Biochemical markers of bone turnover after surgical menopause and hormone replacement therapy

The objective of this study was to evaluate the effect of surgical menopaus e and hormone replacement therapy (HRT) on the new biochemical markers of b one turnover. Fourteen women who had undergone surgical menopause and began HRT 3 months after surgery were recruited for a 1-year study. Results were compared with a control group of 31 healthy premenopausal women of similar age. Serum samples were obtained to determine total alkaline phosphatase, bone alkaline phosphatase, propeptides carboxy- and amino-terminal of type I procollagen (PICP, PINP), osteocalcin, tartrate-resistant acid phosphatas e, and carboxyterminal telopeptides of type I collagen (ICTP and serum CTX) , Urine samples were analyzed for hydroxyproline, pyridinoline, deoxypyridi noline, alpha and beta-carboxy-terminal telopeptides of type I collagen (al pha-CTX and beta-CTX), and amino-terminal telopeptides of type I collagen ( ICTP), Determinations were performed after 3 months of surgical menopause a nd after 3 and 9 months of HRT. All biochemical markers increased after men opause, and most of them normalized after 9 months of HRT. Serum PINP showe d the highest proportion of increased values after surgery among bone forma tion markers (62%), as well as the highest mean percent increase (101%). Am ong bone resorption markers in postmenopausal women, urinary beta-CTX, alph a-CTX, NTX, and serum CTX showed the highest proportion of increased values (100%, 67%, 58%, 58%, respectively) as well as the greatest mean percent i ncrease. They were also the markers with the most marked response to HRT. I n conclusion, serum PINP is the most sensitive marker of bone formation, wh ereas beta-CTX is the most sensitive marker of bone resorption after surgic al menopause. In addition, both markers showed the highest response after H RT. (C) 1999 by Elsevier Science Inc. All rights reserved.