Density In Postmenopausal Women Research Articles

Comparison of Trabecular Bone Score-Adjusted FRAX™ and FRAX™-Bone Mineral Density in Postmenopausal Women with Clinical Vertebral Fractures: A Cross-Sectional, Analytic Study

Background: Ethnicity differentially modulate fracture risk prediction using FRAX™-bone mineral density (BMD). Objective: To compare FRAX™-BMD and trabecular bone score (TBS)-adjusted FRAX™ in the 10-year probability of fracture among Thai postmenopausal woman (PMW) with vertebral fracture (VF). Materials and Methods: The present study was a cross-sectional study conducted by retrospective review of medical records of PMW with VF older than 45 years undergoing lumbar and hip DXA scan. The authors excluded the PMW having been treated with metal implant at the spine, 3 or more lumbar VF, or cancer spreading to vertebral spine. The authors assessed the difference in means of normally distributed data by dependent sample t-test, the correlation between TBS and LS BMD by Pearson correlation, and the difference in proportions of PMW who met intervention threshold (IT) before and after TBS-adjusted FRAX™ by McNemar’s test. A p<0.05 was considered statistically significant. Results: Of the 119 patients, the mean age was 70.8±8.1 years. The mean 10-year probability of a hip fracture by TBS-adjusted FRAX™ was significantly higher than that by FRAX™-BMD with the mean difference of 0.44% (95% CI 0.13 to 0.76). The higher difference in means, using TBSadjusted FRAX™, was even significantly greater in the 10-year probability of major osteoporotic fractures. For either the IT of major osteoporotic fracture or hip fracture, TBS-adjusted FRAX™ resulted in four added PMWs who needed treatment, but without statistical significance. Conclusion: TBS-adjusted FRAX™ had a higher 10-year probability of fracture than FRAX™-BMD. Keywords: Trabecular bone score; FRAX™; Bone mineral density; Postmenopausal women; Osteoporosis

Stress-Related Amygdala Metabolic Activity Is Associated With Low Bone Mineral Density in Postmenopausal Women: A Pilot 18F-FDG PET/CT Study.

BackgroundPsychological stress is associated with postmenopausal osteoporosis. However, the underlying mechanism of stress-related brain neural activity with osteoporosis is not fully elucidated. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an established method to evaluate the metabolic activity of brain amygdala, a region involved in stress. We aimed to evaluate the relationship between metabolic activity of amygdala (AmygA) and osteoporosis in postmenopausal women.Materials and MethodsA total of 115 postmenopausal women who underwent 18F-FDG PET/CT and dual-energy X-ray absorptiometry for routine health screening were enrolled in this study. AmygA was defined as the maximum standardized uptake value (SUVmax) of amygdala divided by the mean SUV of temporal lobe. The levels of psychological stress were measured using the Psychosocial Well-being Index-Short Form (PWI-SF).ResultsThe participants with osteoporosis exhibited significantly higher AmygA than without osteoporosis (0.81 ± 0.16 vs. 0.61 ± 0.13, p < 0.001). The AmygA value of 0.69 was suggested as an optimal cut-off value to identify participant with osteoporosis (sensitivity; 79.1%, specificity; 83.3%, area under the curve; 0.841, p < 0.001). Furthermore, AmygA showed significant association with osteoporosis in postmenopausal woman by multivariate analysis. Psychological stress scale (PWI-SF) was well correlated with AmygA and AmygA was highest in high stress risk-, intermediate in moderate stress risk-, and lowest in healthy group.ConclusionsAmygA measured by 18F-FDG PET/CT is associated with osteoporosis in postmenopausal women. Our results provide the possibility that stress-related neurobiological activity involving amygdala is linked with postmenopausal osteoporosis.

