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- Title
Short-Term Changes in Bone Turnover Markers and Bone Mineral Density Response to Parathyroid Hormone in Postmenopausal Women with Osteoporosis.
- Authors
Bauer, D. C.; Garnero, P.; Bilezikian, J. P.; Greenspan, S. L.; Ensrud, K. E.; Rosen, C. J.; Palermo, L.; Black, D. M.
- Abstract
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 μg/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.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2006, Vol 91, Issue 4, p1370
- ISSN
0021-972X
- Publication type
Article
- DOI
10.1210/jc.2005-1712