الفهرس 
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Abstract
Osteoporosis is a systemic disorder characterized by micro architectural deterioration of bone tissue leading to bone fragility and increased susceptibility to fractures . It is a major health problem for the elderly especially women because of their loss of endogenous estrogen secretion by the ovaries associated with menopause leading to accelerated bone loss. The state of the skeleton can be evaluated by a variety of techniques including histomorphometry , densometry and measurements of calcium fluxes. Biochemical markers of bone remodeling provide an non-invasive mean of complementing these techniques or providing direct information about rate of bone turnover The aim of this work is to study two markers of bone turnover Osteocalcin (OC) bone forming marker and Deoxypyridinoline (DPD) bone resorption marker in postmenopausal women suffering from osteoporosis compared to healthy postmenopausal women, in a trial to assess the role of these two markers in the osteoporosis process in post menopausal women . - A highly significant difference between patients using OCPs and those not using them regarding the value of DPD.-where all patients that used OCPs had a high level of DPD. In patient and control groups: -An inverse correlation was found between the levels of OC and each of age and duration of menopause. In control group :- - No significant correlation was observed between T-score and any of Ca, Ca+2 , Ph, creatinine, OC nor DPD. - No correlation was observed between the urinary level of DPD and any of the mentioned parameters. The sensitivity of urinary level of DPD is 84% while of serum level of OC is 56% and the specificity of DPD is 100% while that of OC is 90%. from the above, the following conclusion might be reached :- • Measurement of urinary level of DPD might be considered both sensitive and specific marker for bone remodeling and detection of bone mineral density in postmenopausal osteoporotic women. • Measurement of serum level of OC is not sensitive in detecting osteoporosis. • Ionized calcium. • Inorganic phosphorus. The present study revealed the following results : - A significant decrease in the serum level of OC in patient group compared to the control group. -A highly significant increase in the urinary level of DPD in the patient group compared to the Control group. In the patient group: - An inverse correlation was observed between T-score and each of age ,duration of menopause ,parity and urinary level of DPD. - A positive correlation was observed between T-score and each of age at menopause and serum level of OC. -No correlation was observed between T-score and Ca, Ca+2, creatinine and Ph serum levels. - A positive correlation was observed between serum level of OC and age at menopause. - An inverse correlation was observed between serum level of OC and each of parity and urinary level of DPD. - A positive correlation was observed between urinary level DPD and each of age ,duration of menopause and parity. - -An inverse correlation was observed between the urinary level of DPD and age at menopause. • Some factors were important in their effect on osteoporosis as age at menopause and parity which seemed to affect both bone formation and resorption in osteoporotic patients while age and duration of menopause affected bone resorption only in the patient group. • Measurement of serum calcium, ionized calcium and phosphorus levels were not affected by the osteoporosis process. from the above conclusions, the following recommendation might be of value : • Measurement of urinary level of DPD could be used as a routine non-invasive, cheap mean in diagnosis of osteoporosis and follow up of the disease. • It is better to combine estimation of bone mass and measurements of bone markers for perfect evaluation of patient’s condition. • The best means of dealing with osteoporosis is the prevention and one of the preventive measures that could be used is family planning as the decrease in the number of pregnancies will have a great impact in minimizing the bone loss in women. • OCPs could be substituted by other methods as intra uterine device (loops) as OCPs might have a possible effect on increasing bone resorption markers.