Relationship Between Depression Anxiety Stress Scale (DASS) and Urinary Hydroxyproline and Proline Concentrations in Hospital Workers / 예방의학회지

OBJECTIVES: Although increased reactive oxygen species (ROS) is caused by stress accelerates collagen degradation, there was no data on the relationship between stress and urinary hydroxyproline (Hyp) and proline (Pro), a good marker of collagen degradation. The purpose of this study was to evaluate the relationship between depression, anxiety, and stress (DAS) and concentrations of urinary Hyp and Pro. METHODS: 97 hospital employees aged 20 to 58 were asked to fill out comprehensive self-administrated questionnaires containing information about their medical history, lifestyle, length of the work year, shit-work and DAS. Depression Anxiety Stress Scale (DASS) was applied to evaluate chronic mental disorders. Urine samples were analyzed using High Performance Liquid Chromatography (HPLC) with double derivatization for the assay of hydroxyproline and proline. RESULTS: The mean value of Hyp and Pro concenturation in all subjects was 194.1+/-113.4 micromol/g and 568.2+/-310.7 micromol/g. DASS values and urinary Pro concentrations were differentiated by sex (female > male, p others, p < 0.05). In the stepwise multiple linear regressions, urinary Hyp and Pro concentrations were influenced by stress (Adjusted r2 = 0.051) and anxiety and job (Adjusted r2 = 0.199), respectively. CONCLUSIONS: We found that stress and anxiety were correlated with urinary Hyp and Pro concentrations. To identifying a definite correlation, further study in large populations will be needed.

Comparação dos efeitos do TENS e dos exercícios terapêuticos sobre os níveis de hidroxiprolina na urina em síndrome do impacto no ombro / Comparison of the effects of TENS and exercises therapy effects on hydroxyproline levels in urine on shoulder pain

Objetivo: Comparar os efeitos da neuroestimulação elétrica transcutânea (TENS) e cinesiologia aplicada, assim como esta isolada, na excreção urinária em indivíduos com a síndrome do impacto do ombro (SIO). Métodos: Participaram do estudo dois grupos de 35 indivíduos cada, sendo 30 mulheres e 40 homens, com idade entre 45 e 60 anos. O grupo controle realizou a cinesiologia aplicada e o grupo experimental realizou o tratamento TENS associado à cinesiologia aplicada. Para a mensuração da hidroxiprolina na urina foi utilizado o protocolo de colorimetria. A coleta urinária foi feita na 1ª, 5ª e 10ª sessão. O tratamento foi realizado em 10 sessões de 55 minutos. O tratamento estatístico utilizado foi feito através da análise de variância One Way (ANOVA). Resultado: Não houve melhora significativa como indicado por F = 0,662, p > 0,05. Conclusão: Os resultados mostraram não haver interação significativa entre os tipos de tratamento com a excreção urinária de hidroxiprolina. Contudo, os resultados obtidos das variáveis mostraram uma forte tendência à melhora, apresentando um resultado mais efetivo no grupo que utilizou somente a cinesiologia aplicada até a quinta sessão e, posteriormente, com uma tendência mais efetiva no grupo que utilizou a cinesiologia aplicada + TENS. O estudo mostrou, também, um resultado mais eficiente do grupo que utilizou apenas a cinesiologia aplicada como tratamento.

Objective: To compare the transcutaneous electrical nerve stimulator (TENS) effects associated to the kinesiology applied, and only the kinesiology applied on the hydroxiproline (HP) excretion on individuals with shoulder pain, during 10 physical therapy sessions with duration of 55 minutes each session for both treatments. Methods: The individuals were divided into two groups of 35 people each, being 30 women and 40 men; aged between 40 and 65 years old. The control group underwent only applied kinesiology and the experimental group applied kinesiology associated to TENS. It was used the colorimetric protocol to measure urinary excretion of HP. Three samples of each variable were carried out on the first, fifth and tenth sessions. The ANOVA test with repeated measures to analyze the HP was used for the statistics. Results: There were no significance as indicated by F = 0.662, p > 0.05. Conclusion: We concluded that the study showed a strong benefit tendency for both groups due to HP decrease levels. As a better result before the 5th session for the group applied kinesiology and after the 5th - 10th session of treatment, for the applied kinesiology + TENS group, although there was no significance based on the statistics. And, also, it showed a better result for the group who practiced only applied kinesiology