Increased frequency of Th17 cells and IL-17 levels are associated with low bone mineral density in postmenopausal women

Osteoporosis is one of the chronic and often neglected bone diseases in aging postmenopausal women that affect the quality of life. Studies on ovariectomized mice models indicated the reciprocal role of Th17 cells and Treg cells in the aetiology of osteoporosis. While Th17 cells promote osteoclastogenesis, Treg cells exhibit anti-osteoclastogenic activity. This exploratory study aimed to determine the difference in the frequency of these T-cell subtypes in pre-and postmenopausal women and to examine their association with BMD. In our study, the frequency of Treg cells, analyzed by flow cytometry, did not differ between pre-and postmenopausal women. However, plasma levels of IL-10 along with IL-10+CD4+T cells were higher in post- compared to premenopausal women. The frequency of Th17 cells was higher in postmenopausal women irrespective of their BMD, however, only postmenopausal women with low BMD had elevated IL-17 levels and their T-scores were associated with Th17 frequency. Collectively, the results suggest that estrogen insufficiency in postmenopausal women may lead to increased Th17 cell frequency and elevated IL-17 levels which are associated with low BMD. This study highlights, Th17 cells and IL-17 as key players in the pathogenesis of osteoporosis and they can be the potential targets for immunotherapy in the treatment of osteoporosis.

Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up.

Clinical psychological factors may predict medical diseases. Anxiety level has been associated with osteoporosis, but its role on bone mineral density (BMD) change is still unknown. This study aimed to investigate the association between anxiety levels and both adherence and treatment response to oral bisphosphonates (BPs) in postmenopausal osteoporosis. BMD and anxiety levels were evaluated trough dual-energy X-ray absorptiometry and the Hamilton Anxiety Rating Scale (HAM-A), respectively. Participants received weekly medication with alendronate or risedronate and were grouped according to the HAM-A scores into tertiles (HAM-A 3 > HAM-A 2 > HAM-A 1). After 24 months, BMD changes were different among the HAM-A tertiles. The median lumbar BMD change was significantly greater in both the HAM-A 2 and HAM-A 3 in comparison with the HAM-A 1. The same trend was observed for femoral BMD change. Adherence to BPs was >75% in 68% of patients in the HAM-A 1, 79% of patients in the HAM-A 2, and 89% of patients in the HAM-A 3 (p = 0.0014). After correcting for age, body mass index, depressive symptoms, and the 10-yr. probability of osteoporotic fractures, anxiety levels independently predicted lumbar BMD change (β = 0.3417, SE 0.145, p = 0.02). In conclusion, women with higher anxiety levels reported greater BMD improvement, highlighting that anxiety was associated with adherence and response to osteoporosis medical treatment, although further research on this topic is needed.

Body composition and bone mineral density in postmenopausal women with rheumatoid arthritis

Aim – to study the relationship between body composition and bone mineral density (BMD) in postmenopausal women with rheumatoid arthritis (RA).Material and methods. 68 postmenopausal women, median age 59 [54; 63] years, with RA were included in the study. Bone mineral density (BMD) and body composition were assessed with dual energy X-ray absorptiometry.Results. 33 (48.5%) women had osteopenia, and 17 (25.0%) – osteoporosis (OP). Low lean muscle mass was found in 10 (14.7%) patients. There were positive correlations between different areal BMD and body weight, trunk fat, trunk lean muscle mass and total lean muscle mass. In the multivariate linear regression analysis total lean muscle mass was associated with BMD of lumbar spine (β=0.638; p=0.001) and total hip (β=0.473; p=0.008), and appendicular lean muscle mass, estimated using the appendicular muscle index, with femoral neck BMD (β=0.360; p=0.014).Conclusion. 73.5% of patients with RA had a reduced BMD, and 14.7% women – low muscle mass. The revealed significant association between the lean muscle mass and BMD of lumbar spine and proximal femur indicates the importance of detecting and correcting low lean muscle mass, as well as preventing its decline in order to prevent loss of BMD and osteoporotic fractures.

Vitamin D Boosts Alendronate Tail Effect on Bone Mineral Density in Postmenopausal Women with Osteoporosis.

