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  • Title: Traditional and novel bone remodeling markers in premenopausal and postmenopausal women.
    Author: Botella S, Restituto P, Monreal I, Colina I, Calleja A, Varo N.
    Journal: J Clin Endocrinol Metab; 2013 Nov; 98(11):E1740-8. PubMed ID: 24001743.
    Abstract:
    CONTEXT: Bone turnover markers (BTMs) may identify changes in bone remodeling within a relatively short time interval before changes in bone mineral density can be detected. New markers such as osteoprotegerin, receptor activator of nuclear factor-κB ligand, and sclerostin have emerged, but there is little information about their potential use in clinical practice. OBJECTIVES: The aim of this study was to analyze the ability of several BTMs to predict bone loss in pre- and postmenopausal women and to monitor the efficacy of treatment in osteoporotic women. DESIGN, PATIENTS, AND SETTING: We performed an observational prospective study in pre- and postmenopausal ambulatory women (n = 72 and n = 152, respectively). INTERVENTION: Postmenopausal women with osteoporosis (n = 18) were treated with risedronate and calcium. Women filled out a questionnaire and underwent bone mineral density measurement using dual-energy x-ray absorptiometry at the time of enrollment and after 1 year of follow-up. BTMs were measured at baseline, at 6 months, and after 1 year. RESULTS: Increased levels of N-terminal propeptide of type 1 procollagen (P1NP) and β-type I collagen telopeptides (CTXs) were associated with low bone mineral density in the premenopausal (P = .02 and P = .04, respectively) and postmenopausal (P = .03 and P = .02) groups. The best analytical performance to diagnose osteoporosis was for β-CTX, osteocalcin, and P1NP, with areas under the curve of 0.70 (P = .005), 0.64 (P = .048), and 0.71 (P = .003). A significant decrease was found in P1NP, osteocalcin, tartrate-resistant acid phosphatase-5b, β-CTX, and bone alkaline phosphatase after 1 year of treatment (all P < .05). CONCLUSIONS: Our data suggest that measurement of β-CTX and P1NP shows adequate analytical performance and could potentially be included in algorithms for the screening of osteoporosis. Furthermore, these two markers, along with osteocalcin and tartrate-resistant acid phosphatase-5b, are useful to monitor the response to risedronate.
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