Effect of Osteroporosis Therapy & Bone Marker Change in Peri Menopousal Women

Abstract

Objectives: There is on the increase of risk of osteoporosis to pre and post menopausal women and there are many medication to treat osteoporosis. But the studies to comparison of effectiveness of osteoporosis treatment and prevention are mostly from western people. So, the study to comparison of effectiveness of medication to treat and prevent of osteoporosis is needed to Korean pre and post menopausal women.

Methods: A total of 131 Pre and post women who visit health examination center in January 2000 - june 2004 who aged from 40 to 78 devided into four group. bisphosphonate(alendronateR, risedronateR, once in a weekly), raloxifene(evistaR 60mg/d), hormone replacement therapy group(conjugated equine estrogen(CEE) 0.625mg/d. medroxyprogesterone acetate(MPA) 2.5mg/d) and no medication group. Number of each group was 30, 29, 42, 30. we have test BMI(kg/m2), blood pressure, blood sugar, cholesterol, liver function test by venous sampling. Lumbar spine(L2-L4) and femoral head BMD were measured by dual x-ray absorptiometry(DXA) at baseline and at 12-month intervals. Lumbar spine(L2-L4) and femoral head BMD, bone marker(NTX, osteocalcin), serum cholesterol level were measured and repeat same test 1 year after. Serum cholesterol included total cholesterol, triglyceride(TG), low density lipoprotein(LDL), high density lipoprotein(HDL).

Results: All change in BMD, BMD T-score, bone marker, cholesterol level were different between each of treat group. The increase of lumbar spine(L2-L4) BMD in bisphosphonate group 6.93% and HRT group 5.14% was greater than raloxifene group 2.03%(P-value 0.000). The increase of lumbar spine(L2-L4) BMD T-score in HRT group 40.91% was greater than raloxifene group 11.46%(P-value 0.004). The increase of femoral head BMD in bisphosphonate group(6.87%) was greater than raloxifenegroup(2.75%)(P-value 0.010). there was no differences in femoral head BMD T-score among the groups. There was no differences among the groups in bone marker(NTX, osteocalcin). In comparison of cholesterol change rate, the increase of HDL in raloxifene group(15.05%) was greater than bisphosphonate(-0.35%) and HRT(-0.69%) group(P-value <0.05). There was no differences among the groups in total cholesterol, TG, LDL.

Conclusion: Bisphosphonate and HRT is significantly greater effect of increasing lumbar vertebral(L2∼L4) and femoral head BMD. Raloxifeneis not significantly effect of increasing lumbar vertebral(L2-L4) and femoral head BMD than bisphosphonate, HRT group. But raloxifene have greater effect of increasing HDL. There was no differences among the groups in bone marker(NTX, osteocalcin).