Vitamin D modulates bisphosphonate (BP) efficacy, but its contribution to bone mineral density (BMD) after BP discontinuation is not known. To address this topic, we performed a retrospective analysis of postmenopausal women exposed to alendronate (ALN) to treat osteoporosis who regularly continued the supplementation of cholecalciferol or calcifediol at recommended doses. In the ninety-six recruited women (age 61.1 ± 6.9 years), ALN was administered for 31.2 ± 20.6 months and then discontinued for 33.3 ± 18.9 months. The modification of 25(OH)D serum levels over time was associated with a change of alkaline phosphatase (r = −0.22, p = 0.018) and C-terminal collagen type 1 telopeptide (r = −0.3, p = 0.06). Women in the tertile of the highest increase in 25(OH)D level showed a 5.7% BMD gain at lumbar spine, that was twice as great in comparison with participants with a lower 25(OH)D variation. At a multiple regression analysis, BMD change was associated with time since menopause (ß = 2.28, SE 0.44, p < 0.0001), FRAX score for major fracture (ß = −0.65, SE 0.29, p = 0.03), drug holiday duration (ß = −2.17, SE 0.27, p < 0.0001) and change of 25(OH)D levels (ß = 0.15, SE 0.03, p = 0.0007). After ALN discontinuation, improving the vitamin D status boosts the ALN tail effect on BMD.

Abstract #1003985: Correlation of Lipid Profile with Bone Mineral Density in Postmenopausal Women

Menopausal women face multiple problems which adversely affect their mental and physical well being. They are prone to develop diabetes, metabolic syndrome, dyslipidemia and osteoporosis. Osteoporosis is often diagnosed late when bone fragility is increased significantly and resulting fractures cause multiple complications.

Evaluation of the relationship between homocysteine levels and bone mineral density in postmenopausal women

Objective The current study aimed to evaluate the relationship between homocysteine (Hcy) levels and bone mineral density (BMD) in postmenopausal women. Methods The present, cross-sectional study included 760 postmenopausal women. The following variables were recorded: age, age at menopause, body mass index (BMI), BMD (measured by dual-energy X-ray absorptiometry [DXA] scanning and expressed as lumbar, femoral neck and total hip T-scores), smoking status, biochemical parameters (Hcy, creatinine, calcium, phosphorus, vitamin D and parathormone levels) and vitamin D supplementation. Results The mean age of the sample population was 56.4 ± 5.77 years and the mean age at menopause was 49.9 ± 3.62 years. The mean BMI was 25.2 ± 4.49 kg/m2. In the current study, a comparison of the subjects with osteoporosis, osteopenia and normal BMD revealed that the subjects in the low BMD group were significantly older (p < 0.001), had a lower age at menopause (p < 0.001) and had lower BMI (p < 0.001). There was no statistically significant difference among the groups with regard to the plasma levels of Hcy (p = 0.946). The levels of Hcy were positively correlated to the creatinine levels (r = 0.21). The present study did not observe any significant correlations between the Hcy levels and other parameters. Conclusions In the present study, 15.3% of the subjects had hyperhomocysteinemia and 62.11% had low BMD. The current results obtained from a group of postmenopausal women suggest that the plasma levels of Hcy are not related to BMD in the lumbar spine (L1–L4), femoral neck and total hip. In the current study, age, age at menopause and low BMI were observed to be associated with low BMD.

Effects of Pilates Exercise on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-analysis.

Despite the popularity of Pilates exercises among postmenopausal women, few studies have devoted attention to verifying the effects of the technique on bone mineral density (BMD), and, to date, no systematic review and meta-analysis have been conducted on this topic. Our objective was to conduct a systematic review and meta-analysis of randomized controlled trials examining the effect of Pilates on BMD. Randomized controlled trials were considered eligible, with follow-up of 6 months and more, which verified the effects of Pilates exercise on the BMD of postmenopausal women. The calculations of the meta-analysis were performed through the weighted mean difference between the Pilates exercise and control groups, through the absolute change between pre- and postintervention in the areal bone mineral density. Three randomized controlled trials met the inclusion criteria and were included in the meta-analysis. Only 1 study presented satisfactory methodological quality. Pilates exercises did not offer significant effects to improve areal bone mineral density of the lumbar spine (0.019 g/cm2 [95% confidence interval (CI), -0.018 to 0.057], P = .32), total hip (0.012 g/cm2 [95% CI, -0.002 to 0.027], P = .10), or femoral neck (0.000 g/cm2 [95% CI, -0.021 to 0.022], P = .97). Pilates exercises had no significant effects on BMD in postmenopausal women. However, the few studies included in the meta-analysis and the low methodological quality of the majority of the studies do not allow safe extrapolation of the results at this time. More robust randomized controlled trials with high methodological quality are needed so that the results of this meta-analysis can be confirmed.

