J Korean Orthop Assoc.  2023 Apr;58(2):124-132. 10.4055/jkoa.2023.58.2.124.

Changes in Bone Mineral Density and Levels of Bone Turnover Markers after Teriparatide Treatment in Patients with Osteoporotic Hip Fractures

• Park EK
• Baek SH
• Shim BJ
• Jeong Bg
• Kim SY

• KMID: 2541467
• DOI: http://doi.org/10.4055/jkoa.2023.58.2.124

Abstract

Purpose
The purposes of this study were to analyze the changes of bone mineral density (BMD) and bone turnover markers and to analyze the correlation between these parameters after teriparatide treatment in patients with osteoporotic hip fractures.
Materials and Methods
We retrospectively reviewed 42 patients who had osteoporotic femoral fractures and administered teriparatide with a minimum follow-up of 1 year. The mean age of the patients was 74.2±9.9 years, and the mean follow-up period was 13.2±3.3 months. Before starting treatment, all patients underwent BMD and measured the serum bone-alkaline phosphatase (B-ALP), C-telopeptide of type I collagen (CTX), and 25 (OH) vitamin D3 levels. The BMD was measured at 1 year and the other parameters were measured at 3 months, 6 months, and 1 year after teriparatide treatment. The changes and the correlations between these variables were analyzed.
Results
The mean BMD in the lumbar spine increased significantly from 0.82±0.19 g/cm² to 0.88±0.18 g/cm² (p=0.019). The mean serum B-ALP was significantly increased from 14.65±6.76 μg/L to 20.61±3.24 μg/L (p=0.028), 21.67±2.59 μg/L (p=0.019), and 17.91±3.29 μg/ L (p=0.031) after 3 months, 6 months, and 1 year of treatment, respectively. The mean serum CTX significantly increased from 0.38±0.13 ng/ml to 0.53±0.08 ng/ml (p=0.021), 0.50±0.12 ng/ml (p=0.032), and 0.50±0.08 ng/ml (p=0.025) after 3 months, 6 months, and 1 year of treatment, respectively. The mean serum 25 (OH) vitamin D3 was increased from 16.12±3.45 ng/ml to 18.35±5.57 ng/ml (p=0.062), 20.72±4.32 ng/ml (p=0.045), and 21.21±6.76 ng/ml (p=0.032) after 3 months, 6 months, and 1 year of treatment, respectively. Serum B-ALP and serum CTX showed a significant correlation with each other at 3 months (r=0.482, p<0.01), 6 months (r=0.400, p<0.05), and 1 year (r=0.379, p<0.05) after treatment.
Conclusion
Teriparatide treatment in patients with osteoporotic femoral fractures showed significant increases in lumbar spine BMD, serum B-ALP, CTX, and 25 (OH) vitamin D3, and a significant correlation was observed between serum B-ALP and CTX. Serum B-ALP reached a maximum at 6 months of treatment and CTX at 3 months of treatment.

Keyword

osteoporotic hip fracture; teriparatide; bone mineral density; bone turnover markers