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

ABSTRACT

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.