Evaluation of different biochemical markers of bone turnover as a diagnostic tool for osteoporosis in postmenopausal women

Osteoporosis is a major global health problem affects mainly elderly and postmenopausal women with increased risk of bone fractures. The value of different biochemical markers of bone turnover as diagnostic tool for osteoporosis is still debated. The aim of this study is to assess the value of different biochemical markers of bone turnover as a diagnostic tool for osteoporosis in postmenopausal women. We measured fasting urinary calcium [Uca], total ALP, inorganic phosphorus [Pi], urinary deoxypyridino-line [DPD], carboxyterminal telopeptide of collagen type I [ICTP] and serum N-terminal telopeptide [NTX] in 40 postmenopausal females [diagnosed by DEXA as osteoporotic, | mean age, 60.2 years], 16 preimenopausal non-osteoporotic females [mean age, 39.1 years] and 24 healthy controls [mean; age, 29.2 years]. The postmenopausal osteoporotic group showed significantly higher levels of ALP, DPD, NTX and ICTP compared to controls [p<0.001] and only ALP was significantly higher in preimenopausal group compared to controls [p<0.001]. However, there was no significant difference of Uca and Pi among the three groups. On comparing peri and postmenopausal groups together, DPD, NTX and ICTP were the only markers that clearly discriminate the two groups being higher in the osteoporotic postmenopausal group. There were significant negative correlations between bone mineral density [BMD] and each of ALP, DPD, NTx, and ICTP. The clinical utility of DPD, NTx and ICTP in identifying patients with osteoporosis was assessed by ROC [receiver operating characteristic] curve analysis. This revealed that the best diagnostic cut-off level for DPD was 6.8nM DPD/mM creatinine. This gave a diagnostic sensitivity of 100% and specifity 100%, whereas NTx at a level 17.0 nM BCE had a diagnostic sensitivity of 100% and specifity of 98%. Regarding ICTP at cut-off level of 3.6 microg/L its sensitivity was 88% and specifity was 65% which considered the lesser better sensitivity and specifity among the three studied parameters

Study of the relation of interleukin-6, essential fatty acids, and estrogen in bone metabolism in elderly women

The aim of this study was to evaluate and assess the relation of interleukin-6, essential fatty acids, and estrogen to the development of osteoporosis in women of different age groups. This study was carried on 40 women divided in two groups: the first group [GI] included 20 apparently healthy women above 65 years and the second group [GII] included 20 healthy women between 20-30 years of age. Serum osteocalcin, estrogen, interleukin-6 by ELISA, Urinary hydroxyproline by ELISA, essential fatty acid in the blood by Gas Liquid Chromatography, serum calcium, and phosphorus were estimated as well as bone density. The current study revealed a significant decrease of serum estrogen in GI when compared to GII [p<0.05], a significant increase of serum interleukin-6, osteocalcin, urinary hydroxyproline in GI when compared to GII [p<0.05], a significant decrease of bone density in GI when compared to GII [p<0.05]. A significant strong positive correlation between interleukin-6 and bone density in both groups were found. From this study, it is concluded that low estrogen level and high interleukin-6 could be used as a predictor for the occurrence of low bone density and the production of osteoporosis with the subsequent occurrence of fractures in post menopausal women

Utilidad clínica de los marcadores de formación y resorción ósea / Clinical utility of biochemical merkers of bone turnover

Se evaluó el recambio óseo en distintas situaciones fisiológicas y patológicas que alteran el metabolismo óseo. A tal fin se analizó la utilidad de un marcador bioquímico de formación como la fosfatasa alcalina ósea (FAO) y uno de resorción ósea, como la fracción carboxilo terminal del telopéptido del colágeno tipo I (CTX). En la población adulta normal los hombres y mujeres premenopáusicas no presentaron diferencias significativas. Contrariamente, las mujeres posmenopáusicas tuvieron niveles de FAO y CTX significativamente mayores que éstos dos grupos (p<0,01). Entre el segundo y tercer trimestre de embarazo ambos marcadores aumentaron significativamente (FAO: p<0,009 y CTX: p<0,0003). Mientras la FAO no varió en posmenopáusicas ante el tratamiento hormonal de reemplazo (THR), el CTX disminuyó significativamente (p<0,001). Mujeres posmenopáusicas osteopénicas y osteoporóticas presentaron niveles de CTX y FAO significativamente menores luego de THR o tratamiento con bifosfonatos respecto de las no tratadas (FAO: p<0,05 y 0,03 y CTX: p<0,02 y 0,0001 respectivamente). Pacientes con insuficiencia renal en hemodiálisis presentaron niveles séricos de FAO y CTX significativamente mayores que los controles sanos por edad y sexo (p<0,05). Pacientes hipertiroideos, pagéticos o con patología ósea secundaria a enfermedad celíaca disminuyeron los niveles de FAO y CTX en forma significativa (p<0,05) luego del tratamiento específico. Como se esperaba, el marcador de resorción respondió más rápidamente a cambios en el remodelamiento óseo. Si le sumamos la alta especificidad y sensibilidad del CTX, se sugiere que éste marcador sería de utilidad en todas aquellas patologías en que se sospeche alteración o se quiera determinar el grado del remodelamiento óseo

