Bone mineral density and biochemical indicators of bone remodeling in menopausal women

Bone density and biochemical parameters in menopause

Authors

  • Lućana Zec KBC Rijeka - Sušak
  • Gordana Starčević Klasan Fakultet zdravstvenih studija Sveučilište u Rijeci

Keywords:

alkaline phosphatase, deoxypyridinoline, bone density, menopause, osteoporosis

Abstract

Introduction: Menopause is a period marked by major changes in women, manifested by a decrease in bone mineral density, deoxypyridinoline, vitamin D, and alkaline phosphatase levels. Therefore, the main objectives of this research were to determine whether there is a difference in bone mineral density in women who have been in menopause for less than 5 years and in women who have been in menopause for more than 5 years and to compare biochemical indicators of bone remodeling in both groups.
Participants and methods
The study included 37 women divided into a group of women who have been in menopause for less than 5 year (N=13 women) and a group of women who have been in menopause for more than 5 years (N=24 women). Serum alkaline phosphatase and vitamin D, and urinary deoxypyridinoline were measured. In addition, all women underwent bone density measurement of the lumbar spine and femoral neck using dual-energy x-ray absorptiometry.
Results: Results showed that there was a statistically significant decrease in the level of the deoxypyridinoline in urine, while the values of vitamin D and alkaline phosphatase obtained from the analysis of blood samples did not differ significantly in the two groups. Bone mineral density values for the lumbar spine and left femur were significantly lower in the group of women who have been in menopause for more
than 5 years.
Conclusion: The results obtained showed that the biochemical indicators of bone remodeling increased in the first five years after menopause, and the determination of these parameters in blood and urine could be an effective method for determining patients with rapid bone remodeling after the onset of menopause.

References

Rizzoli R, Bonjour JP. Determinants of peak bone mass and mechanisms of bone loss. Osteoporosis International 1999;9(2):S17–S23.

Kanis JA, McCloskey EV, Johansson H, Reginster JY. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2013;24(1):23–57.

Kanis JA , Borgström F, Compston J, Dreinhöfer K, Nolte E, Jonsson L, Lems WF, McCloskey EV, Rizzoli R, Stenmark J. SCOPE: a scorecard for osteoporosis in Europe. Arch Osteoporos 2013;8(1):144.

Kehler T. Epidemiologija osteoporoze i osteoporotičnih prijeloma. Reumatizam 2014;61(2):60-64.

WHO collaborating Centre for metabolic bone diseases. Assessment of osteoporosis at the primary health care level. University of Sheffield Medical School, 2008.

Prevention and management of osteoporosis : report of a WHO scientific group. World Health Organization. https://apps.who.int/iris/handle/10665/42841.

Lane NE. Epidemiology, etiology, and diagnosis of osteoporosis. Am J Obstet Gynecol 2006;194(2 Suppl):S3-11.

Miller PD, Hochberg MC, Wehren LE, Ross PD, Wasnich RD. How useful are measures of BMD and bone turnover? Curr Med Res Op 2005;21:545-54.

Bernardi D, Zaninotto M, Plebani M. Requirements for improving quality in the measurement of bone markers. Clinica Chimica Acta 2004;346: 79-86.

Lian JB, Stein GS, Canalis E, Gehron Robey P, Boskey AL. Bone formation: Osteoblast lineage cells, growth factors, and the mineralization process. U: M.J. Favus, ur. Primer on the metabolic bone diseases and disorders of mineral metabolism. Philadelphia: Lippincott Williams & Wilkins; 1999, str. 14-29.

Sacide A, Abdullah E, Huseyin K, Can BO, Nurettin A Diagnostic Utility of Osteocalcin, Undercarboxylated Osteocalcin, and Alkaline Phosphatase for Osteoporosis in Premenopausal and Postmenopausal Women. Annals of labaratory medicine. 2011.

Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporosis Int 1994;4(6):368-81.

Lindsay R. The menopause and osteoporosis. Obstet Gynecol 1996;87(2 Suppl):16S-19S.

Tang BMP, Eslick GD, Nowson C, Smith C, Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 2007;370(9588):657-66.

Kuchuk NO, van Schoor NM, Pluijm SM; Chines A, Lips P. Vitamin D status, parathyroid function, bone turnover, and BMD in postmenopausal women with osteoporosis: global perspective. J Bone Miner Res 2009;24(4):693-701.

Lips P, Hosking D, Lippuner K, Norquist JM, Wehren L, Maalouf et al. The prevalence of vitamin D inadequacy amongst women with osteoporosis: An international epidemiological investigation. J Intern Med 2006;260:245– 254.

Nawawi HM, Yazid TN, Ismail NM, Mohamad AR, Nirwana SI, Khalid BA. Serum bone specific alkaline phosphatase and urinary deoxypyridinoline in postmenopausal osteoporosis. Malays J Pathol 2001;23(2):79-88.

Atalay S, Elci A, Kayadibi H, Onder CB, Aka N. Diagnostic utility of osteocalcin, undercarboxylated osteocalcin, and alkaline phosphatase for osteoporosis in premenopausal and postmenopausal women. Ann Lab Med 2012;32(1):23-30.

Rai AD, Sherpa ML, Singh A, Thejaswi SG, Bhutia RD. Bone Alkaline Phosphatase and Urine Hydroxyproline Assay in Pre and Postmenopausal Women in the State of Sikkim and its Correlation with Bone Mineral Density. J Midlife Health 2021;12(4):304-309.

Indumati V, Patil VS, Jailkhani R. Hospital based preliminary study on osteoporosis in postmenopausal women. Indian J Clin Biochem. 2007 Sep;22(2):96-100.

Punda M. Denzitometrija kao zlatni standard u dijagnostici osteoporoze. Medicus [Internet]. 2022 [pristupljeno 11.12.2023.];31(2 Osteoporoza):185-192. Dostupno na: https://hrcak.srce.hr/291559

Published

2023-12-22

Issue

Section

Originalni znanstveni rad