Efficacy of Low Dose Denosumab in Maintaining Bone Mineral Density in Postmenopausal Women With Osteoporosis Switching From 60mg to 30mg 6 Monthly: A Real World, Prospective Observational Study

Introduction: Denosumab, a fully human monoclonal antibody to RANK-ligand, has been shown to increase bone mineral density (BMD) and reduce the risk of fracture in postmenopausal women with osteoporosis. Cessation of denosumab is associated with rises in bone remodelling, reductions in BMD and an increased risk of fracture. The primary objective of this study is to evaluate the efficacy of low dose denosumab (30mg/6 months) in preventing bone loss in postmenopausal women with osteoporosis switching from 60mg to 30mg every 6 months. We report the effects of low dose denosumab for upto 2years in patients previously treated with denosumab for >=3 years as well as < 3years. Methods: Following informed consent, postmenopausal women with osteoporosis who had been on denosumab 60mg every 6 months were switched to receive 30mg of denosumab every 6 months.. Patients with an additional skeletal disorder, prior fragility fracture, or on oral steroids (daily in the past 12 months) were excluded. The primary endpoint was the percent change in BMD at the lumbar spine (LS), total hip (HP), femoral neck (FN) and 1/3 radius (1/3R) at 12 and 24 months. Secondary outcomes were adverse effects and fracture Results: 127 patients were included in the study. 44 patients had received 60 mg for 3 years or longer before transitioning to 30mg and 83 patients switched before completing 3 years on full dose therapy. Patients on less than 3yrs of 60mg therapy before the switch showed a significant improvement in BMD at LS (+2.00%, 95% CI 0.49% to 3.51%, n = 55, p-value = 0.01) 1 year post transition. There were no significant changes at the FN, TH or 1/3 radial sites 1 year post transition compared to baseline. At 2 years post transition (n=35) significant changes were noticed at LS (+4.65%, 95% CI 2.29% to 7.01%, p value <0.001), FN (+ 4.87%, 95% CI 1.46% to 8.28%, p value = 0.006) and 1/3 radial sites (+4.95%, 95% CI 0.73% to 9.17%, p value = 0.02). No significant changes were noted at TH. Similar results were seen with prior denosumab therapy for <3years No fractures were observed in this observational study. Conclusions: Switching from 60mg of denosumab to 30 mg every 6 months was not associated with reductions in BMD and may be a valuable treatment option in patients who have completed long term denosumab therapy.

Effects of thyroid-stimulating hormone suppression after thyroidectomy for thyroid cancer on bone mineral density in postmenopausal women: a systematic review and meta-analysis

ObjectivesWe assessed thyroid-stimulating hormone (TSH) suppression effects on bone mineral density (BMD) in postmenopausal women who underwent thyroidectomy.Data sourcesPubMed, EMBASE, Cochrane Library, Web of Science and SCOPUS were searched from...

Low TSH Levels Within Euthyroid Range Could Play a Negative Role on Bone Mineral Density in Postmenopausal Women with Type 2 Diabetes.

ObjectiveWe aimed to evaluate the relationship between thyroid-stimulating hormone (TSH) and bone mineral density (BMD) in euthyroid type 2 diabetes (T2D).MethodsThis retrospective analysis enrolled 439 T2D patients with normal thyroid function, including 226 males and 213 females. All the female patients were postmenopausal. Serum glycosylated hemoglobin A1c (HbA1c), TSH, free triiodothyronine (FT3), and free thyroxine (FT4) concentrations were analyzed. BMD of the lumbar spine (L1–L4), femoral neck, and hip joint was determined using dual-energy X-ray absorptiometry.ResultsThe patients were grouped based on tri-sectional quantiles of the TSH levels: 0.55~1.70mIU/L (Group 1), 1.71~2.58mIU/L (Group 2), and 2.59~4.74mIU/L (Group 3). Our data showed that, in male patients, no difference in BMD was identified among groups. In postmenopausal women, unlike at the lumbar spine (P = 0.459), the mean BMD at the femoral neck (P = 0.014) and hip joint (P = 0.014) had a statistical difference among groups and increased with TSH level. In addition, our analysis demonstrated that TSH levels shown no correlation with BMD at all sites in males. However, in females, BMD at the femoral neck (r = 0.156, P = 0.023) and hip joint (r = 0.172, P = 0.012) had a positive correlation with TSH levels. After adjusting for age and BMI, multiple regression analysis showed that TSH levels influenced BMD at the femoral neck (β = 0.188, P = 0.001) and hip joint (β = 0.204, P = 0.001) in female patients.ConclusionIn summary, our data demonstrates that low TSH levels are associated with decreased BMD at the femoral neck and hip joint in postmenopausal T2D women with euthyroidism.

