Turkish Journal of Physical Medicine and Rehabilitation 2005 , Vol 51 , Num 2

Relationship Between Bone Mineral Density and Biochemical Markers of Bone Turnover

Nuriye Gürer 1 ,Reyhan Başak 2 ,Cengiz Bahadır 3 ,Hüsniye Koç 1 ,Yalçın Polat 1 ,Sacide Atalay 4 ,Can Bora Önder 1
1 Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul
2 Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Biyokimya Bölümü, İstanbul
3 Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul
4 Atatürk Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği, İzmir

Objective: Osteoporosis is a disease defined by decreased bone mass and alteration of microarchitecture which results in increased bone fragility and risk of fracture. The detoriation of trabecular microarchitecture induced by elevated bone turnover plays an important role in the pathogenesis of osteoporotic fractures. This study was designed to evaluate the correlation of bone mineral density measurement and the levels of biochemical markers of bone turnover.


Materials and Methods: According to the WHO criteria 23 osteoporotic, 44 osteopenic postmenopausal and 23 premenopausal women were included in this study. Bone mineral density at spine (L2-L4) and femoral neck was measured by dual-energy x-ray absorbtiometry (DEXA) and t scores were obtained. Alkaline phosphatase (ALP) and osteocalcin were measured as markers of bone formation whereas tartrate resistant acid phosphates (TRAP) and C-terminal telopeptide (CTX) were determined as markers of bone resorbtion in the serum. 

Results: Both bone formation and resorption markers were found to be increased in patients with low bone mineral density. In the patients with osteoporosis and osteopenia, there were weak correlations which were not statistically significant between BMD and ALP, osteocalcin, TRAP and CTX. 

Conclusion: Our findings demonstrate that high bone turnover is associated with low bone mineral density and biochemical markers of bone turnover may be helpful in the prediction and monitoring of osteoporosis.  

Keywords : Osteoporosis, bone turnover, osteocalcin, alkaline phosphatase, C-Telopeptide