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The purpose of this study was to evaluate the effects of alendronate and calcitriol combined with hormone replacement therapy in postmenopausal osteoporotic women. Seventy-nine postmenopausal women who visited Kangnam St. Mary´s Hospital were assessed to evaluate the impacts of each drug on bone mineral density and bone metabolism. Group Ⅰ was composed of 20 women who received estrogen only, Group Ⅱ was composed of 28 women who received estrogen with addition of calcitriol (0.5㎍ daily), and Group Ⅲ was composed of 31 women who received estrogen with addition of alendronate (10㎎ daily). In all subjects, bone mineral density (BMD) was measured in the lumbar vertebrae (L2-4) and femur neck using dual energy absorptiometry (DEXA), and serum osteocalcin, serum total alkaline phosphatase and urine deoxypyridinoline were measured at the beginning of the treatment and after 12 months of treatment. BMD of the lumbar vertebrae in Group Ⅱincreased significantly compared to basal level at 12 months, but not in Group Ⅰ and Ⅲ. As for BMD of the femur neck, it increased significantly during the treatment in Group Ⅰ and Group Ⅱ, but not in group Ⅲ. Serum osteocalcin in Group Ⅲ decreased significantly at 12 months of treatment compared with Group Ⅰ and Ⅱ. Serum alkaline phosphatase in Group Ⅰ and Ⅲ decreased significantly at 12 months of treatment compared with Group Ⅰ. Urine deoxyptyridinoline in Group Ⅰ, group Ⅱ and Group Ⅲ decreased but was statistically insignificant. From the above results, it might be suggested that the combined therapy (estrogen with daily addition of alendronate or calcitriol) is more effective than the estrogen therapy only for the protection of decreasing bone mineral density in the postmenopausal women.
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