Effect of different hormonal treatment modalities on biochemical markers of bone remodling in postmenopausal women

ABSTRACT

Is to measure some of the biochemical markers of bone formation and bone resorption in postmenopausal women before and after hormone replacement therapy. Thirty postmenopausal women and fifteen healthy pre-menopausal women were included in this work. Postmenopausal women were allocated into two groups. Group I receiving Estrogen replacement therapy. Group II receiving Combined hormone replacement therapy. The following serum markers were evaluated before the start and two weeks after the end of the study; total and ionized calcium, inorganic phosphorus, alkaline phosphataseiso enzyme, osteocalcin. Also urinary deoxypyridinoline cross links were assessed. Bone densitometry using quantitative computed tomography was done. In postmenopausal women of this study, there was an increase in both bone formation markers as well as bone resorption markers but in favour of bone resorption with diminished bone mass. There was significant reduction of both serum alkaline phosphatase and osteocalcin in both groups following treatment. This reduction was also noticed in both groups in urinary deoxypyridinoline / creatinine after hormonal therapy. However, bone mineral density showed no obvious changes in both groups after three months of replacement therapy. Changes in biochemical markers of bone turnover preceded changes in bone density observed by densitometry. These effects were similar in both groups receiving two different forms of hormone replacement therapy