disease. None of the patients had a severe underlying disease such as tiiahetes, ..... JM, Riggs. BL. Utility of type. I collagen propeptide assays for assessing.
Technical Is Bone
Alkaline
Phosphatase
an Adequate
Marker
of Bone
Metabolism During Acute Corticosteroid Treatment? Anne Peretz,” Muriel Moris, / Dominique Willems,2 and Pierre Bergmann2 (I Rheumatol. Clin., Dept. of Intern. Med., 2 Lab. of Clin. Chem. and Exp. Mcdl., Brugmnann Univ. Hosp., Place Arthur Van Gehuchten 4, B-l020 Bruxelles, Belgique; *author for correspondence: fax 32 2 477 21 78, e-mnail pbergman@ resulb.ulb.ac.he) Corticosteroids are effect is evidenced biochemnical markers cm (BGP) or Cross-sectional and timne course
known
to
by a decrease of bone
decrease imi the formnation
bone formation. This serum concentrations of such as serum osteocal-
type I procollagen propeptide (PICP) /1, 2j. studies have shown differences in the mnagnitutle of the response, depending on the investigated
serumn hone marker, the corticosteroiti dose, and the route of administration /3/. High doses of intravenous methylprednisolone (pulse MPS) have been recently shown to induce a rapid and important decrease in BGP /4/ and PICP /5/. Recently, the measuremnent of bone alkaline phosphatase (BAP) by IRMA was proposed as a miew marker of osteoblastic function, BAP having l)een shown to l)e quite tiiscriminant in several conditions of increased hone turnover, e.g., postmenopausal osteoporosis [6/. In this longitudinal study, we report the evolution of BAP, BGP, amid PICP during the first 72 h after MPS atimninistration. Seven patients with severe rheumnatic diseases (rheuniatoid arthritis, polymyositis, anti Reiter disease) received a course of pulse MPS, pulse therapy having been intiicated for a flare of the disease. None of the patients had a severe underlying disease such as tiiahetes, cirrhosis, neoplasia, cardiac insufficiency, or mnetaholic hone disease, and they had satisfactory renal function (serum creatinine
0. C)
0.
20
0
40
80
60
C
>
0. 4
u
20
40
60 Time
Fig. 1. Evolution
of osteocalcin
(BGP),
type
I collagen
propeptide
80 (H) (PICP)
and bone alkaline phosphatase (BAP) during baseline assessment (not significant) and after intravenous administration 0f 1 g of methylprednisolone (MPS). Results are expressed as mean ± SE. BGP and PICP evolution with time: significant (Tukey test: p