Biochemical versus radiological studies for early detection of steroid-induced bone depletion in children

To examine the early effects of the usual dose of prednisone treatment [1-2mg/kg / day] for about one month on bone depletion in different pediatric diseases. Bone mineral density [BMD] was measured using quantitative computed tomography [QCT]. Bone formation was quantified by measurement of serum osteocalcin, alkaline phosphatase, calcium and phosphorus. Bone resorption was measured by urinary excretion of calcium, phosphorus and hydroxyproline. BMD was significantly reduced in the steroid treated group [P < 0.05]. As regards bone formation parameters, only osteocalcin was significantly reduced [P < 0.05] while other parameters were not different. Urinary hydroxyproline and phosphorus as parameters of bone resorption were significantly elevated [P < 0.01 and < 0.05 respectively] with no change in urinary calcium excretion. No correlation has been found between BMD and any of the laboratory markers. One month treatment with prednisone in the usual dose is associated with some degree of bone depletion and although osteocalcin and hydroxyproline values were significantly different in the steroid treated group, yet they are weak substitutes for radiological studies [bone densitometry] in monitoring bone density in these patients

Some biochemical markers of bone formation and bone resorption in elderly patients with hip fracture

Serum concentrations of some biochemical markers of bone turnover were measured in 40 elderly patients who sustained hip fracture. They were 20 elderly males and 20 postmenopausal females showing different grades of radiological and histopathological osteoporosis. In addition, 20 radiologically free subjects [10 postmenopausal females, and 10 elderly males] served as controls. To all studied subjects the following bone markers were done: serum osteocalcin, serum total and bone specific alkaline phosphatase and urinary hydroxyproline.Serum total and ionized calcium, inorganic phosphorus and urinary calcium were also estimated. Markers of bone formation: osteocalcin and bone specific alkaline phosphatase were significantly increased in postmenopausal female patients and elderly male patients. Urinary hydroxyproline, a marker of bone resorption was also significantly increased in these two groups when compared to the controls. Based on some biochemical data [and not radiological] osteomalacia could be suspected in 20% of postmenopausal female patients and 15% of elderly male patients. These data are suggestive of high rate of bone turnover in such elderly patients where bone resorption exceeds bone formation leading to low skeletal mass which has an essential role in bone fracture

Evaluation of some biochemical and radiological changes in bone metabolism during corticosteroid therapy

Osteoporosis is considered as a major outcome of corticosteroid administration. The evaluation of the degree of osteoporosis in patients on steroid therapy was examined by many studies. This work aimed at the assessment of bone turnover markers, as well as, quantitative computed tomography as measures for detection of osteoporosis in patients receiving corticosteroids. This has been achieved through the biochemical detection of bone turnover markers [total alkaline phosphatase [SAP], osteocalcin [OC], urinary excretion of hydroxyproline/creatinine [OHPr/Cr]] and QCT scanning of L[2]-L[4] Vertebrae. Our results demonstrated that 60% of patients on steroids had complaints related to osteoporosis. Concerning the biochemical parameters of bone turnover SAP tended to be higher in patients than in control. Also, OC is significantly reduced [P

