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

Weiguo Li; Hua Lin; Yong Qiu; Yongmei Zhang; Xin Chen

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 143osteoporotic 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.