Bone mineral density and biochemical markers of bone turnover in peri- andpostmenopausal women

Bone mineral density (BMD) measured by densitometry is the elective paramet er for the diagnosis of osteopenia and osteoporosis. Biochemical markers ha ve been proposed as sensitive indicators of high bone turnover and for moni toring response to antiresorptive treatment. We conducted a retrospective s tudy to investigate the values of biochemical markers of bone metabolism wi th a. view to early diagnosis of osteoporosis and monitoring of hormone rep lacement and calcitonin therapy. The subjects were 415 women, mean age 51 /- 8 years (43-62 years) in peri- and postmenopause, recruited at the Menop ause Center of Obstetrics and Gynecology Department of Siena University and divided in five groups. Bone densitometry was performed in all subjects an d blood samples were taken for assayed biochemical markers, that is, [osteo calcin (OC), parathyroid hormone (PTH), type 1 procollagen (PICP), and calc itonin (CT)]. Three groups of women were divided into two subgroups: those with normal an d those with low BMD (<1 SD). Basal concentrations of PCP 1, OC, PTH, and C T were compared in the various groups. Two groups of postmenopausal women w ith BMD below the normal were treated with estrogen replacement therapy and unmodified eel calcitonin. We evaluated whether some of these biochemical markers of bone turnover cou ld help identify women with low BMD and whether they could be useful for mo nitoring the results of antiresorptive therapies. Markers of bone formation (PICP and OC) made it possible to distinguish wom en with high turnover who are at risk for osteoporosis from women with low turnover in menopause. A good correlation was also found between changes in levels of these markers and changes in BMD during treatments, which sugges ts that the PICP and OC would be useful for monitoring response to antireso rptive therapy.