Estimation of bone mineral density and its correlations with homocysteine, and various other biochemical bone markers in postmenopausal women

Authors

  • Rajeev Verma Department of Medicine, King George’s Medical University, Lucknow, India, India
  • Satish Kumar Department of Endocrinology, King George’s Medical University, Lucknow, India, India
  • Isha Atam Department of Medicine, King George’s Medical University, Lucknow, India, India
  • Virendra Atam Department of Medicine, King George’s Medical University, Lucknow, India, India
  • Sudhir Verma Department of Medicine, King George’s Medical University, Lucknow, India, India
  • Satyendra Kumar Sonkar Department of Medicine, King George’s Medical University, Lucknow, India, India
  • Ajay Kumar Department of Medicine, King George’s Medical University, Lucknow, India, India
  • Shyam Chand Chaudhary Department of Medicine, King George’s Medical University, Lucknow, India, India

DOI:

https://doi.org/10.21276/IJRDPL.2278-0238.2019.8(4).22-28

Keywords:

Bone mineral density, cathepsin K, homocysteine, osteoporosis, postmenopausal

Abstract

Introduction- Omocysteine (HCY) prevents collagen cross-linking and activates osteoclast function within the bones. Bone mineral density (BMD) may be affected by Hyperhomocysteinemia via Cathepsin K. Aim- To find the correlation of BMD with biochemical bone markers. Methods- BMD was investigated by the DXA scan with the help of the Hologic QDR1000 system. As per WHO guidelines, subjects were divided into three different subsets with; normal bone mass, osteopenia, and osteoporosis. Every subject underwent routine biochemical laboratory investigations, HCY, Vitamin B12, and folic acid levels. Results-Among 355 postmenopausal women, 69% (245) had osteoporosis while 11.27% (40) had normal BMD (mean age, 53 ± 8.35 years) and 19.72% (70) had osteopenia (mean age 52.86 ± 7.93 years). The mean age in the osteoporotic group was 56.49 ± 6.65 years. The mean levels of HCY in the three groups were 15.58± 7.92 μmol/L, 16.13± 7.34μmol/L and 17.05± 5.13μmol/L, respectively. Hip BMD showed a strong inverse correlation with age (r=-0.360, p=0.002), while no significant correlations were found between weight and BMI. PTH was consistently seen to be negatively correlated with BMD at Spine (r=-0.0339, p=0.004), Forearm (r=-0.267, p=0.027), and Hip (r=-0.224, p=0.064). Conclusion- Low BMD is an important problem in postmenopausal female patients. Age and duration of menopause are independent risk predictors for the development of osteoporosis. Vitamin D levels do not predict low BMD in postmenopausal females. Weight is protective for osteoporosis especially at spine and forearm BMD. Vitamin B12 and Hcy levels did not correlate with low BMD.

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References

Unni J. Third consensus meeting of Indian Menopause Society (2008): A summary. Journal of Mid-life health. 2010 Jan;1(1):43. https://doi.org/10.4103/0976-7800.66987

Pinkerton JV, Stovall DW. Reproductive aging, menopause, and health outcomes. Annals of the New York Academy of Sciences. 2010 Aug;1204(1):169-78. https://doi.org/10.1111/j.1749-6632.2010.05526.x

Inoue H, Takamori M, Shimoyama Y, Ishibashi H, Yamamoto S, Koshihara Y. Regulation by PGE2 of the production of interleukin?6, macrophage colony stimulating factor, and vascular endothelial growth factor in human synovial fibroblasts. British journal of pharmacology. 2002 May;136(2):287-95. https://doi.org/10.1038/sj.bjp.0704705

ESHRE Capri Workshop Group. Bone fractures after menopause. Human reproduction update. 2010 Apr 28;16(6):761-73. https://doi.org/10.1093/humupd/dmq008

Mittal M, Verma R, Mishra A, Singh A, Kumar V, Sawlani KK, et al. Relation of bone mineral density with homocysteine and cathepsin K levels in postmenopausal women. Indian journal of endocrinology and metabolism. 2018 Mar;22(2):261. https://doi.org/10.4103/ijem.ijem_575_17

Behera J, Bala J, Nuru M, Tyagi SC, Tyagi N. Homocysteine as a pathological biomarker for bone disease. Journal of cellular physiology. 2017 Oct;232(10):2704-9. https://doi.org/10.1002/jcp.25693

Fratoni V, Brandi M. B vitamins, homocysteine and bone health. Nutrients. 2015;7(4):2176-92. https://doi.org/10.3390/nu7042176

