Ann Rehabil Med.  2018 Jun;42(3):441-448. 10.5535/arm.2018.42.3.441.

The Changes of CTX, DPD, Osteocalcin, and Bone Mineral Density During the Postmenopausal Period

Affiliations
  • 1Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea. ghichan@hotmail.com

Abstract


OBJECTIVE
To investigate appropriate treatment time and useful bone turnover markers (BTMs) for monitoring bone turnover during the postmenopausal period, we analyzed changes of two bone resorption markers; serum carboxyterminal telopeptide of collagen I (s-CTX), urine deoxypyridinoline (u-DPD), one bone formation marker; serum osteocalcin (s-OC), and bone mineral density (BMD) in Korean postmenopausal women.
METHODS
Seventy-eight menopausal women were divided into three groups according to postmenopausal period: group I (0-5 years), group II (6-10 years), group III (≥10 years). All groups were subdivided into an osteoporosis group (T-score≤-2.5) and a non-osteoporosis group (T-score>-2.5). BTMs such as s-CTX, u-DPD, s-OC, and BMD (g/cm²) were measured by dual-energy X-ray absorptiometry (DXA) in all patients. Analysis of variables among groups based on the postmenopausal period was performed using ANOVA.
RESULTS
There was significant negative correlation between BMD and postmenopausal period. The levels of all BTMs including s-CTX, u-DPD, and s-OC were highest in group II and the increased levels of all BTMs subsequently declined in group III. The levels of BTMs were higher in the osteoporosis groups than in the non-osteoporosis groups in all subjects. It was statistically significant that the level of s-CTX in group I was higher in the osteoporosis group than in the non-osteoporosis group.
CONCLUSION
This study showed that bone resorption and bone formation were the highest 5-10 years after menopause, and s-CTX is more useful than u-DPD among the bone resorption markers. It's important to measure serially both BMD and BTM within 10 years after menopause for accurate diagnosis and management for postmenopausal osteoporosis.

Keyword

Postmenopause; Osteoporosis; Biomarker; Bone density

MeSH Terms

Absorptiometry, Photon
Bone Density*
Bone Remodeling
Bone Resorption
Collagen
Diagnosis
Female
Humans
Menopause
Osteocalcin*
Osteogenesis
Osteoporosis
Osteoporosis, Postmenopausal
Postmenopause*
Collagen
Osteocalcin

Figure

  • Fig. 1. Comparison of bone turnover markers among study groups. CTX, serum carboxy-terminal telopeptide of collagen I; DPD, urine deoxypyridinoline; OC, serum osteocalcin.


Cited by  1 articles

Association between Serum Osteocalcin Levels and Metabolic Syndrome according to the Menopausal Status of Korean Women
Jin-Sook Moon, Mi Hyeon Jin, Hyun-Min Koh
J Korean Med Sci. 2021;36(8):e56.    doi: 10.3346/jkms.2021.36.e56.


Reference

1. Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med. 1993. 94:646–50.
2. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001; 285:785–95.
3. Kim G. Immobilization osteoporosis. Osteoporosis. 2011; 9:1–17.
4. Kim HD, Kim SH, Kim DK, Jeong HJ, Sim YJ, Kim GC. Change of bone mineral density and relationship to clinical parameters in male stroke patients. Ann Rehabil Med. 2016; 40:981–8.
Article
5. Riggs BL, Melton LJ. Involutional osteoporosis. N Engl J Med. 1986; 314:1676–86.
Article
6. Kim GC, Jeong HJ, Roh KH, Chung HC, Kim HY, Lee HN. The changes of bone mineral density, biochemical bone markers, and lipid profiles according to duration of menopause and HRT. J Korean Acad Rehabil Med. 2001; 25:491–7.
7. Riggs BL, Melton LJ. The prevention and treatment of osteoporosis. N Engl J Med. 1992; 327:620–7.
Article
8. Stepan JJ. Prediction of bone loss in postmenopausal women. Osteoporos Int. 2000; 11 Suppl 6:S45–54.
Article
9. Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2013; 24:23–57.
Article
10. Kanis JA, Black D, Cooper C, Dargent P, Dawson-Hughes B, De Laet C, et al. A new approach to the development of assessment guidelines for osteoporosis. Osteoporos Int. 2002; 13:527–36.
Article
11. Vasikaran S, Eastell R, Bruyere O, Foldes AJ, Garnero P, Griesmacher A, et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int. 2011; 22:391–420.
Article
12. Kim GC, Jeong HJ, Ha HS, Lee SJ. Therapeutic effect according to estrogen dosage on combined therapy with estrogen and alendronate in postmenopausal osteoporosis. J Korean Acad Rehabil Med. 2006; 30:247–53.
13. Vasikaran SD. Utility of biochemical markers of bone turnover and bone mineral density in management of osteoporosis. Crit Rev Clin Lab Sci. 2008; 45:221–58.
Article
14. Hlaing TT, Compston JE. Biochemical markers of bone turnover: uses and limitations. Ann Clin Biochem. 2014; 51(Pt 2):189–202.
15. Garnero P, Sornay-Rendu E, Claustrat B, Delmas PD. Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study. J Bone Miner Res. 2000; 15:1526–36.
Article
16. Mun KH, Kim CP, Kang BG, Lee YG. The biochemical bone marker of the pre and postmenopausal osteoporotic women. J Korean Acad Rehabil Med. 1998; 22:93–9.
17. Grampp S, Genant HK, Mathur A, Lang P, Jergas M, Takada M, et al. Comparisons of noninvasive bone mineral measurements in assessing age-related loss, fracture discrimination, and diagnostic classification. J Bone Miner Res. 1997; 12:697–711.
Article
18. Ivaska KK, Lenora J, Gerdhem P, Akesson K, Vaananen HK, Obrant KJ. Serial assessment of serum bone metabolism markers identifies women with the highest rate of bone loss and osteoporosis risk. J Clin Endocrinol Metab. 2008; 93:2622–32.
Article
19. Delmas PD, Eastell R, Garnero P, Seibel MJ, Stepan J; Committee of Scientific Advisors of the International Osteoporosis Foundation. The use of biochemical markers of bone turnover in osteoporosis. Osteoporos Int. 2000; 11 Suppl 6:S2–17.
Article
20. Rosen CJ, Chesnut CH, Mallinak NJ. The predictive value of biochemical markers of bone turnover for bone mineral density in early postmenopausal women treated with hormone replacement or calcium supplementation. J Clin Endocrinol Metab. 1997; 82:1904–10.
Article
21. Garnero P, Hausherr E, Chapuy MC, Marcelli C, Grandjean H, Muller C, et al. Markers of bone resorption predict hip fracture in elderly women: the EPIDOS prospective study. J Bone Miner Res. 1996; 11:1531–8.
Article
22. Hochberg MC, Greenspan S, Wasnich RD, Miller P, Thompson DE, Ross PD. Changes in bone density and turnover explain the reductions in incidence of nonvertebral fractures that occur during treatment with antiresorptive agents. J Clin Endocrinol Metab. 2002; 87:1586–92.
Article
23. Melton LJ, Khosla S, Atkinson EJ, O’Fallon WM, Riggs BL. Relationship of bone turnover to bone density and fractures. J Bone Miner Res. 1997; 12:1083–91.
Article
24. Chavassieux P, Portero-Muzy N, Roux JP, Garnero P, Chapurlat R. Are biochemical markers of bone turnover representative of bone histomorphometry in 370 postmenopausal women? J Clin Endocrinol Metab. 2015; 100:4662–8.
Article
Full Text Links
  • ARM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr