Abstract
BackgroundOsteoporosis is a major health problem of elders. Dual X-ray absorptiometry (DEXA) is the commonly used modality for diagnosis osteoporosis; serum markers have been suggested for predicting osteoporosis and discriminate osteoporotic from healthy subjects. We aimed to analyze the status of some bone turnover biochemical markers namely PINP, B-ALP, estrogen, and progesterone in the elderly osteoporotic and osteopenic women as probable markers for the discrimination between patients and healthy individual in diagnosing osteoporosis, and also, to detect the impact of osteoporosis on quality of life of patients using assessment of the quality of life for osteoporosis (ECOS-16). Post-menopausal 108 females were involved in the current study, divided into two groups (osteoporotic group (60 with BMD˂-2.5), osteopenic group (48 with BMD between − 1 and − 2.5)), and 60 healthy elderly females as control group were involved in the study. Serum levels of procollagen type I N-terminal propeptide (PINP), bone alkaline phosphatase (B-ALP), estrogen, and progesterone were measured by ELISA technique.ResultsPINP and B-ALP significantly differ between studied groups. Also, PINP and B-ALP levels had high sensitivity and specificity to discriminate osteoporotic patients from healthy individuals. PINP and B-ALP significantly correlated with bone mineral density (BMD) and with ECOS-16. Estrogen differs significantly between osteoporotic and osteopenic groups and significantly correlated with bone mineral density of femur (BMD-F) and bone mineral density of spine (BMD-S) in the osteopenic group. Progesterone differed significantly between patients and controls and significantly correlated with BMD-F in the osteoporotic group.ConclusionWe can consider PINP and B-ALP as biomarkers for early detection then monitoring of osteoporosis. Measuring these serum markers can replace the assessment of BMD if not available. Also, it could replace the gap between BMD subsequently spaced assessment or could be of value in cases with severe spondylosis, DISH syndrome, old spondylarthritis, and/or previous spinal surgery. Sex hormones could not differentiate the normal from the osteoporotic/osteopenic patients, so they cannot be used as diagnostic or prognostic markers. Validation of this assumption needs large and longitudinal studies.
Highlights
Osteoporosis is a major health problem of elders
From attendants of the rheumatology, geriatric, and general medicine outpatient clinics during this period, 108 subjects were involved in the current study after performing dual-energy X-ray absorptiometry (DEXA) to confirm the diagnosis of osteoporosis or osteopenia. 60 healthy control selected from attendants of ophthalmology, dermatology, and general surgery outpatient clinics
The significance of the obtained results was judged at the 5% level. This cross-sectional, case-control study was held in the period from January 2018 till February 2020 and included 108 female patients with osteoporosis/osteopenia, and 60 age-matched healthy females served as a control group
Summary
Dual X-ray absorptiometry (DEXA) is the commonly used modality for diagnosis osteoporosis; serum markers have been suggested for predicting osteoporosis and discriminate osteoporotic from healthy subjects. We aimed to analyze the status of some bone turnover biochemical markers namely PINP, B-ALP, estrogen, and progesterone in the elderly osteoporotic and osteopenic women as probable markers for the discrimination between patients and healthy individual in diagnosing osteoporosis, and to detect the impact of osteoporosis on quality of life of patients using assessment of the quality of life for osteoporosis (ECOS-16). Serum levels of procollagen type I Nterminal propeptide (PINP), bone alkaline phosphatase (B-ALP), estrogen, and progesterone were measured by ELISA technique. Measuring bone mineral density (BMD) using dual-energy X-ray absorptiometry (DEXA) is the commonly used test for diagnosing osteoporosis and osteopenia [5]. Researchers try to find serum markers to diagnose low bone mineral density and, they found that bone turnover markers may be considered as predictors of osteoporosis and osteopenia [6]. PINP had been suggested as a reference serum marker of bone formation [10]
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