BIOCHEMICAL MARKERS OF CALCIUM AND BONE METABOLISM IN THE MONITORING OF OSTEOPOROSIS TREATMENT

Biochemical markers of bone turnover are extremely useful in monitoring the treatment in osteoporosis. Due to the fact that in postmenopausal osteoporosis, bone resorption is increased and biochemical markers are found to be significantly increased, a possible utility in evaluating the treatment effect emerged. It was proved that antiresorbtive treatment is decreasing the bone resorbtion markers serum level, which is a relevant aspect for treatment monitoring. The aim of the present study was to evaluate the predictive value of the bone turnover markers changes for bone mineral density response in women treated for postmenopausal osteoporosis, for one year with antiresorbtive therapy. The obtained results were conclusive: antiresorbtive treatment decreased significantly serum osteocalcin level and increased significantly serum parathyroid hormone (PTH) concentration after 6 months. The decrease in osteocalcin levels after 6 months was significantly correlated to the increase in lumbar spine bone mineral density (BMD) after one year of treatment. 25-OH vitamin D levels did not change significantly in 6 months of oral supplementation, probably due to the short time but also to insufficient doses in a deficient population. In clinical practice, monitoring treatment with bone markers is useful mostly to identify the pure responder or non-responder to the treatment. This aspect could indicate and sustain an early change in treatment, before the first evaluation of the bone mineral density by DXA.