비스포스포네이트를 복용한 폐경 여성에서 골 교체 지표와 연골표지인자의 측정

Abstract

Objectives: This study was conducted to assess whether treatment with bisphosphonate affects the levels of bone turnover markers (urine deoxypyridinoline, serum osteocalcin) and cartilage turnover marker (serum cartilage oligomeric matrix protein, COMP).

Methods: 30 postmenopausal women within 1 year from the diagnosis of menopause were enrolled in our study. These patients were divided into bisphosphonate, or control groups according to the treatment they received. Blood samples for turnover markers were taken before the initiation of medication, after 3 and 6 months. Known bone markers such as serum osteocalcin, urine deoxypyridinoline and cartilage marker such as serum cartilage oligomeric matrix protein (COMP) were evaluated.

Results: 20 without severe hot flushes, but with osteoporosis or osteopenia received alendronate sodium 70 mg weekly regimen (BPN group) and 10 patients received no medication (control group). The mean osteocalcin levels and urine deoxypyridinoline levels were suppressed according to the treatment period in BPN group but not in control group. In BPN group, mean COMP levels remained similar at 0, 3 and 6 months with no statistical significance. However, mean COMP levels of BPN group were significantly decreased in comparison to the control after 6 months (19.08 ± 7.44 μg/mL vs. 22.50 ± 6.93 μg/mL, P=0.022). There existed significant correlations between osteocalcin, UDP and COMP (r=0.596 between osteocalcin and UDP, r=0.431 between UDP and COMP, r=0.341 between osteocalcin and COMP).

Conclusion: Bisphophonate significantly suppressed the excretion of bone turnover marker in the patients, but tended to decrease cartilage marker. These results indicate that the treatment with bisphosphonate not only favorably affect bone metabolism but also decrease cartilage turnover, with possible implication for improving osteoporosis and osteoarthritis in postmenopausal women