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Korean Journal of Obstetrics & Gynecology 2003;46(7):1316-1324.
Published online July 1, 2003.
Study for Usefulness of Total Alkaline Phosphatase as a Biochemical Markers of Bone Turnover in Healthy Menopausal Women.
Yun Seok Yang, Joon Suk Park
Department of Obstetrics and Gynecology, Eulji University Hospital, Daejeon, Korea.
Abstract
OBJECTIVE
Total alkaline phosphatase (TALP) has been common bone formation marker of managing individual cases of highly abnormal bone remodeling, such as paget's disease. However, the lack of bone specificity of TALP balances such as bone loss resulting from postmenopausal estrogen deficiency and osteoporosis. This study investigated usefulness of TALP as a biochemical markers of bone turn over in healthy menopausal women. METHODS: The levels of urinary deoxypyridinoline (DPD), serum total alkaline phosphatase (TALP), osteocalcin (OC) were determined. Bone mineral density (BMD) were also measured by dual energy X-ray absorptiometry (DEXA). We compared the biochemical markers of bone turnover and serum TALP among 3 group classified by menopausal state, and among 3 groups classified by WHO classification of osteoporosis. Also we analyzed the correlation between bone markers with BMD and bone markers with age. RESULTS: All biochemical markers of bone turnover (TALP, DPD, OC) were increased significantly with age. There were negative correlation between Biochemical markers of bone turnover and spinal BMD (TALP; r=-0.440, p<0.01, DPD; r=-0.380, p<0.001, OC; r=-0.328, p<0.001, respectively). Biochemical markers of bone turnover (TALP, DPD, OC) in osteoporosis group were significantly higher than osteopenia and normal BMD group. The TALP significantly increased in osteopenia group compared normal BMD group but not DPD and OC. Biochemical markers of bone turnover (TALP, DPD, OC) were increased from premenopause to postmenopause. There were positive correlation between DPD and OC (r=0.365, p<0.001). TALP correlated well with DPD (r=0.490, p<0.001) and OC (r=0.433, p<0.001). CONCLUSION: Because of these association, we concluded that total alkaline phosphatase is a useful biochemical markers of bone turnover and reflects the bone turnover in healthy menopausal women characterized by more subtle remodeling imbalances such as bone loss resulting from postmenopausal estrogen deficiency and osteoporosis.
Key Words: Bone turnover markers, Total alkaline phosphatase, Osteoporosis, Menopause


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