The clinical value of BALP on diagnosis and treatment of osteoporosis in postmenopausal women

摘要

Objective: To investigate the changes of bone-specific alkaline phosphatase(BALP) in postmenopausal women, analyze the relationship between BALP and bone mineral density, and study the effects of treatment with risedronate on BALP. Methods: In this study, 243 women who were all at least 1 year past natural menopause were divided into two groups according to WHO standards. Group I was 100 osteopenic patients aged from 43 to 85 (mean age, 61.2 years). Group II was 143 osteoporotic patients aged from 45 to 80(mean age, 62.6 years). Bone mineral density(BMD) was measured by dual-energy X-ray absorptiometry (DEXA) and bone-specific alkaline phosphatase(BALP) was tested among all the patients. All the osteoporotic patients received 1-year Risedronate treatment. BALP was tested again after 3 months treatment of Risedronate for osteoporotic patients and BMD was measured after 1-year treatment. All data were processed by the application of statistical package SAS for windows V.6.12. Results: BALP was greater in the osteoporotic patients as compared with the osteopenic patients (P < 0.05). There was also a significant difference of BALP in the patients before and after treatment of risedronate(P < 0.05). BALP was greater in the patients who were less than 5 years past a natural menopause as compared with those who were more than 5 years past a natural menopause(P < 0.05). There was no significant difference of BALP in the patients who were more than 10 years past a natural menopause. Risedronate decreased serum BALP significantly. Logistic regression analyses showed that 3-month percentage decrease in BALP was profoundly associated with the 1-year percentage increase in BMD(r = 0.696, P < 0.01). Conclusion: BALP can predict the response in bone mass during Risedronate treatment in postmenopausal women and identify those noncompliant patients. 3-month percentage change in serum BALP was significantly correlated with the increase of BMD. Serum BALP can play a role in the monitoring of risedronate-treated postmenopausal women with osteoporosis, but it is poor to predict the treatment effects on an individual level.