Retraction Note: Associations between VDR Gene Polymorphisms and Osteoporosis Risk and Bone Mineral Density in Postmenopausal Women: A systematic review and Meta-Analysis

Editor's Note: this Article has been retracted; the Retraction Note is available at https://doi.org/10.1038/s41598-021-88654-1.

Bone mineral density in postmenopausal women with type 2 diabetes mellitus with and without diabetic nephropathy

Bone mineral density in postmenopausal women with type 2 diabetes mellitus with and without diabetic nephropathy

59. Tamoxifen for Puberty Induction and Bone Mineral Density Protection in a Gender Non Binary Patient With 46, XY Complete Gonadal Dysgenesis: A Case Report

<h3>Background</h3> 46XY complete gonadal dysgenesis patients present with primary amenorrhea and delayed puberty. There is an increased risk of gonadoblastoma and often undergo surgical resection. Following diagnosis, sex hormone replacement therapy is started for puberty induction. Tamoxifen prevents loss of bone mineral density in postmenopausal women and has been used to treat gynecomastia in prepubertal males. We present a case of a nonbinary patient with 46XY complete gonadal dysgenesis where typical sex hormone replacement therapy would be incongruent with the patient's gender identity and instead, tamoxifen was used for puberty induction and bone health protection. <h3>Case</h3> A 15 year old patient with autism and ADHD presented with primary amenorrhea. Breast development occurred 1.5 years prior without development of pubic or axillary hair. They had previously identified as gender neutral. They had an elevated FSH (51mIU/mL), elevated LH (16mIU/mL), low estradiol (<2.5pg/mL), low testosterone (10ng/dL), and karyotype 46XY SRY+ of unknown molecular etiology. Sonography showed a prepubertal uterus (4.5 × 0.5 × 2.5cm) and intraabdominal gonads. The workup was suggestive of 46XY complete gonadal dysgenesis. DEXA scan showed decreased bone mineral density for chronologic age (Z score -2.3, whole body BMD:0.71 g/cm2). They were counseled regarding the risk of gonadoblastoma in intraabdominal gonads and elected to undergo a laparoscopic gonadectomy. They expressed concerns about sex hormone replacement and did not wish to develop secondary sex characteristics that would be incongruent with their nonbinary identity. A selective estrogen receptor modulator (tamoxifen) was started for bone health protection without the development of secondary sex characteristics. At 4 months, their height had increased 2cm and had a reduction in breast tissue. At 1 year, their height had increased 5cm and the increase in growth velocity showed pubertal induction. Repeat ultrasound demonstrated a uterus size of 6 × 1.3 × 2.2 cm and a non-visualized endometrial stripe. DEXA showed improvement (Z score -2.2, whole body BMD:0.81 g/cm2). Tamoxifen was titrated up to a goal dose of 15-20mg daily. Mental health and psychosocial adaptation was regularly screened following the DSD-TRN protocol. The patient has not had any menstrual bleeding, continues on the tamoxifen, and plans to undergo a hysterectomy at the age of 18. <h3>Comments</h3> Following gonadectomy in patients with 46XY complete gonadal dysgenesis, hormone replacement therapy is imperative for overall heath, puberty induction, and bone health. In patients who require sex hormone replacement but whose gender is not consistent with a male or female gender identity, a selective estrogen receptor modulator can be used.

Effect of Tibolone on Bone Mineral Density in Postmenopausal Women: Systematic Review and Meta-Analysis.

