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SERUM BETA CROSSLAPS AS A PREDICTOR FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN

Yıl 2015, Cilt: 78 Sayı: 2, 36 - 40, 14.08.2015
https://doi.org/10.18017/iuitfd.m.13056441.2015.78/2.36-40

Öz

Objective: To evaluate bone turnover by an early marker, CrossLaps (beta-CTx), in postmenopausal women receiving hormone replacement therapy (HRT) or bisphosphonates (BP) to reduce bone loss.

Materials and methods: Thirty patients with no menstruation for at least one year, FSH>40 IU/L, estrogen <20ng/mL at the time of presenting to Zeynep Kamil Women and Children’s Training and Research Hospital were included in this study. The patients were divided into two groups, the HRT group and the BP group. In the HRT group (n=12), patients were prescribed 1mg estradiol, 0.5mg norethisterone acetate and 1000mg calcium (Ca) daily for 6 months. In the BP group (n=18), patients were given 70mg alendronate weekly for 6 months. Bone density was evaluated using dual-energy X-ray absorptiometry at the beginning of the study and after six months. T-scores were used for the quantitative evaluation of bone loss. At the beginning and at the end of the six months, serum Beta-CTx levels were measured. Differences in the T-scores and serum beta-CTx levels of the study groups were compared.

Results: The T-scores of patients who received BP were significantly higher compared with those of patients on HRT at the beginning of the study (p<0.01). The T-scores of patients who received BP were significantly higher than those on HRT at the end of six months (p<0.05). Within either group, the T-scores at the beginning and at the end of six months were not statistically significantly different (p>0.05). The serum beta-CTx levels of patients who received BP were significantly higher compared with those on HRT at the beginning of the study (p<0.01). Beta-CTx levels were also higher compared with patients receiving HRT after the six-month period (p<0.05). The serum beta-CTx levels were significantly lower at the end of the six months in patients who received BP compared with the levels at the beginning (p<0.05).

Conclusion: Changes in serum beta-CTx measurements are detectable earlier than warning signs in bone mineral densitometry and may be a better guide to follow the effectiveness of treatment, especially in patients with high bone turnover; however, long-term studies are required for standard clinical use.

Kaynakça

  • McCombs JS, Thiebaud P, McLaughlin-Miley C, Shi J. Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas. 2004;48:271-87.
  • Anna Daroszewska. Prevention and treatment of osteoporosis in women: an update. Obstetrics, Gynaecology & Reproductive Medicine. 2012;22:162-9.
  • Peichl P, Griesmacherb A, Marteau R. et al. Serum crosslaps in comparison to serum osteocalcin and urinary bone resorption markers. Clinical Biochemistry 2001;34:131-9.
  • Albright F, Smith PH, Richelson AM. Postmenopausal osteoporosis: its clinical features. JAMA 1941;116:2465-74.
  • Bowring CE, Francis RM. National Osteoporosis Society’s Position statement on hormone replacement therapy in the prevention and treatment of osteoporosis. Menopause Int. 2011;17:63-5
  • Garnero P. New biochemical markers of bone turnover. IBMS Bone Key 2008;5:84–102.
  • Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A et al. IOF-IFCC Bone Marker Standards Working Group. Markers of bone turnover for the predictionof fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporosis International 2011;22:391–420.
  • Vasikaran S, Cooper C, Eastell R, Griesmacher A, Morris HA, Trenti T et al. International Osteoporosis Foundation and International Federation of Clinical Chemistry and Laboratory Medicine position on bone marker standards in osteoporosis. Clin Chem Lab Med. 2011;49:1271-4.
  • Overgaard K, Christiansen C. A new biochemical marker of bone resorption for follow up on treatment with nasal salmon calcitonin. Calcif Tissue Int 1996;59:12-6.
  • Ravn P, Clemmesen B, Christiansen C. Biochemical markers can predict the response in bone mass during alendronate treatment in early postmenopausal women. Bone 1999;24:237-44.
  • Garnero P, Delmas PD. Contribution of bone mineral density and bone turnover markers to the estimation of risk of osteoporotic fracture in postmenopausal women. J Musculoskel Neuron Interact 2004;4:50-63.
  • Zhao J, Xia W, Nie M, Zheng X, Wang Q, Wang X et al. The levels of bone turnover markers in Chinese postmenopausal women: Peking Vertebral Fracture study. Menopause. 2011;18:1237-43.
  • Tanko LB, Mouritzen U, Lehmann HJ, Warming L, Moelgaard A, Christgau S. Oral ibandronate: changes in markers of bone turnover during adequately dosed continuous and weekly therapy and during different suboptimally dosed treatment regimens. Bone 2003;32:687-93.
  • Rogers A, Glover SJ, Eastell R. A randomised, double-blinded, placebo-controlled, trial to determine the individual response in bone turnover markers to lasofoxifene therapy. Bone 2009;45:1044-52.
  • Christgau S, Bitsch-Jensen O, Hanover BN, Gamwell HE, Ovist P, Alexandersen P. Serum Crosslaps for monitoring the response in individuals undergoing antiresorptive therapy. Bone 2000;26:505-11.

