Short-term changes in bone turnover markers and bone mineral density response to parathyroid hormone in postmenopausal women with osteoporosis

D. C. Bauer, P. Garnero, J. P. Bilezikian, S. L. Greenspan, K. E. Ensrud, C. J. Rosen, L. Palermo, D. M. Black

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99 Scopus citations


Context: Treatment of osteoporotic women with PTH increases biochemical markers of bone turnover, increases axial bone mineral density (BMD), and reduces fracture risk. Objective: Our objective was to determine the relationship between levels of baseline turnover before PTH therapy and short-term changes in turnover during PTH therapy and subsequent changes in areal and volumetric BMD. Design and Setting: We conducted a randomized, placebo-controlled trial at four academic centers. Patients: Patients included 238 postmenopausal women with low hip or spine BMD. Intervention: Subjects were randomized to sc PTH (1-84), 100 μg/d (119 women), for 1 yr. Main Outcome Measure: Bone turnover markers were measured in fasting blood samples collected before therapy and after 1 and 3 months. Areal and volumetric BMD at the spine and hip were assessed by dual-energy x-ray absorptiometry and quantitative computed tomography (QCT) after 1 yr of therapy. Results: Among women treated with PTH alone, the relationships between baseline turnover and 1-yr changes in dual-energy x-ray absorptiometry and QCT BMD were inconsistent. Greater 1- and 3-month increases in turnover, particularly the formation marker N-propeptide of type I collagen, were associated with greater increases in areal BMD. When volumetric hip and spine BMD were assessed by QCT, greater short-term increases in turnover were even more positively associated with 1-yr increases in BMD. Each SD increase in the 3-month change of N-propeptide of type I collagen was associated with an a 21% greater increase in QCT spine trabecular BMD. Conclusions: Greater short-term changes in turnover with PTH therapy are associated with greater 1-yr increases in spine and hip BMD among postmenopausal osteoporotic women.

Original languageEnglish (US)
Pages (from-to)1370-1375
Number of pages6
JournalJournal of Clinical Endocrinology and Metabolism
Issue number4
StatePublished - Apr 2006


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