الفهرس 
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Abstract
Osteoporosis is a world wide public health problem. The population most likely to be affected, the elderly, is expanding at a rate of nearly 20% peredecade. Consequently, one can predict that the number of osteoporosis associated fractures per year will be more than double by the middle of the 21st century. Accordingly, the aim of the present work was to asses the diagnostic effectiveness of DPD as a bone resorption marker in postmenopausal osteoporotic womens associated with fracture.and osteocalcin as a bone formation marker in the same group, of patients as well as to evaluate their validity in predicting early bone loss. The study was conducted on 49 postmenopausal osteoporotic subjects classified into 40 patients and 9 control. Results of the present study revealed that the postmenopausal osteoporotic womens with fractures had significantly higher s. ostescalcin alkaline phosphatase, calcium phosphorous and urinary deoxyridinoline as compared to the postmenopausal osteoporotic womens without fracture (control). In conclusion, the present work revealed that DPD and osteocalcin are excellent bone resorption and formation markers respectively that could efficiently diagnose osteoporosis. They were even more sensitive and superior to bone mineral density measurements in identifying females with early bone loss. Both markers had high diagnostic performances when studied individually, however, combined use of DPD and osteocalcin raised the diagnostic sensitivity up to 96% among patients with osteoporosis. The present study recommends the concomitant use of DPD and osteocalcin in conjunction with densitometry in screening for osteoporosis. This will have its impact on early management of these patients, which might prevent disease progression and reduce morbidity.