Gold EB. The timing of the age at which natural menopause occurs. Obstetrics and Gynecology Clinics. 2011 Sep 1;38(3):425-40. https://doi.org/10.1016/j.ogc.2011.05.002

Khadilkar AV, Mandlik RM. Epidemiology and treatment of osteoporosis in women: an Indian perspective. International journal of women's health. 2015;7:841. https://doi.org/10.2147/ijwh.s54623

Marwaha RK, Tandon N, Garg MK, Kanwar R, Narang A, Sastry A, et al. Bone health in healthy Indian population aged 50 years and above. Osteoporosis international. 2011 Nov 1;22(11):2829-36. https://doi.org/10.1007/s00198-010-1507-8

Leppänen OV, Sievänen H, Jokihaara J, Pajamäki I, Kannus P, Järvinen TLN. Pathogenesis of Age-Related Osteoporosis: Impaired Mechano-Responsiveness of Bone Is Not the Culprit. PLoS ONE 2008;3:e2540. https://doi.org/10.1371/annotation/5d8eaa9e-b4b2-4b90-8fa6-242ba94fac5e

Sunyecz JA. The use of calcium and vitamin D in the management of osteoporosis. Therapeutics and Clinical Risk Management 2008;4:827-36. https://doi.org/10.2147/tcrm.s3552

Lips P, van Schoor NM. The effect of vitamin D on bone and osteoporosis. Best Practice & Research Clinical Endocrinology & Metabolism 2011;25:585-91. https://doi.org/10.1016/j.beem.2011.05.002

G R, Gupta A. Vitamin D Deficiency in India: Prevalence, Causalities and Interventions. Nutrients 2014;6:729-75. https://doi.org/10.3390/nu6020729

Kota S, Jammula S, Kota S, Meher L, Modi K. Correlation of vitamin D, bone mineral density and parathyroid hormone levels in adults with low bone density. Indian J Orthop 2013;47:402-7. https://doi.org/10.4103/0019-5413.114932

Bahtiri E, Islami H, Rexhepi S, Qorraj-Bytyqi H, Thaçi K, Thaçi S, et al. Relationship of homocysteine levels with lumbar spine and femur neck BMD in postmenopausal women. Acta Reumatol Port. 2015 May 18;40(4):355-62. https://doi.org/10.1007/s00774-015-0699-6

Gerdhem P, Ivaska KK, Isaksson A, Pettersson K, Väänänen HK, Obrant KJ, et al. Associations between homocysteine, bone turnover, BMD, mortality, and fracture risk in elderly women. Journal of Bone and Mineral Research. 2007 Jan;22(1):127-34. https://doi.org/10.1359/jbmr.061003

Kim JI, Moon JH, Chung HW, Kong MH, Kim HJ. Association between Homocysteine and Bone Mineral Density according to Age and Sex in Healthy Adults. Journal of Bone Metabolism 2016;23:129-34. https://doi.org/10.11005/jbm.2016.23.3.129

Green TJ, McMahon JA, Skeaff CM, Williams SM, Whiting SJ. Lowering homocysteine with B vitamins has no effect on biomarkers of bone turnover in older persons: a 2-y randomized controlled trial. The American journal of clinical nutrition 2007;85:460-4. https://doi.org/10.1093/ajcn/85.2.460

Cagnacci A, Bagni B, Zini A, Cannoletta M, Generali M, Volpe A. Relation of folates, vitamin B12 and homocysteine to vertebral bone mineral density change in postmenopausal women. A five-year longitudinal evaluation. Bone 2008;42:314-20. https://doi.org/10.1016/j.bone.2007.10.022

Van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, van der Klift M, de Jonge R, Lindemans J, et al. Homocysteine levels and the risk of osteoporotic fracture. New England Journal of Medicine. 2004 May 13;350(20):2033-41. https://doi.org/10.1056/nejmoa032546.

How to cite this article:

Verma R, Kumar S, Atam I, Atam V, Verma S, Sonkar SK, Kumar A and Chand S. Int. J. Res. Dev. Pharm. L. Sci. 2019; 8(4): 22-28. doi: 10.13040/IJRDPL.2278-0238.8(4).22-28

This Journal is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.

Published

2019-10-15

How to Cite

Verma, R. ., Kumar, S. ., Atam, . I. ., Atam, V. ., Verma, S. ., Sonkar, S. K. ., Kumar, A. ., & Chaudhary, . S. C. . (2019). Estimation of bone mineral density and its correlations with homocysteine, and various other biochemical bone markers in postmenopausal women. International Journal of Research and Development in Pharmacy & Life Sciences, 8(4), 22-28. https://doi.org/10.21276/IJRDPL.2278-0238.2019.8(4).22-28