POSTMENOPOZAL KADINLARDA OSTEOPOROZU ÖNGÖRMEDE SERUM BETA CROSSLAPS

Yıl 2015, Cilt: 78 Sayı: 2, 36 - 40, 14.08.2015
https://doi.org/10.18017/iuitfd.m.13056441.2015.78/2.36-40

Öz

Amaç: Postmenopozal kemik yıkımını azaltmak amacıyla hormon replasman tedavisi (HRT) veya bifosfonat (BP) tedavisi verilen hastalarda tedavi sürecinde kemik yıkım hızının güncel bir marker olan serum crosslaps (β-CTx) ile değerlendirilmesi.

Gereç ve yöntemler: Zeynep Kamil Eğitim Araştırma Hastanesi polikliniğine başvuran en az bir yıl süredir menstruasyonu olmayan, Follikül Stimulan Hormon değeri (FSH) > 40 IU/L Östrojen (E2) < 20ng/ml olan 30 hasta çalışmaya dahil edildi. Araştırmaya katılan hastalar, HRT alan ve BP tedavisi alan olmak üzere iki gruba ayrıldı. HRT alan gruptaki (n=12) hastalara 6 ay süre ile günlük 1mg estradiol, 0.5mg norethisterone acetate ve 1gr kalsiyum (Ca) tedavisi verildi. BP alan gruptaki (n=18) hastalara ise 6 ay süre ile haftalık 70mg alendronat ve 1mg Ca tedavisi verildi. Başlangıçta ve 6. ay sonunda tüm hastaların kemik yoğunluğu ölçümü dual-enerji X-ray absorbsiyometri (DEXA) kullanılarak yapıldı. Hastaların T skorları kemik yıkımının kantitatif değerlendirilmesi için kullanıldı. Başlangıçta ve 6. ay sonunda serum β-CTx seviyesi ölçüldü. Hasta gruplarının 6. ay sonundaki T-skorlarındaki değişim ile serum β-CTx değişimleri karşılaştırıldı.

Bulgular: BP kullanan olguların başlangıç T-skoru düzeyleri, HRT kullanan olgulara göre anlamlı yüksekti (p < 0.01). BP kullanan olguların 6. aydaki T skoru düzeyleri, HRT kullanan olgulardan anlamlı düzeyde yüksek bulundu (p < 0.05). Her iki grupta da; başlangıçtaki T skoru düzeyine göre 6. ay T skoru düzeyinde istatistiksel olarak anlamlı bir değişim görülmemiştir (p > 0.05). BP kullanan olguların başlangıçtaki β-CTx düzeyleri, HRT kullanan olgulardan anlamlı yüksekti (p < 0.01). BP kullananların 6. aydaki β-CTx düzeyleri, HRT alanlardan anlamlı düzeyde yüksek bulundu (p < 0.05). BP kullanan olgularda; başlangıçtaki β-CTx düzeyine göre 6. ay β-CTx düzeyinde görülen düşüş istatistiksel olarak anlamlı bulunmuştur (p < 0.05).

Sonuç: Serum β-CTx ölçümü erken dönemde değişim göstererek özellikle hızlı kemik kaybı olan hastalarda tedavinin etkinliğini değerlendirmede kemik mineral yoğunluğuna göre daha erken yol gösterici olmakla birlikte bu konuda daha uzun süreli çalışmalara ihtiyaç vardır

