Details
Category: Volume 06 Issue 03 March 2018
Hits: 1241

Title: A Prospective Comparative Study between Bone Biomarkers & DEXA Scan Absorptiometry in Diagnosis & Therapeutic post treatment follow up of Osteoporosis

Authors: Ahmed Alkhuzai FICMS, Hisham A. Getta FICMS, Salah M. Fateh DMRD/FIBMS

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i3.139

Abstract

Introduction: We try to study the best method in diagnosis & therapeutic follow up post treatment respond in osteoporotic patients. Used the advantages of Dexa scan Absorptiometry and bone biomarkers for diagnosis & therapeutics post treatment follow up monitoring of osteoporotic patients were treated by different modalities.

Methods: Prospective comparative studies were randomized according to national osteoporotic foundation. Performed on 200 osteoporotic patients from March 2010 to April 2012, in private clinic sharing private Hematological and Dexa Scan Absorptiometry clinic in Sulaimaniyah city. All these patients with clinical sign of osteoporosis, also all of patients with history of osteoporotic fractures plus surgical history "Hysterectomy, Mastectomy, ooperectomy" were classified into two groups. Group A 100 patients used Dexa scan Absorptiometry for diagnosis & therapeutics treatment monitoring follow up. Group B100 patients were used bone biomarker "Vit D3, PTH, ALK, Osteocalcin" for evaluation & monitoring bone turnover used in diagnosis & therapeutic post treatment follow up of osteoporotic patients. The patients were follow up for 2 years period. The outcome measurements were according to Ancillary results scores of national osteoporotic foundations.

Results: In both group A & group B significant reduction in the mean of Ancillary results scores base line for both Dexa scan Absorptiometry & bone biomarkers were seen early & at 6 months ,1 year and 2 years follow up period visit of osteoporotic patients. Also, there were significant differences (p-value < 0.0001) to the same period of follow up between groups A there were used Dexa scan Absorptiometry as superior to bone biomarkers in diagnosis of osteoporotic patients. In Compared to group B depend on bone biomarkers there were superior in therapeutics post treatment follow up than Dexa scan Absorptiometry.

Conclusions: We concluded that Dexa scan Absorptiometry & Bone Biomarkers both are significant in diagnosis and post therapeutic treatment follow up of osteoporotic patients, However, Bone Biomarkersis superior in post therapeutic treatment than Dexa Scan Absorptiometry which is superior in diagnosis of osteoporotic patients for 2 years study follow up.

References

  1. National Osteoporosis Foundation. America’s Bone Health: The State of Osteoporosis and Low Bone Mass in Our Nation. Washington, DC: National Osteoporosis Foundation; 2002.
  2. Moyad MA. Preventing male osteoporosis: prevalence, risks, diagnosis and imaging tests. Urol Clin N Am. 2004;31:321–330. doi: 10.1016/j.ucl.2004.01.008.
  3. Neetakumar, Ammini AC, Tandon N, Goswami R, Dineshkumar, Singh A. Ethnic variation of host and risk factors in silent epidemic of osteoporosis. Orthoped Today. 2004;VI(4):240–244.
  4. Kanis JA, Melton LJ III, Christiansen C, Johnston CC, Khaltaev N.The diagnosis of osteoporosis. J Bone Miner Res. 1994;9(8):1137-1141
  5. Raisz LG. Physiology and pathophysiology of bone remodeling. Clin Chem. 1999;45:1353–1358.
  6. Black D, Bilezikian J, Ensrud K, Greenspan S, Palermo L, Hue T, et al. One year of alendronate after one year of parathyroid hormone(1–84) for osteopor-osis. N Engl J Med. 2005;353:555–565.
  7. Garnero P, Darte C, Delmas P. A model to monitor the efficacy of alendronate treatment in women with osteoporosis using a biochemical marker of bone turnover. Bone. 1999;24:603–609.
  8. Cremers S, Garnero P. Biochemical markers of bone turnover in the clinical development of drugs for osteoporosis and metastatic bone disease: potential uses and pitfalls. Drugs. 2006;66:2031–2058.
  9. Charles P, Poser JW, Mosekilde L, Jensen FT. Estimation of bone turnover evaluated by 47Ca-kinetics. Efficiency of serum bone gamma-carboxyglutamic acid-containing protein, serum alkaline phosphatase, and urinary hydroxyproline excretion. Journal of Clinical Investigation. 1985;76:2254–2258.
  10. Eriksen EF, Charles P, Melsen F, Mosekilde L, RisteliL, Risteli J. Serum markers of type I collagen formation and degradation in metabolic bone disease: correlation with bone histomorphometry. Journal of Bone Mineral Research. 1993;8:127–132.
  11. Paul Robertson, MD , Sundeep Khosla, MD. Translational Endocrinology & Metabolism. The endocrine society. Volume I, Number 1, 2010
  12. Allison JL, Stephen H, Richard E. Measurement of osteocalcin. Ann Clin Biochem. 2000;37:432–446.
  13. Swaminathan R. Biochemical markers of bone turnover. Clin Chim Acta. 2001;313:95–105.
  14. National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Washington, DC: National Osteoporosis Foundation; 2014.
  15. S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, Md.: U.S. Department of Health and Human Services, Office of the Surgeon General; 2004.
  16. National Osteoporosis Foundation. America's Bone Health: The State of Osteoporosis and Low Bone Mass in Our Nation. Washington, DC: National Osteoporosis Foundation; 2002.
  17. World Health Organization. WHO scientific group on the assessment of osteoporosis at the primary health care level: summary meeting report. Brussels, Belgium; May 5–7, 2004. Geneva, Switzerland: World Health Organization; 2007.
  18. S. Preventive Services Task Force. Screening for osteoporosis: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2011;154(5):356–364.
  19. Lewiecki EM. Bone density monitoring to monitor osteoporosis therapy in clinical practice. Am Fam Physician. 2010;82 (7):749–754.
  20. Combs BP, Rappaport M, Caverly TJ, Matlock DD. “Due” for a scan: examining the utility of monitoring densitometry. JAMA Intern Med. 2013;173(21):2007–2009.
  21. World Health Organization. Assessment of fracture risk and its implication to screening for postmenopausal osteoporosis: Technical report series 843. Geneva: WHO,1994
  22. Kanis J. Diagnosis of osteoporosis and assessment of fracture risk. Lancet 2002;359:1929-36
  23. Garnero P. Markers of bone turnover for the prediction of fracture risk. Osteoporos Int. 2000;11 Suppl 6:S55-65
  24. Delmas PD, Eastell P, Garnero P, Seibel MJ, Stepan J, Committee of Scientific Advisors of the International Osteoporosis Foundation. The use of biochemical markers of bone turnover in osteoporosis. Osteoporos Int. 2000;11 Suppl 6:S2-17.
  25. Johnell O, Odén A, De LAet C, Garnero P, Delmas PD, Kanis JA. Biochemical indices of bone turnover and the assessment of fracture probability. Osteoporosis Int 2002;13:523-6
  26. Delmas PD, Vrijens B, Roux C, Le-Moigne-Amrani A,. Eastell R, Grauer A, Watts NB, Pols HA, Ringe JD, Cahall D. A Reinforcement Message Based on Bone Turnover Marker Response Influences Long-Term Persistence with Risedronate in Osteoporosis: The IMPACT Study.. ASBMR 2003 [Poster M330]

Corresponding Author

Ahmed Alkhuzai FICMS

Faculty of Medicine, Sulaimani University, Iraq