Article
Changes of Biochemical Markers during the Fracture Healing in Osteoporosis.
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Published: | November 11, 2003 |
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Outline
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Introduction
The aim of this experimental study was to evaluate the changes of biochemical markers during the fracture healing of distal radius fractures in premenopausal patients and postmenopausal patients with osteoporosis.
Materials and Methods
The study included 9 pre- (36±6.5 years) and 35 postmenopausal patients (68,5±7.4 years) with a fracture of the distal radius, although 10 pre- (34.3±3 years) and 19 postmenopausal women (64.4±7.2 years) without a fracture were admitted to this study. By means of quantitative computed tomography of the lumbar spine, we distinguished a non-osteoporotic postmenopausal group (T-score ≥d -2.5) and an osteoporotic postmenopausal group with a T-score below -2.5. All patients with a distal radius fracture were divided by the method of therapy (conservative / operative). Blood and urine samples were obtained at the time of admission. Thereafter, samples were collected 2, 4, 10 and 14 days after the injury, in 6 patients samples were collected over 6 weeks. The following biochemical bone markers were measured:
Serum: Crea, Ca, P, ALP, bALP, PICP, OC, ucOC, Vit. K, BSP
Urine: Crea, Ca, P, PYD, DPD, NTx
Results
In groups without a fracture (control group), the concentrations of biochemical markers were significantly lower than in groups during the osteoporotic and non-porotic fracture healing. The comparison of the pre- and postmenopausal fracture healing revealed less differences of concentration. The postmenopausal patients exhibited higher concentrations of activity. During the changes of the osteoporotic and non-porotic fracture healing significant differences were recognized. Bone resorption markers (PYD, DPD, NTx) of the premenopausal and postmenopausal non-porotic group started to increase in the first 4 days and returned to intial vales at the 5th day post fractionem. Bone formation markers (ALP, bALP, PICP, OC, ucOC) started to increase slowly during the fracture healing and showed significant differences of concentration between the bone healing in osteoporotic and non-porotic bone, also between the bone healing in young and postmenopausal patients. A significant increase of bone formation markers was noticed in the non-osteoporotic group.
Conclusion
In conclusion, biochemical formation and resorption markers reflected the bone remodelling process during the osteoporotic and non-porotic fracture healing. They changed differently depending upon the fracture and the bone mineral density. In osteoporotic bone no significant differences of concentration of bone formation and resorption markers could observed compared to the healing process of non-osteoporotic bone and the healing process of bone in young human beings.