Background
: In general, increased body weight may be a risk factor for hypertension, diabetes, hyperlipidemia, and coronary heart disease. It is very difficult to lose weight especially in aged people. Osteoporosis is commonly developed in aged. Many reports revealed that obesity may prevent bone loss. The protective effect of obesity on bone has been ascribed to a high body fat content. Obese aged people can be very confused whether to decide to lose weight or not.

Methods : We evaluated 137 women aged over 60 who visited a health care center of a university hospital in Seoul from Jan.1999 to Oct. 1999 to determine the effects of obesity on bone mineral density in aged Korean women. We measured anthropometrical charactersitics, BMD of lumbar spine, markers of bone turnover, and FSH of the subjects.

Results : The results revealed that obese group had a greater BMD at lumbar spine, but the levels of FSH were noted to be lower than the non-obese group. But, none of the markers of bone turnover showed significant differences between the two groups. BMI was positively correlated with BMD (r=0.455, P<0.001) by Pearson's correlation matrix. Also, the level of total alkaline phosphatase significantly had negative association with BMD. The level of FSH revealed that it had a negative correlation (r=-0.290, P<0.01) with BMI.

Conclusion : We concluded that obesity might have a protective effect related with FSH. Prospective studies on endocrinologic association with BMD, bone markers, FSH and estradiol will be needed.

Background
: Increased bone turnover results in bone loss after menopause. After menopause, the major cause of bone loss is estrogen deficiency. Rate of bone loss seems to increase after menopause and then formation coupled with resorption is also increased. Antiresorptive drugs are known to be helpful in preventing bone loss. Alendronate is one of antiresorptive drugs for the treatment of osteoporosis which results in a decrease in bone turnover. Some papers report about nonresponders to antiresorptive drugs, and screening people early is very important to optimal management. There are no available data of Korean people. Therefore, this study evaluated the effects of alendronate in Korean postmenopausal osteoporosis patients after 3 months of treatment.

Methods : We studied 96 women with postmenopausal osteoporosis (bone mineral density{BMD} T score<2.5) who visited Climacteric Clinic in Samsung Cheil Hospital from Jan. 1999 to Jul. 1999. Subjects were stratified in to 3 group: Group 1 treated with alendronate (Fosamax ; MSD, Rahyway, NJ, USA) 10mg/day and estrogen, Group 2 treated with calcitonin nasal spray 100 IU every other day and estrogen, and Group 3 treated with estrogen alone for 3 months. We measured serum marker of bone formation (osteocalcin [BGP]), and marker of bone resorption (deoxypyridinoline [DPYD] from urine at baseline and 3 months after treatment.

Results : The mean difference in change of markers among the three groups at the end of study that were significant were BGP 25.7±4.8% and DPYD 23.3±2.3%. DPYD known as bone resorption marker showed a significant response in alendronate and estrogen therapy group than estrogen alone group (P<0.05). Also, BGP showed response to estrogen alone, and calcitonin and estrogen group, but its responsiveness was lesser than alendronate therapy.

Conclusion : Our data showed that using alendronate with estrogen in patients of osteoporosis further prevents bone resorption. Therefore, we conclude that alendronate therapy with estrogen is helpful managing osteoporosis patients.