Clinical profile of 128 subjects operated for primary hyperparathyroidism

From 1960 to 1990, one hundred twenty eight (128) subjects with primary hyperparathyroidism were operated in the University Hospital. The medical records were reviewed. Serum and urine chemistries were done by conventional methods, serum PTH was done by RIA's (N-, C-, and midregion) and intact by IRMA and 1,25 dihydroxycholecalciferol by a non equilibrium receptor assay from calf thymus and preceded by double Sep-Pak chromatography. The distal third of the radius (nondominant arm) was used to evaluate radial bone density (RBD), using single photon absorptiometry (Norland) and the lumbar bone density (LBD) was measured by dual energy X Ray absorptiometry (DEXA). The RBD was done in 41 females and 15 males and the LBD in 12 females and 4 males. The series comprised 95 females, age range from 15 to 79 years, and 33 males, age range from 14 to 69 years. Prominent clinical features included nephrolithiasis in 72 subjects (56 per cent), osteitis fibrosa cystica in 2, isolated familial hyperparathyroidism in 4 subjects in one family, 7 subjects with MEN-1 in 3 families, and 4 subjects with MEN-2 in one family. Only 7 subjects were asymptomatic. Serum calcium was elevated in all, serum alkaline phosphatase was elevated in 24 per cent and urinary hydroxiproline was increased in 48 per cent. Serum phosphorus was low in 92 per cent. PTH assay was either elevated or inappropriately normal for the serum calcium in all patients tested. Serum 1,25 D was elevated in 57 per cent. The PTH level was positively correlated with the serum calcium (r = 0.70), but had no significant correlation with the serum phosphorus and the 1,25 D. The RBD expressed as the standard deviation from that of the mean for age and sex matched controls was > or = 2 SD below the mean in 39 per cent of females and in 40 per cent of males. In contrast to the RBD none of the subjects tested had a LBD > or = 2 SD below the age and sex adjusted mean. 103 subjects had adenomas, 20 primary hyperplasia, 2 carcinomas and in 3 surgical exploration was unsuccessful. As to the outcome of Surgery, 117 (93 per cent) were cured. Thus, in this series, successful surgery for primary hyperparathyroidism is the rule. Primary hyperparathroidism is rarely asymptomatic and appendicular bone disease and nephrolithiasis are commonly seen.

Influence of Aloe vera on collagen turnover in healing of dermal wounds in rats.

Treatment of full-thickness wounds with A. vera, on rats resulted in increased biosynthesis of collagen and its degradation. A corresponding increase in the urinary excretion of hydroxyproline was also observed. Elevated levels of lysyl oxidase also indicated increased crosslinking of newly synthesised collagen. The results suggest that A. vera influences the wound healing process by enhancing collagen turnover in the wound tissue.

Hidroxiprolina urinária na forma hepatoesplênica da esqustossomose mansônica / Urinary hidroxyproline excretion in human hepatosplenic mansoni schistosomiasis

A hidroxiprolina é um aminoácido fundamental do colágeno, assim a sua determinaçÝo tem sido utilizada como método da avaliaçÝo quantitativa do colágeno em vários tecidos animais. A execreçÝo urinária de hidroxiprolina está elevada nas doenças que envolvem o metabolismo do colágeno. Em um grupo de 16 pacientes com esquistossomose na forma hepatoesplênica foi encontado uma excreçÝo urinária média de hidroxiprolina de 41, 83mg/24h.Quando comparado este resultado com o valor médio de 27,57mg/24h, encontrado em um grupo de controle de 10 voluntários, sem antecedentes de esquistossomose mansônica, por meio do teste de diferença das médias t-student, fica demonstrada uma direrença estatísticamente significante. Assim o método, associado a outros, pode ser avaliado como um meio nÝo invasivo para o seguimento de pacientes esquistossomóticos após o tratamento clínico

Determination of hydroxyproline in urine of acute and chronic rheumatic heart disease patients

The present study was directed towards determination of changes in total urinary hydroxyproline excretion and hydroxyproline/creatinine ratio as important indices for collagen turnover in cases of rheumatic heart disease. The study indicated a significant increase in the total urinary hydroxyproline excretion and hydroxyproline/ creatinine ratios in patients with rheumatic heart disease, than those of control group, there was also a significant increase in both of them in patients with active rheumatic heart disease, than patients with chronic rheumatic heart disease. It has been mentioned that collagen metabolism in patients with rheumatic fever is disturbed, and this disturbance may contribute to the pathogenesis of the disease. Therefore, the measurement of these parameters could be used as an important marker of rheumatic heart disease and rheumatic activity and for the diagnosis and follow up of rheumatic heart disease

Papel del hueso en la fisiopatologia de la hipercalciuria idiopatica: efecto del aminobisfosfonato alendronato / Role of the bone in the physiopathology of idiopathic hypercalciuria: effect of amino-bisphosphonate alendronate

