Serum Alkaline Phosphatase During Hormone Treatment in Early Postmenopausal Women

Abstract

A new model was proposed for use in establishing optimal treatment of postmenopausal osteoporosis. When hydroxyproline is taken as an estimate of bone resorption and alkaline phosphatase (ALP) of bone formation, the model indicates that the difference between hydroxyproline and ALP is reflected in the negative Ca balance and thus the decline in bone mineral content (BMC). Since BMC increases during estrogen treatment in postmenopausal women, in whom ALP declines gradually, this apparently only happens because of a rapid decline in hydroxyproline. This decline together with BMC, must be dose-related since changes in ALP are uncorrelated to the estrogen dose. This model fits the generally accepted opinion that the effect of estrogen on bone loss in postmenopausal osteoporosis is limited, declines with age and is dose-related. Estrogen treatment should be introduced early after the menopause in order to obtain the optimum prophylactic effect.