Kaynakça

  • McCombs JS, Thiebaud P, McLaughlin-Miley C, Shi J. Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas. 2004;48:271-87.
  • Anna Daroszewska. Prevention and treatment of osteoporosis in women: an update. Obstetrics, Gynaecology & Reproductive Medicine. 2012;22:162-9.
  • Peichl P, Griesmacherb A, Marteau R. et al. Serum crosslaps in comparison to serum osteocalcin and urinary bone resorption markers. Clinical Biochemistry 2001;34:131-9.
  • Albright F, Smith PH, Richelson AM. Postmenopausal osteoporosis: its clinical features. JAMA 1941;116:2465-74.
  • Bowring CE, Francis RM. National Osteoporosis Society’s Position statement on hormone replacement therapy in the prevention and treatment of osteoporosis. Menopause Int. 2011;17:63-5
  • Garnero P. New biochemical markers of bone turnover. IBMS Bone Key 2008;5:84–102.
  • Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A et al. IOF-IFCC Bone Marker Standards Working Group. Markers of bone turnover for the predictionof fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporosis International 2011;22:391–420.
  • Vasikaran S, Cooper C, Eastell R, Griesmacher A, Morris HA, Trenti T et al. International Osteoporosis Foundation and International Federation of Clinical Chemistry and Laboratory Medicine position on bone marker standards in osteoporosis. Clin Chem Lab Med. 2011;49:1271-4.
  • Overgaard K, Christiansen C. A new biochemical marker of bone resorption for follow up on treatment with nasal salmon calcitonin. Calcif Tissue Int 1996;59:12-6.
  • Ravn P, Clemmesen B, Christiansen C. Biochemical markers can predict the response in bone mass during alendronate treatment in early postmenopausal women. Bone 1999;24:237-44.
  • Garnero P, Delmas PD. Contribution of bone mineral density and bone turnover markers to the estimation of risk of osteoporotic fracture in postmenopausal women. J Musculoskel Neuron Interact 2004;4:50-63.
  • Zhao J, Xia W, Nie M, Zheng X, Wang Q, Wang X et al. The levels of bone turnover markers in Chinese postmenopausal women: Peking Vertebral Fracture study. Menopause. 2011;18:1237-43.
  • Tanko LB, Mouritzen U, Lehmann HJ, Warming L, Moelgaard A, Christgau S. Oral ibandronate: changes in markers of bone turnover during adequately dosed continuous and weekly therapy and during different suboptimally dosed treatment regimens. Bone 2003;32:687-93.
  • Rogers A, Glover SJ, Eastell R. A randomised, double-blinded, placebo-controlled, trial to determine the individual response in bone turnover markers to lasofoxifene therapy. Bone 2009;45:1044-52.
  • Christgau S, Bitsch-Jensen O, Hanover BN, Gamwell HE, Ovist P, Alexandersen P. Serum Crosslaps for monitoring the response in individuals undergoing antiresorptive therapy. Bone 2000;26:505-11.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Klinik Araştırma
Yazarlar

Murat Aslan Bu kişi benim

Ebru Çöğendez

Meryem Eken

Petek Arıoglu Bu kişi benim

Sadiye Eren Bu kişi benim

Yayımlanma Tarihi 14 Ağustos 2015
Gönderilme Tarihi 31 Aralık 2014
Yayımlandığı Sayı Yıl 2015 Cilt: 78 Sayı: 2

Kaynak Göster

APA Aslan, M., Çöğendez, E., Eken, M., Arıoglu, P., vd. (2015). SERUM BETA CROSSLAPS AS A PREDICTOR FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN. Journal of Istanbul Faculty of Medicine, 78(2), 36-40. https://doi.org/10.18017/iuitfd.m.13056441.2015.78/2.36-40
AMA Aslan M, Çöğendez E, Eken M, Arıoglu P, Eren S. SERUM BETA CROSSLAPS AS A PREDICTOR FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN. İst Tıp Fak Derg. Ağustos 2015;78(2):36-40. doi:10.18017/iuitfd.m.13056441.2015.78/2.36-40
Chicago Aslan, Murat, Ebru Çöğendez, Meryem Eken, Petek Arıoglu, ve Sadiye Eren. “SERUM BETA CROSSLAPS AS A PREDICTOR FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN”. Journal of Istanbul Faculty of Medicine 78, sy. 2 (Ağustos 2015): 36-40. https://doi.org/10.18017/iuitfd.m.13056441.2015.78/2.36-40.
EndNote Aslan M, Çöğendez E, Eken M, Arıoglu P, Eren S (01 Ağustos 2015) SERUM BETA CROSSLAPS AS A PREDICTOR FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN. Journal of Istanbul Faculty of Medicine 78 2 36–40.
IEEE M. Aslan, E. Çöğendez, M. Eken, P. Arıoglu, ve S. Eren, “SERUM BETA CROSSLAPS AS A PREDICTOR FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN”, İst Tıp Fak Derg, c. 78, sy. 2, ss. 36–40, 2015, doi: 10.18017/iuitfd.m.13056441.2015.78/2.36-40.
ISNAD Aslan, Murat vd. “SERUM BETA CROSSLAPS AS A PREDICTOR FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN”. Journal of Istanbul Faculty of Medicine 78/2 (Ağustos 2015), 36-40. https://doi.org/10.18017/iuitfd.m.13056441.2015.78/2.36-40.
JAMA Aslan M, Çöğendez E, Eken M, Arıoglu P, Eren S. SERUM BETA CROSSLAPS AS A PREDICTOR FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN. İst Tıp Fak Derg. 2015;78:36–40.
MLA Aslan, Murat vd. “SERUM BETA CROSSLAPS AS A PREDICTOR FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN”. Journal of Istanbul Faculty of Medicine, c. 78, sy. 2, 2015, ss. 36-40, doi:10.18017/iuitfd.m.13056441.2015.78/2.36-40.
Vancouver Aslan M, Çöğendez E, Eken M, Arıoglu P, Eren S. SERUM BETA CROSSLAPS AS A PREDICTOR FOR OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN. İst Tıp Fak Derg. 2015;78(2):36-40.

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