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Claude D. Arnaud, Biochemical Markers of Bone Turnover for Predicting BMD in Early Postmenopausal Women, The Journal of Clinical Endocrinology & Metabolism, Volume 83, Issue 3, 1 March 1998, Pages 1044–1045, https://doi.org/10.1210/jcem.83.3.4668-8
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We have noted some disturbing inconsistencies and inaccuracies and found the breadth of analysis lacking in the recent report by Rosen et al. (1). The authors compared the responses of various biochemical markers of bone metabolism in a study of hormone replacement therapy (HRT) in postmenopausal women. The study reported results for N-telopeptides of type I collagen (NTx), deoxypyridinoline (Dpd), osteocalcin (OC), and bone alkaline phosphatase (BAP) in 236 women randomized to receive either calcium alone (CTL) or calcium plus HRT. The study was conducted over the course of one year, and bone mineral density of the lumbar spine and hip were measured by dual-energy x-ray absorptiometry at baseline, 3, 6, and 12 months. Markers were measured at baseline, 1, 3, 6, and 12 months. Almost all of the analyses had been previously reported by Chesnut et al. (2), with the exception of the addition of the Dpd measurements.
The authors reported in the Results section of their paper that a significant decrease from baseline (P < 0.0001) was seen in the HRT group at 1 month with NTx, Dpd, and OC. However, in the Discussion, they stated that the earliest and most significant change from baseline was noted for NTx and OC. These two statements do not appear compatible in view of the statistics presented. We are concerned that this conclusion was drawn on the basis of the relative percent changes observed for the different markers,− 28%, −10%, and −15%, respectively. Percent change, however, is not a statistical measure and ignores the contribution of the variability inherent in each of the different biochemical markers.
