Serum bone alkaline phosphatase is a useful marker to evaluate lumbar bone mineral density in Japanese postmenopausal osteoporotic women during denosumab treatment

Abstract

A worldwide health concern, osteoporosis (OP), increases the risk of bone fracture and results in morbidity. This study examined whether the representative bone absorption marker serum tartrate-resistant acid phosphatase 5b (TRACP-5b) or bone formation marker bone alkaline phosphatase (BAP) could estimate primary OP status and denosumab efficacy in a real-world setting. We retrospectively enrolled 114 female postmenopausal primary OP patients in Japan. Values and percent changes in TRACP-5b, BAP, lumbar 1–4 bone mineral density (L-BMD), and total hip BMD (H-BMD) were assessed before treatment and at 4, 8, and 12 months of therapy to identify the correlations between the percent changes in bone metabolic markers and BMD. We also established two sets of subgroups based on the upper limits of reference values in Japan for serum: TRACP-5b (<420 mU/dL) and (≥420 mU/dL) and BAP (<14.5 µg/L) and (≥14.5 µg/L). Negative correlations were observed for the percent changes of TRACP-5b and H-BMD at 4 months (r=−0.3476) and 8 months (r=−0.3880), for the percent changes of BAP and H-BMD at 8 months (r=−0.3354), and for the percent changes of BAP and L-BMD at 12 months (r=−0.3186). We observed a significant difference between the subgroups for the percent changes of L-BMD at 8 months (p=0.013) and 12 months (p=0.004) in BAP values. These results suggest that TRACP-5b and BAP had negative correlations with BMD, and that BAP represented a useful serum marker to evaluate L-BMD during denosumab therapy for OP.

Biochemical and Hematological Correlates of Elevated Homocysteine in National Surveys and a Longitudinal Study of Urban Adults

“…Our study is to date the first to show that higher blood Hcy is associated with elevated alkaline phosphatase, both cross-sectionally and longitudinally. Thus, although the main modifiers of Hcy are B-vitamins, particularly folate and vitamin B-12, liver enzymes are correlates of Hcy that can be modulated with reduced alcohol consumption [55], and alkaline phosphatase in particular is a key mediator in the reported association between Hcy and reduction in bone mineral density associated with osteoporosis among postmenopausal women [56,57]. Thus, Hcy may be merely a marker of certain health outcomes, while liver enzyme elevations can act as the main causal pathway.…”

The Beneficial Effect of Boswellic Acid on Bone Metabolism and Possible Mechanisms of Action in Experimental Osteoporosis

“…The clearance of calcium and phosphorus in urine was drastically decreased by the administration of AKBA and estradiol, and a possible explanation for these findings could be the estrogenic effect of AKBA. Higher ALP in serum generally happens in diseases of bone and liver [ 48 ]. An increase in the level of ALP was observed in ovariectomized rats.…”

Metabolic Alterations in Older Women With Low Bone Mineral Density Supplemented With Lactobacillus reuteri

“…In addition, two biochemical markers of bone turnover, bone-specific alkaline phosphatase (BAP) and N-terminal telopeptide (NTX), were associated negatively with bone related traits, such as total tibia vBMD and cortical vBMD, which were consistent with previous results. (26)(27)(28)(29) To investigate associations between clinical outcomes and the metabolites that responded differently between L. reuteri and placebo groups, we calculated the Pearson's correlation coefficients between clinical characteristics and differential metabolites at baseline and 12 months, respectively. We found that 13 and 9 metabolites were correlated (P < 0.05) with total tibia vBMD at baseline and 12 months, respectively (Supplemental…”