Osteoporosis, Alkaline Phosphatase Isoenzyme Measurements and the Effect of Nutritional Supplements.

Presented at the 3rd Bath Conference: Osteoporosis and Bone Mineral Measurement, 23-26th June 1992. In: Current Research in Osteoporosis and Bone Mineral Measurement II. Ed.: EFJ Ring, British Institute of Radiology, London, 1992. A series of organ derived isoenzymes of alkaline phosphatase (EC ALP) are present in blood serum. The activity of bone ALP is increased during bone development in children and in and in healing fractures as well as in a variety of bone diseases. Total ALP remains normal in osteoporosis. Magnesium is involved in suppressing parathyroid hormone and in stimulating calcitonin. Manganese is essential for bone growth and it interacts with oestrogens. Zinc is essential for bone formation and deficiencies are associated with bone loss as well as reduced ALP activity. Copper status affects bone resorption and severe vitamin C deficiencies are associated with osteoporosis. Boron may minimise osteoporosis possibly by incresing endogenous oestradiol. We have measured nutrients related to bone metabolism as well as total and bone ALP in five small groups of women before and after six weeks of nutritional supplementation. The tests were repeated after a further six weeks during which boron was added to the supplement programe. The groups were: 1) 5 controls, 2) 4 menstruating women with two or more nutrient deficiencies, 3) 4 post-menopausal women with no evidence of osteoporosis and 5) 3 post-menopausal women on hormone replacements. Much lower bone ALP levels and quite marked nutrient deficiencies were demonstrated in the osteoporotic women. The levels normalised with nutritional supplementation except in one of the women on HRT whose bone ALP remained low. It was not possible to deduce from our results whether there was a further beneficial effect when boron was added to the supplement programme. It seems very likely that the prevalence of nutritional deficiencies and the high incidence of osteoporosis are connected. We believe that further investigation of these interactions will increase the understanding of the metabolic basis of osteoporosis and, hopefully, lead to preventive measures and more adequate treatment.