Serum bone Gla-protein: a specific marker for bone formation in postmenopausal osteoporosis

Mean (+/- SD) serum bone Gla-protein (BGP or osteocalcin) was normal (7.0 +/- 3.3 ng/ml) in 26 patients with untreated postmenopausal osteoporosis ( PMO ). But 9 patients had values either above (4) or below (5) the normal values obtained in 35 age-matched control women (6.9 +/- 1.25 ng/ml). Serum BGP correlated positively with relative osteoid volume, relative osteoid surfaces, tetracycline labelled surfaces, and bone formation rate but not with resorption surfaces. Based on normal values for osteoid volume, patients were classified as having high (HF, 9 patients), normal (NF, 12 patients) and low osteoid formation (LF, 5 patients). Serum BGP (+/- SEM) was significantly lower in LF group (2.7 +/- 0.9 ng/ml) and significantly higher in HF group (9.7 +/- 0.8 ng/ml) than in the NF group (7.0 +/- 0.6 ng/ml). Serum alkaline phosphatase and urinary hydroxyproline did not discriminate between these three groups and did not correlate significantly with any of the measured histomorphometric indices in biopsy specimens in these patients. Serum BGP appears to be a specific marker for bone formation and can predict the histological profile in PMO . Serum BGP might be useful in investigating patients with PMO and should be valuable in assessing the effects of treatments that increase bone formation.