Estudios previos de nuestro laboratorio han demonstrado una disminución del contenido mineral del hueso y una correlación entre la disminución del contenido mineral y la producción de distintas citoquinas que intervienen en el proceso de resorción ósea. Al mismo tiempo, observamos que el tratamiento a corto plazo con alendronato produce una disminución del calcio urinario en pacientes con hipercalciuria idiopática. En el presente estudio analizamos los efectos del alendronato a largo plazo (10 mg/día por un año) sobre el calcio y la hidroxiprolina urinaria y el contenido mineral óseo en 18 hipercalciúricos y 8 normocalciúricos con litiasis urinaria. Las características clínicas, así como la distribución por edades y sexo fue similar en ambos grupos. En calcio urinario disminuyó significativamente al final del primer mes y continuó bajo posteriormente (277 + 28, antes vs. 202 + 26 mg/g creatinina, después de 12 meses con alendronato, p<0.01). La hidroxiprolina urinaria disminuyó significativamente durante el estudio (125,5 + 32.1 vs. 39.66 + 17.5 mg/g creatinina, p<0.05). El calcio sérico, la filtración glomerular y el sodio urinario no se modificaron durante el estudio. La densidad mineral ósea en columna lumbar, determinada por densitometría por rayos X, se incremento significativamente el primer año de 1.162 + 0.231 a 1.197 + 0.248 g/cm2 (p<0.01). No se observaron cambios en la densidad mineral del cuello de fémur. Estos cambios se asociaron a una disminución en la transcripción del mRNA para IL-1 alpha, determinados por la reacción en cadena de polimerase (PCR), en células mononucleares no estimuladas. Los sujetos normocalciúricos no demostraron cambios significativos en la excreción urinaria de calcio. En resumen, los cambios observados en el calcio urinario y otros parámetros metabólicos óseos sugieren un papel importante del hueso en la fisiopatología de la hipercalciuria idiopática.

Modificación de la reabsorción ósea con terapia hormonal de reemplazo en la postmenopausia / Modification of bone resorption with replacement hormonal therapy in postmenopause

Eighty three postmenopausal women without replacement hormonal therapy, 54 postmenopausal women receiving replacement hormonal therapy and 16 premenopausal women (considered as control group) were studied. Hydroxyproline was measured in an early morning urine sample, after one day of diet without meat or gelatin. Urinary hydroxyproline in premenopausal women was 33.7ñ7.9 mg/g creatinine. The figure for postmenopausal women with hormonal replacement therapy was 33.5ñ7.9 mg/g creatinine. Postmenopausal women without replacement therapy had an urinary hydroxyproline of 47.4ñ8.5 mg/g creatinine, significantly higher than that of premenopausal and supplemented women. In 21 postmenopausal women, hydroxyproline was measured before and after 3 months of replacement therapy; values decreased 35.5ñ11 percent in this period and there was a direct correlation between initial values and the degree of reduction (r=0.69, p<0.001). Postmenopausal women receiving hormone replacement therapy have a urinary hydroxyproline excretion similar to that of premenopausal women

Sensibilidad de los marcadores del remodelamiento óseo: su modificación en la menopausia, ante la terapia estrogénica de reemplazo y ante una enfermedad metabólica generalizada / Markers of bone turnover, their sensibility to bone remodeling: changes in menopause, in hormone replacement therapy and in a metabolic bone disease