Simple SummaryLow bone mineral density (osteoporosis) is associated with vertebral and nonvertebral fractures in postmenopausal women. Tibolone is a low-risk hormone replacement therapy alternative to estrogen therapy, effective in the treatment of menopausal symptoms and prevention of bone loss, but the evidence is controversial. This systematic review with meta-analysis summarizes the clinical trials of the tibolone effect on percentage change of bone mineral density in the lumbar spine, femoral neck, and total hip in postmenopausal women. The results show that tibolone 2.5 mg dose increases the percent change in bone mineral density compared with non-active controls at 24 months in lumbar spine and femoral neck, regardless of the scanner used to evaluate the bone mineral density. No difference was observed when 2.5 mg tibolone dose was compared with estrogen therapy at 24 months, and both treatments have a positive effect on the bone mineral density. In conclusion, tibolone increases bone mineral density compared to non-active controls, and there was no difference when it is compared to estrogenic therapy; thus, tibolone is an alternative treatment for menopausal symptoms and bone protection.Low bone mineral density (BMD) on postmenopausal women causes bone fragility and fracture risk. Tibolone seems to prevent bone loss. Therefore, this systematic review with meta-analysis synthesizes the tibolone effect on BMD percent change in lumbar spine (LS), femoral neck (FN), and total hip (TH) in postmenopausal women. Controlled trials that provided tibolone evidence on the efficacy of tibolone in preventing loss of BMD were included. Regarding the included studies, a pooled mean difference (MD) with 95% confidence intervals (95%CI) was estimated to determine the BMD percentage change. Eleven studies were identified and eight were included in the quantitative analysis. Tibolone at a dose of 2.5 mg increased BMD compared with non-active controls at 24 months in LS (MD 4.87%, 95%CI: 4.16–5.57, and MD 7.35%, 95%CI: 2.68–12.01); and FN (MD 4.85%, 95%CI: 1.55–8.15, and 4.21%, 95%CI: 2.99–5.42), with Hologic and Lunar scanners, respectively. No difference was observed when tibolone 2.5 mg dose was compared with estrogen therapy (ET) at 24 months, LS (MD −0.58%, 95%CI: −3.77–2.60), FN (MD −0.29%, 95%CI: −1.37–0.79), and TH (MD −0.12%, 95%CI: −2.28–2.53). Therefore, tibolone increases BMD in LS and FN compared to non-active controls, and there was no showed difference with ET.

Positive association of high-density lipoprotein cholesterol with lumbar and femoral neck bone mineral density in postmenopausal women

ObjectiveExperimental studies suggest that lipids affect bone metabolism. We aimed to elucidate whether lipid levels are associated with bone mineral density (BMD) in a cohort of postmenopausal women. DesignA cross-sectional study of participants in the Chronic Ailment Reduction after MENopause (CARMEN) cohort. Women underwent assessment of clinical and analytical parameters, including fasting lipid levels. BMD was assessed at both lumbar spine and hip. Homogeneity in the cohort was optimized by filtering out a series of confounding variables with a known impact on bone. Main outcome measuresAssociation of BMD at lumbar spine and femoral neck with lipid levels. ResultsA total of 667 of the 1304 screened women were analyzed. A strong correlation was revealed between total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in univariate analysis. Multivariate analysis detected a significant positive association of HDL-C with BMD at both spine (p = 0.007) and femoral neck (p = 0.013). Other independent predictors of spine BMD were years since menopause (ysm, negatively associated), and body mass index (BMI) and estradiol, both positively associated with BMD. The other independent variables in the femoral neck were ysm and glucose (negatively associated) and BMI, estradiol, and phosphate, all positively associated with BMD. ConclusionLevels of HDL-C, but not TC, LDL-C or triglycerides, were positively associated with BMD at both the lumbar spine and femoral neck in a homogeneous cohort of postmenopausal women.

Associations of Circulating Levels of Sphingosine 1-Phosphate with the Trabecular Bone Score and Bone Mineral Density in Postmenopausal Women

