India seems to have the highest prevalence of osteoporosis. With growing awareness of osteoporosis and its impact on life span especially in India, special attention is being paid to early detection, management and treatment of postmenopausal osteoporosis in women. Measurement of BMD and osteocalcin are of value in estimating bone turnover rates. The aim of this study is (1) to measure the specific, sensitive bone formation marker such as osteocalcin and BMD in postmenopausal osteoporosis women and postmenopausal non-osteoporosis women; (2) the follow up study to evaluate the impact of specific antiresorptive therapy (alendronate ? calcium ? vitamin D) regimen in postmenopausal osteoporosis by assaying osteocalcin and BMD. Sixty clinically diagnosed postmenopausal osteoporosis patients and 60 normal subjects (postmenopausal non-osteoporosis women) were recruited as control. Mean bone mineral density T score and Z score was significantly decreased (P \ 0.001) in postmenopausal osteoporosis patients as compared to controls. Highly significant increase in the mean score of BMD-T score and Z score from baseline to post therapy of 3 months was observed in postmenopausal osteoporosis women. Serum osteocalcin levels were significantly increased (P \ 0.001) as compared to control group. Serum osteocalcin levels were decreased significantly (P \ 0.001) from baseline to post therapy of 3 months in postmenopausal osteoporosis women. BMD is the best quantifiable predictor of osteoporotic fracture and osteocalcin is specific, sensitive, promising, currently used marker for better prognosis of osteoporosis and for monitoring responses to antiresorptive therapy.

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.

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