Serum 25-hydroxyvitamin D and bone turnover markers in Palestinian postmenopausal osteoporosis and normal women

Akram Kharroubi,Elias Saba,Hisham Darwish,Khaldoun Bader,Riham Smoom

doi:10.1007/s11657-017-0306-7

Akram Kharroubi, Elias Saba + Show 3 more

Open Access

https://doi.org/10.1007/s11657-017-0306-7

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Abstract

SummaryThis study evaluated the association of vitamin D and bone markers with the development osteoporosis in Palestinian postmenopausal women. Even though vitamin D deficiency was very high for the recruited subjects, it was not associated with osteoporosis except for bones of the hip. Age and obesity were the strongest determining factors of the disease.PurposeThe purpose of this study was to investigate the association of bone mineral density (BMD) with serum vitamin D levels, parathyroid hormone (PTH), calcium, obesity, and bone turnover markers in Palestinian postmenopausal women.MethodsThree hundred eighty-two postmenopausal women (≥45 years) were recruited from various women clinics for BMD assessment (131 women had osteoporosis and 251 were normal and served as controls). Blood samples were obtained for serum calcium, PTH, 25(OH)D, bone formation (N-terminal propeptide (PINP)), and bone resorption (serum C-terminal telopeptide of type I collagen (CTX1)) markers.ResultsWomen with osteoporosis had statistically significant lower mean weight, height, body mass index (BMI), and serum calcium (p < 0.05) compared to controls. No significant differences were detected between the mean values of bone turnover markers (CTX and PINP), 25(OH)D, and PTH of the two groups. Women with vitamin D deficiency (severe and insufficiency) represented 85.9% of the study subjects. Multiple and logistic regression showed that age and BMI significantly affected BMD and vitamin D had a significant association with BMD only at the lumbar spine. BMI was positively correlated with BMD and PTH but negatively correlated with vitamin D. Logistic regression showed that the odds ratio (OR) for having osteoporosis decreased with increasing BMI (overweight OR = 0.11, p = 0.053; obese OR = 0.05, p = 0.007).ConclusionsThere was no direct correlation between BMD and PTH, bone turnover markers, and vitamin D except at the lumbar spine. A negative correlation between BMD and age and a positive correlation with BMI were observed. The protective effect of obesity on osteoporosis was complicated by the effect of obesity on vitamin D and PTH.

Highlights

Osteoporosis is a widespread disease characterized by significant decrease in bone quality as a consequence of deterioration in bone microarchitecture and low bone mass [1, 2]
We investigated the correlation between Bone mineral density (BMD) at various specific skeletal sites with serum levels of 25(OH)D, parathyroid hormone (PTH), calcium, specific markers of bone formation, and bone resorption, in addition to other non-genomic factors including age, height, weight, and body mass index (BMI) among Palestinian postmenopausal women
STD standard deviation, N number of subjects, BMI body mass index, PINP procollagen type I N propeptide, CTX1 serum C-terminal telopeptide of type I collagen, PTH parathyroid hormone, BMD bone mineral density age was significantly higher compared to normal control subjects (68.2 vs. 61.3 years, respectively, p < 0.0001)

Summary

Introduction

Osteoporosis is a widespread disease characterized by significant decrease in bone quality as a consequence of deterioration in bone microarchitecture and low bone mass [1, 2]. The Middle East countries enjoy sunshine year around, their populations suffer from significant vitamin D deficiency in all ages and have one of the highest rates of rickets in the world [10, 15, 18, 19]. Several factors contribute to the development of vitamin D deficiency and its negative physiological impact on bones including decreased dietary intake, inadequate production of the vitamin in the skin, and disturbances in the production of the active hormonal form of vitamin D [10, 15, 20,21,22,23]. Vitamin D deficiency, which is common among the Saudi Arabian population, reached 41–64% among young females 12–18 years old [24,25,26,27]. In addition to the vitamin D status, mutations in the vitamin D receptor markedly contribute to the complications of vitamin D deficiency on bone health [28, 29]

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