Despite the potential roles of sphingosine 1-phosphate (S1P) as a biomarker of osteoporotic fracture (OF), independent of bone mineral density (BMD) and clinical risk factors (CRFs), its association with bone microarchitecture, a key determinant of bone quality, have not been studied yet. We here investigated the association of S1P with the trabecular bone score (TBS), an index of the bone microarchitecture. The plasma S1P concentrations, TBS, and BMD were measured in the 339 postmenopausal women. The S1P level was inversely correlated with the TBS (γ=–0.096, p=0.049) and BMD at the femur neck (FN-BMD: γ=–0.122, p=0.025) and tended to be inversely correlated the BMD at the total hip (TH-BMD: γ=–0.096, p=0.079), but not at the lumbar spine (LS-BMD). After adjusting for fracture risk assessment tool probabilities of major OF from CRFs, the S1P level was inversely associated with the TBS (β=–0.096, p=0.049) and FN-BMD (β=–0.118, p=0.025) and tended to be inversely associated with the TH-BMD (β=–0.092, p=0.083). Compared with subjects in the lowest S1P tertile, those in the highest S1P tertile had a significantly lower TBS (p=0.032) and BMD at femur (p=0.004–0.036). These findings indicated that a high S1P level in postmenopausal women was inversely associated with the both bone mass and microarchitecture, reflecting the compromised bone strength.

Association between Malondialdehyde, GSH/GSSG Ratio and Bone Mineral Density in Postmenopausal Women

Background: Osteoporosis is one of chronic degenerative diseases especially in postmenopausal women, characterized by a decreased bone mass due to imbalance activity between osteoblasts and osteoclasts. Recently, oxidative stress is believed to play an important role in osteoporosis pathogenesis. Oxidative stress is commonly considered as the consequence of an imbalance between pro and antioxidants species, which results in damage in the affected tissue. Malondialdehyde (MDA) is frequently used as a biomarker of oxidative stress in many health problems since MDA is produced at high levels during lipid peroxidation. Meanwhile, glutathione is well known as one of antioxidant which against oxidative stress by preserving its homeostasis in the reduced form of glutathione sulfhydryl (GSH) and the oxidized form of glutathione disulphide (GSSG). This study was aimed to determine the association between MDA, GSH/GSSG ratio and bone mineral density (BMD) in postmenopausal women.Materials and method: We conducted a cross-sectional study in 40 postmenopausal women. MDA and GSH/GSSG ratio were assessed by enzyme-linked immunosorbent assay (ELISA). Bone mineral density (BMD) was obtained from secondary data. The statistical analysis was conducted using Spearman rho’s correlation test.Results: Based on the test, we didn’t found significant correlation between MDA and BMD (r=-0.054, p=0.741), but we found significant moderate correlation between GSH/GSSG ratio (r=0.436, p=0.005) and BMD in postmenopausal women. Conclusion: There was no correlation between MDA and BMD in postmenopausal women. However, there was significant moderate correlation between GSH/GSSG ratio and BMD in postmenopausal women.Keywords: MDA, GSH/GSSG ratio, BMD, osteoporosis

Effects of Lemon Beverage Containing Citric Acid with Calcium Supplementation on Bone Metabolism and Mineral Density in Postmenopausal Women: Double-Blind 11-Month Intervention Study

A critical factor for preventing osteoporosis after menopause is attenuation of the accelerated turnover rate of bone metabolism. The present randomized controlled study was conducted to clarify the effects of a lemon beverage with calcium (Ca) supplementation that makes use of the chelating action of citric acid. Comprehensive evaluations of bone were performed by assessments of bone mineral density (BMD) and biomarkers related to bone turnover. Seventy-nine postmenopausal women were enrolled and asked to participate in an 11-month continuous intake of the test beverages. The subjects were divided into three groups: those who consumed a lemon beverage containing citric acid with Ca supplementation (LECA group), those who consumed a lemon beverage containing citric acid without Ca supplementation (LE group), and those who consumed no test beverage (control group). Using a double-blind protocol, subjects in the LECA and LE groups consumed one bottle containing 290 mL of the test beverage each day. The ratio of change in BMD after 11 months was significantly higher in the LECA group as compared to the control and LE groups. The LECA group also showed significant decreases in concentrations of tartrate-resistant acid phosphatase 5b (TRACP-5b), a bone resorption marker, and bone alkaline phosphatase (BAP) as compared to the other groups, as well as a significant decrease in concentration of osteocalcin (OC), a bone formation marker, as compared to the LE group. Based on our findings, we speculated that bone resorption and bone formation in postmenopausal women might be suppressed along with an increase in Ca resorption caused by chelation of citric acid in association with continuous ingestion of a Ca-supplemented lemon beverage containing citric acid, resulting in suppression of high bone metabolic turnover. In addition, the results provide information regarding BMD maintenance in the bones of the trunk, including the lumbar spine and proximal femur.