Document Detail

Short-term changes in bone turnover markers and bone mineral density response to parathyroid hormone in postmenopausal women with osteoporosis.
MedLine Citation:
PMID:  16449339     Owner:  NLM     Status:  MEDLINE    
CONTEXT: Treatment of osteoporotic women with PTH increases biochemical markers of bone turnover, increases axial bone mineral density (BMD), and reduces fracture risk. OBJECTIVE: Our objective was to determine the relationship between levels of baseline turnover before PTH therapy and short-term changes in turnover during PTH therapy and subsequent changes in areal and volumetric BMD. DESIGN AND SETTING: We conducted a randomized, placebo-controlled trial at four academic centers. PATIENTS: Patients included 238 postmenopausal women with low hip or spine BMD. INTERVENTION: Subjects were randomized to sc PTH (1-84), 100 mug/d (119 women), for 1 yr. MAIN OUTCOME MEASURE: Bone turnover markers were measured in fasting blood samples collected before therapy and after 1 and 3 months. Areal and volumetric BMD at the spine and hip were assessed by dual-energy x-ray absorptiometry and quantitative computed tomography (QCT) after 1 yr of therapy. RESULTS: Among women treated with PTH alone, the relationships between baseline turnover and 1-yr changes in dual-energy x-ray absorptiometry and QCT BMD were inconsistent. Greater 1- and 3-month increases in turnover, particularly the formation marker N-propeptide of type I collagen, were associated with greater increases in areal BMD. When volumetric hip and spine BMD were assessed by QCT, greater short-term increases in turnover were even more positively associated with 1-yr increases in BMD. Each sd increase in the 3-month change of N-propeptide of type I collagen was associated with an a 21% greater increase in QCT spine trabecular BMD. CONCLUSIONS: Greater short-term changes in turnover with PTH therapy are associated with greater 1-yr increases in spine and hip BMD among postmenopausal osteoporotic women.
D C Bauer; P Garnero; J P Bilezikian; S L Greenspan; K E Ensrud; C J Rosen; L Palermo; D M Black
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2006-01-31
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  91     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-07     Completed Date:  2006-05-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1370-5     Citation Subset:  AIM; IM    
Department of Medicine, University of California-San Francisco Coordinating Center, 185 Berry 5700, San Francisco, CA 94107, USA.
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MeSH Terms
Absorptiometry, Photon
Aged, 80 and over
Alendronate / therapeutic use
Biological Markers
Bone Density / drug effects*
Bone Density Conservation Agents / therapeutic use
Bone and Bones / drug effects,  metabolism*
Middle Aged
Osteoporosis, Postmenopausal / drug therapy*,  metabolism*
Parathyroid Hormone / pharmacology*,  therapeutic use*
Grant Support
Reg. No./Substance:
0/Biological Markers; 0/Bone Density Conservation Agents; 0/Parathyroid Hormone; 66376-36-1/Alendronate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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