Treatment of Osteopenic Menopause Women as a Public Health Problem with Nasal Calcitonin; an Original Study on Follow up Markers

Introduction: Various therapeutic options such as Calcitonin are suggested for patients with low bone density. However, the efficacy remains uncertain in all patients. C-telopeptide of type I collagen (CTx) is the authentic bone marker which is recently used to assess the bone turnover. This study aimed at revealing the therapeutic effects of Calcitonin on osteopenic women via serum CTx and assessment of other biochemical markers. Methods: we conducted a before-after clinical trial on menopause women with low bone mineral density (bone mineral density score less than ۱.۵ SD of peak bone mass) attending Baqiyatallah hospital clinic. They received ۲۰۰ IU Calcitonin nasal spray, calcium (۱۰۰۰ mg) and vitamin D (۴۰۰ IU). Then the serum CTx and other laboratory parameters were compared after a ۶ months treatment. The data was analyzed using SPSS ver.۱۶, paired T-test and regression model. Results: The study population included ۱۱۵ menopause women with the mean age of ۵۸.۷۵ ± ۸.۱۵ years. The CTx amount decreased significantly compared with that of the baseline level (۳.۲۰۳ ± ۲.۲۴ vs. ۲.۴۹۷ ± ۱.۶۵۷ Pmol/lit, P <۰.۰۰۱). Also, Bone Mineral Densitometry of spine increased significantly from ۰.۸۳۴±۰.۱۱۲ to ۰.۸۵۲±۰.۱۲۲ (P =۰.۰۰۳). Serum levels of PTH, Ca, AST, ALT and alkaline phosphatase total had also changed insignificantly (P >۰.۰۵). Conclusion: Nasal spray of Calcitonin could be effective on the progression of osteoporosis by decreasing bone tissue turnover and improving the bone density. Further controlled-studies with a larger sample size and a longer duration of follow up are recommended.