SUMMARY: The aims of the present st

SUMMARY: The aims of the present study were to study the presence of skeletal fluorosis, various serum biomarkers of bone turnover and remodeling, and the urinary fluoride (F) levels in 57 elderly persons who had lived in the high Doi Saket district for more than 10 years with a life-time use of high-F water (n=40) or low-F water (n=17). The subjects were examined for the signs and symptoms of skeletal fluorosis. Serum markers were measured for bone formation (alkaline phosphatase, total P1NP andosteocalcin) and bone resorption (β-isomerized C-terminal telopeptides (β-CTx) orbeta crosslaps, calcium, and phosphorus). The results showed that when the high-F and low-F groups were compared, there was an increase in osteocalcin in the high-F group but no significant differences in the serum levels of calcium, phosphorus, beta crosslaps, total P1NP, or alkaline phosphatase. A non-significant trend was present for an increased level of beta crosslaps in the high-F group, suggesting that bone resorption might be abnormal in this group and lead to bone deformities. The F intake was significantly related to the serum phosphorus, the total P1NP, and the osteocalcin. Moreover, the urinary F level and the urinary F to creatinine ratio were significantly related to the total P1NP (r=0.385) and the osteocalcin (r=0.399). The use of high-F water for drinking and cooking was considered to stimulate and increase abnormal bone formation with a significant increase in the bone formation marker osteocalcin. A non-significant trend was present for thetotal P1NP andthe osteocalcin levels to be associated with the presence of grade 1 or 2 skeletal fluorosis.