Evalua una batería de marcadores bioquímicos específicos y sensibles para predecir cambios en la velocidad del remodelamiento óseo. Se estudió a mujeres sanas pre y postmenospáusicas y en estas últimas a su vez se evaluó los cambios producidos después de 90 días de una terapia hormonal de reemplazo. Respecto de los marcadores bioquímicos de formación, la FA total aumentó en las postmenospáusicas respecto del grupo premenospáusico (P < 0,0001), al igual que la BGP (1 < 0,01); en cambio, la FA ósea no registró cambios significativos. Luego de la terapia hormonal de reemplazo ninguno de estos marcadores registraron cambios significativos. Todos los marcadores de resorción aumentaron en als mujeres postmenospáusicas. Los convencionales tales como el calcio urinario/creatinina y la hidroxiprolina con un p < 0,01 y p < 0,006 respectivamente. Los nuevos marcadores de resorción presentaron los siguientes cambios: Pyr p < 0,001; 72 por ciento; D-Pyr p < 0,003, 27 por ciento y Crosslaps p < 0,003, 70 por ciento de aumento respectivamente. Ante la terapia estrogénica, si bien los marcadores convencionales no mostraron diferencias significativas respecto del nivel basal, la Pyr disminuyó significativamente en un 15 por ciento (p < 0,03), la D-Pyr en un 15 por ciento (p < 0,04) y los Crosslaps en un 39 por ciento (p < 0,001). También se investigó la precisión diagnóstica de los marcadores bioquímicos en pacientes con un remodelamiento óseo aumentado, como es el caso de enfermedades celíacas. Estas se compararon con los normales que presentaban igual estado estrogénico observándose distintos comportamientos entre pre y postmenospáusicas. La BGP aumentó sólo en las celíacas premenospáusicas (p < 0,003). La FA total en los dos grupos estrogénicos (p < 0,0001 y p < 0,005 respectivamente), al igual que la FA ósea (p < 0,0003 y p< 0,0004, respectivamente). El marcador de resorción D-Pyr no presentó diferencias significativas en ninguno de los dos grupos, la Pyr sílo en las premenopáusicas (p < 0,01). La hidroxiprolina aumentó en ambos (p < 0,04 y p < 0,004, respectivamente), al igual que los Crosslaps (p < 0,001 para los dos grupos estrogénicos)

Indice de hidroxiprolina: influencia de la muestra en la interpretación de los resultados / Hidroxyproline index: influence of the sample in results interpretation

El índice de hidroxiprolina es un indicador de crecimiento, originalmente utilizado en muestras de orina casual, asumiendo que sus variaciones a lo largo del día no son significativas. Sin embargo, la excreción de hidroxiprolina sigue un ritmo circadiano. El objetivo de este trabajo fue evaluar las variaciones que dependan de la muestra utilizada y en qué medida afectan la interpretación de los resultados obtenidos. Para ello, se recolectaron 3 muestras de orina diferentes: basal, primera micción de la mañana y casual, en 11 niños normales entre 3 y 9 años de edad. Se compararon los valores obtenidos en las 3 muestras para el mismo niño mediante ANOVA con Medidas Repetidas y a posteriori el Test de Tukey. Los índices de hidroxiprolina determinados en orina casual fueron significativamente más bajos que los realizados en orina basal (p < 0,01) o en la primera micción de la mañana (p < 0,01), mientras que las diferencias entre estas dos últimas muestras fueron no significativas. 7 niños presentaron índices menores al valor de referencia cuando se determinaron en orina casual, 2 niños cuando se utilizó la primera micción de la mañana y sólo 1 cuando se usó orina basal. El índice de hidroxiprolina varió con la muestra utilizada y dicha variación afectó la interpretación de los resultados. Basados en dichos resultados y en las particularidades de las muestras estudiadas, consideramos que la orina casual no es apropiadad para la determinación de este indicador, siendo la muestra de orina basal la más indicada. La primera micción de la mañana podría emplearse cuando la recolección de orina basal no fuera posible

Toxicity of dimethoate on urinary hydroxyproline in rats.

The effect of the administration of three different concentrations (2.25, 1.13 and 0.56 mg/100 g body weight) of dimethoate on the urinary excretion of total, non dialysable and free hydroxyproline were studied in female albino rats. Compared to controls, the urine contents were significantly lower in higher concentration (2.25 mg/100 g body weight) of dimethoate treated rats. The results clearly indicate that the urine contents were not much affected in lower concentration (0.56 mg/100 g body weight) of dimethoate treated rats compared to the other concentrations (1.13 and 0.56 mg/100 g body weight) of dimethoate treated rats.

Fasting urine hydroxyproline / creatinine as estimates of bone resorption in postmenopausal women

Serum level of alkaline phosphatase [as estimate of bone formation] and urinary levels of hydroxyproline/creatinine [HPR/CR] and calcium/creatinine [Ca/CR] ratios [as estimates of bone resorption] together with serum calcium and phosphorus levels were determined in 10 healthy premenopausal females and in 13 postmenopausal women. Serum phosphorus level together with urinary HPR/CR and Ca/CR ratios were significantly increased after menopause, meanwhile serum calcium was decreased, while no significant difference was noticed when the premenopausal and postmenopausal women were compared with respect to serum alkaline phosphatase. Both urinary HPR/CR and Ca/CR ratios were found to be negatively correlated to the duration after menopause. Correlation between HPR/CR and Ca/CR in fasting urine samples of postmenopausal women was of high significance