women Treated with Hormone Replacement or Calcium Supplementation / 대한산부인과학회잡지

OBJECTIVE: To identify the effectiveness of bone turnover indexes for bone loss or gain in early postmenopausal women. METHOD: This study was performed in 240 menopausal women(mean age, 50 yr), who were randomized to hormone replacement therapy(HRT) or calcium supplementation(CS, 500mg/day) for 1yr. Urinary N-telopeptide(NTx) and osteocalcin(OC), as well as spine and femoral neck bone mineral density(BMD) were measured at baseline and 1, 3, 6, 12 months after treatment. RESULTS: Women receiving HRT(n=110) showed a significant increase in spine BMD(+2.6%; P<0.0001) and hip BMD(+1.1%; P<0.05) compared to women receiving CS, who showed a decline at both sites (-1.0%; P<0.01). Both markers showed time dependent decreases in women receiving HRT(P<0.001) and no change in women receiving calcium alone. When baseline indexes of turnover were divided by quartile, there was a significantly greater increase in BMD among those with the highest NTx, OC levels compared to that in those with the lowest NTx, OC levles(P<0.05). When subjects receiving HRT were compared by their positive or negative skeletal response at 1yr and their baseline turnover marker, initial NTx values were significantly higher in those that gained bone than in those that lost bone (P<0.001). Calcium supplementation women in the highest quartile for NTx at baseline had significantly greater decreases in spine BMD than subjects with the lowest NTx values(P<0.005). CONCLUSIONS: For early postmenopausal women there are differential responses of biochemical markers to HRT and calcium supplementation. Baseline urinary NTx and serum osteocalcin were good predictors of change in spine BMD after 1yr of either HRT or calcium supplementation. It is concluded that markers of bone formation and resorption can be used clinically to predict future BMD in early postmenopausal women.

Changes of markers of bone turnover and spinal BMD after 1 year treatment according to treatment strategies & predictability of changes of BMD by changes of bone markers in Korean postmenopausal women with osteoporosis

BACKGROUND: Increased BMD after treatment means that the treatment regimen was effective to prevent fracture associated with osteoporosis. But changes of BMD reflected at least after 1 year. Now we use markers of bone turnover more easily, and they reflects bone metabolism faster than BMD within 3 4 months. Some data showed that changes of bone markers after 3 months could predict the changes of the BMD after 1 year. METHODS: 126 postmenopausal Korean women with osteoporosis were evaluated who visited Samsung Cheil hospital from Aug. 1997 to July 2000, with respect to markers of bone turnover and BMD at lumbar spine. Subjects were classified into 3 groups, HRT only group, HRT with alendronate group and HRT with calcitonin group. To evaluate the effectiveness of treatment regimen, we compared changes of markers after 3 months and changes of spinal BMD after 1 year treatment among 3 groups. And also evaluate the predictability of the changes of markers of bone turnover after 3 months about the changes of spinal BMD, multiple regression analysis were made. RESULTS: Our results showed those findings 1. Percent changes of markers of bone turnover decreased significantly compared with baseline(osteocalcin 30.4 53.4%, total alkaline phosphtase 26.7 20.0%, deoxypyridinoline 19.0 30.1%, and mean percent changes of markers among three groups showed no significant differences. 2. No significant relationships were noted between percent changes of spinal BMD and percent changes of markers of bone turnover. 3. Percent changes of BMD at lumbar spine were increased significantly after 1 year treatment(HRT only 5.6 3.6%, HRT with calcitonin 7.8 4.5%, HRT with alendronate 9.8% 4.7%). CONCLUSION: These results made conclusion that changes of markers of bone trunover after 3 months couldn't predict the changes of spinal BMD after 1 year treatment. But, HRT with antiresorptive agents may be effective in treating postmenopausal osteoporotic Korean women.

The changes of bone mineral density and biochemical bone markers after GnRH agonist treatment in patients with endometriosis / 대한산부인과학회잡지

OBJECTIVE: To investigate the basal bone mineral density(BMD)s of the lumbar spine and femur of patients with endometriosis, and the changes of BMDs and biochemical bone markers after 6 months of gonadotropin releasing hormone(GnRH) agonist treatment. METHODS: The initial BMDs of 35 women with endometriosis were measured by dual energy x-ray absorptiometry at department of obstetrics & gynecology Yongsan Hospital, College of Medicine, Chung Ang University from April 1996 to May 1999. 19 patients of these group was repeatedly measured after 3.6mg subcutaneous depot injection of goserelin(Zoladex) every 4 weeks for 24 weeks. Osteocalcin and Deoxypyridinoline were measured before goserelin treatment, at 3 months, and at 6 months completion of goserelin treatment. RESULTS: Patients with endometriosis did not show the significant difference in mean BMD of lumbar spine and femur in comparison with age matched normal women. Patients treated with goserelin for 6 months showed 0.064+/-0.030g/cm2(5.56%) decrease of BMD in lumbar spine, 0.038+/-0.040g/cm2(3.85%) decrease in femur neck, 0.055+/-0.047g/cm2(6.10%) decrease in Ward triangle, 0.041+/-0.031g/cm2(5.19%) decrease in femoral trochanter. These data had statistical significance(p<0.001). At first 3 months and on completion of 6 months goserelin treatment, there were increase of 66.1%, 122.3% in serum osteocalcin respectively, and increase of 35.2%, 39.6% in urine deoxypyridinoline respectively, compared with pretreatment value. CONCLUSION: From these results, it is concluded that the BMDs of patients with endometriosis were normal, and after 6 months GnRH agonist treatment, bone loss was 3.85%-6.10%, and the values of biochemical bone markers were increased.