Skip to main content

Advertisement

Log in

Effect of Antiresorptive Therapy on Urinary Hydroxyproline in Postmenopausal Osteoporosis

  • Original Article
  • Published:
Indian Journal of Clinical Biochemistry Aims and scope Submit manuscript

Abstract

Osteoporosis becomes a serious health threat for older postmenopausal women by predisposing them to an increased risk of fracture. Osteoporosis and associated fractures are an important cause of morbidity and mortality. Special attention is being paid to early detection, management, and treatment of postmenopausal osteoporosis in women. Biochemical markers can enable dynamic and rapid measurement of total body skeletal metabolism and will be clinically useful in the management of postmenopausal osteoporosis women (PMO) and also for assessing the effects of antiresorptive therapy. With this view, we planned to assess osteoclastic activity by determining urinary hydroxyproline in osteoporotic women. The aim of this study is to measure urinary hydroxyproline (expressed as mg of hydroxyproline/g of creatinine) and serum ascorbic acid in postmenopausal women with osteoporosis and without osteoporosis. These biochemical parameters were determined 3 months post antiresorptive therapy (alendronate + calcium + vitamin D) in postmenopausal osteoporosis patients. 60 postmenopausal women with osteoporosis in the age group 45–60 years and 60 healthy postmenopausal women (normal bone mineral density) in the same age group were included in the study. Urinary hydroxyproline levels were significantly increased (P < 0.001) in PMO at baseline level as compared to control group. These levels were decreased significantly (P < 0.001) post therapy in PMO patients. Serum vitamin C levels were significantly decreased (P < 0.001) in PMO patients at baseline level as compared to controls. No significant change occurred of serum vitamin C level post therapy. Raised excretion of hydroxyproline at the baseline level might be due to increased degradation of collagen type I from the bone matrix in osteoporosis. Breakdown of collagen seems to be lowered as reflected by lowering of hydroxyproline excretion post antiresorptive therapy. Alteration in the concentration of this marker can be very well utilized to monitor the effectiveness of therapy. Thus simple, direct urinary assay to measure bone resorption is very useful in monitoring the therapy in PMO and may become an integral part of the management of osteoporosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Brown SA, Rosen CJ. Osteoporosis. Med Clin N Am. 2003;87:1039–63.

    Article  PubMed  Google Scholar 

  2. Gupta A. Osteoporosis in India-the nutritional hypothesis. Natl Med J Indian. 1996;9(6):268–74.

    CAS  Google Scholar 

  3. Fact and statistics about osteoporosis and its impact. International Osteoporosis Foundation, Osteoporosis Society of India. Action plan osteoporosis. Consensus statement of an expert group, New Delhi. 2011. http://www.osteofound.org/press_centre/fact_sheet.html.

  4. Neetakumar, Ammini AC, Tandon N, Goswami R, Dineshkumar, Singh A. Ethnic variation of host and risk factors in silent epidemic of osteoporosis. Orthop Today. 2004;6(4):240–4.

    Google Scholar 

  5. Sachdeva A, Seth S, Khosla AH, Sachdeva S. Study of some common biochemical bone turnover markers in postmenopausal women. Indian J Clin Biochem. 2005;20(1):131–4.

    Article  Google Scholar 

  6. Axelrod DW, Teitelbaum SL. Results of long-term cyclical etidronate therapy: bone histomorphometry and clinical correlates. J Bone Miner Res. 1994;9S1:136.

    Google Scholar 

  7. Stevenson JC, Whitehead MI. Postmenopausal osteoporosis. Br Med J. 1982;285:585–7.

    Article  CAS  Google Scholar 

  8. Delmas PD. Biochemical markers of bone turnover for the clinical investigation of osteoporosis. Osteoporos Int. 1993;3(1):81–6.

    Article  PubMed  Google Scholar 

  9. George BO. Urinary and anthropometrical indices of bone density in healthy Nigerian adults. J Appl Sci Environ Mgt. 2003;7(1):19–23.

    Google Scholar 

  10. McCormick DB, Greene HL. Vitamins. In: Burtis CA, Ashwood ER, editors. Tietz Textbook of Clinical Chemistry. 3rd ed. Philadelphia: W.B. Saunders Co.; 1999. p. 999–1028.

  11. Bergman I, Loxley R. The determination of hydroxyproline in urine hydrolysates. Clin Chim Acta. 1970;27:347–9.

    Article  PubMed  CAS  Google Scholar 

  12. Bonsnes RW, Taussky HH. On the colorimetric determination of creatinine by the Jaffe reaction. J Boil Chem. 1945;158:581–91.

    CAS  Google Scholar 

  13. Justesen TI, Petersen JLA, Ekbom P, Damm P, Matheisen ER. Albumin-to-creatinine ratio in random urine samples might replace 24 h urine collections in screening for Micro-and Macroalbuminuria in pregnant women with type-1 diabetes. Diabetes Care. 2006;29(4):924–5.

    Article  PubMed  Google Scholar 

  14. Indumati V, Patil VS, Jailkhani R. Hospital based preliminary study of osteoporosis in postmenopausal women. Indian J Clin Biochem. 2007;22(2):96–100.

    Article  CAS  Google Scholar 

  15. Lofman O, Magnusson P, Toss G, Larsson L. Common biochemical markers of bone turnover predicts future bone loss: a 5-year follow-up study. Clin Chim Acta. 2005;356:67–75.

    Article  PubMed  Google Scholar 

  16. Eastell R, Robins SP, Colwell T, Assiri AMA, Riggs BL, Russell RGG. Evaluation of bone turnover in type I osteoporosis using biochemical markers specific for bone formation and resorption. Osteoporos Int. 1993;3:255–60.

    Article  PubMed  CAS  Google Scholar 

  17. Fardellone P, Brazier M, Kamel S, Gueris J, Graulet AM, Lienard J, Sebert JL. Biochemical effects of calcium supplementation in postmenopausal women: influence of dietary calcium intake. Am J Clin Nutr. 1998;67:1273–8.

    PubMed  CAS  Google Scholar 

  18. Kamel S, Fardellone P, Meddah B, Gondelmann FL, Sebert JL, Brazier M. Response of several markers of bone collagen degradation to calcium supplementation in postmenopausal women with low calcium intake. Clin Chem. 1998;44(7):1437–42.

    PubMed  CAS  Google Scholar 

  19. Horowitz M, Need AG, Morris HA. Biochemical effects of calcium supplementation in postmenopausal osteoporosis. Eur J Clin Nutr. 1988;42:775–8.

    PubMed  CAS  Google Scholar 

  20. Chavan SN, More U, Mulgund S, Saxena V, Sontakke AN. Effect of supplementation of vitamin C, and E on oxidative stress in osteoporosis. Indian J Clin Biochem. 2007;22(2):101–5.

    Article  CAS  Google Scholar 

  21. Simon JA, Hudes ES. Relation of ascorbic acid to bone mineral density and self reported fractures among US adults. Am J Epidemiol. 2001;154(5):427–33.

    Article  PubMed  CAS  Google Scholar 

  22. Morton DJ, Barret Conner EL, Schneider DL. Vitamin C supplements use and bone mineral density in postmenopausal women. J Bone Miner Res. 2001;16(1):135–40.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vanita R. Jagtap.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jagtap, V.R., Ganu, J.V. Effect of Antiresorptive Therapy on Urinary Hydroxyproline in Postmenopausal Osteoporosis. Ind J Clin Biochem 27, 90–93 (2012). https://doi.org/10.1007/s12291-011-0185-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12291-011-0185-4

Keywords

Navigation