Evaluation of bone mineral density and its correlation with homocysteine and other biochemical bone markers in postmenopausal women

Authors

  • Gopinath P. Department of Orthopedics, Adichunchanagiri Institute of Medical Sciences, Balagangadharanatha Nagara, Bellur, Karnataka, India
  • Abdul Ravoof Department of Orthopedics, Adichunchanagiri Institute of Medical Sciences, Balagangadharanatha Nagara, Bellur, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20182981

Keywords:

Homocysteine, BMD, Postmenopausal women

Abstract

Background: Osteoporosis is more common in post-menopausal women. Early detection of bone loss by bone mineral density helps to confirm the diagnosis of osteoporosis and assesses the future risk of osteoporotic fractures. Recent studies have revealed the association between increased plasma concentrations of homocysteine (Hcy), and reduced bone mineral density. Nevertheless, inconsistencies persist in the literature. Thus, the need for this study arose to investigate the possible relationship between serum Hcy status and bone mineral density on a group of post-menopausal women. The objective of the study was to assess bone mineral density (BMD) in postmenopausal women and to correlate the same with biochemical bone markers like homocysteine, serum alkaline phosphatase (ALP), calcium and phosphorous levels.

Methods: One hundred (100) postmenopausal women were recruited to enter this cross-sectional study. Out of which 86 postmenopausal females, were grouped into osteopenic and osteoporotic based on low t –scores. Bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DEXA) and serum Hcy, serum ALP, calcium and phosphorus levels were estimated. The relationship of Hcy with BMDand other biochemical markers was estimated using Pearson’s correlation.

Results: Serum Hcy levels were significantly higher in osteoporotic women when compared to other BMD groups, and were inversely correlated with BMD. No statistical difference was seen with other biochemical bone markers like calcium, Phosphorus and ALP.

Conclusions: This study shows that Hcy status is associated with BMD in osteoporotic postmenopausal women. BMD evaluation in postmenopausal women with high Hcy levels may have prognostic and therapeutic potentials, which needs to be explored through further Prospective studies.

References

Government of India: Ministry of Home Affairs 2011, Office of the Registrar General & Census Commissioner, India.

Beloyartseva M, Mithal A, Kaur P, Kalra S, Baruah MP, Mukhopadhyay S, Bantwal G, Bandgar TR. Widespread vitamin D deficiency among Indian health care professionals. Arch Osteoporos. 2012;7(1-2):187-92.

Malhotra N, Mithal A. Osteoporosis in Indians. Indian J Med Res. 2008;127(3):263-8.

Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4(1):46-56.

Ambrish M, Dhingra V, Lau E. The Asian Audit: Epidemiology, costs and burden of osteoporosis in Asia’, International Osteoporosis Foundation; 2009: 24-29.

Gallagher JC, Tella SH. Prevention and treatment of postmenopausal osteoporosis. The J Steroid Biochem Molecular Biol. 2014;142:155-70.

Bhattrai T, Bhattacharya K, Chaudhuri P, Sengupta P. Correlation of common biochemical markers for bone turnover, serum calcium and alkaline phosphatase, in post-menopausal women. Malays J Med Sci. 2014;21:58–61.

Kumar A, Devi SG, Mittal S, Shukla DK, Sharma S. A hospital based study of biochemical markers of bone turnovers & bone mineral density in north Indian women. Indian J Med Res. 2013;137(1):48-56.

Salari P, Abdollahi M. Association of hyperhomo-cysteinemia with osteoporosis: a systematic review. Therapy. 2008;5(2):215–22.

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;40(4):355–62.

Bozkurt N, Erdem M, Yilmaz E, Erdem A, Biri A, Kubatova A, et al. The relationship of homocyteine, B12 and folic acid with the bone mineral density of the femur and lumbar spine in Turkish postmenopausal women. Arch Gynecol Obstet. 2009;280:381-7.

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 J Endocr Metab. 2018;22:261-6.

Masse PG, Boskey AL, Ziv I, Hauschka P, Donovan SM, Howell DS, et al. Chemical and biomechanical characterization of hyperhomocysteinemic bone disease in an animal model. BMC Musculoskelet Disord. 2003;4:2-2.

Onyeukwu CU, Nsonwu AC. Biochemical bone turnover markers in postmenopausal women in Calabar municipality. Asian J Biochem. 2007;2(1):130–5.

Fratoni V, Brandi ML. B Vitamins, Homocysteine and Bone Health. Nutrients. 2015;7(4):2176-92.

Zhu Y, Shen J, Cheng Q, Fan Y, Lin W. Plasma homocysteine level is a risk factor for osteoporotic fractures in elderly patients. Clinical Interventions in Aging. 2016;11:1117-21.

Bucciarelli P, Martini G, Martinelli I, et al. The relationship between plasma homocysteine levels and bone mineral density in postmenopausal women. Eur J Intern Med. 2010;21(4):301–5.

Baines M, Kredan MB, Usher J, Davison A, Higgins G, Taylor W, et al. The association of homocysteine and its determinants MTHFR genotype, folate, vitamin B12 and vitamin B6 with bone mineral density in postmenopausal British women. Bone. 2007;40:730-6.

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. N Engl J Med. 2004;350(20):2033–41.

Cagnacci A, Baldassari F, Rivolta G, Arangino S, Volpe A. Relation of homocysteine, folate, and vitamin B12 to bone mineral density of postmenopausal women. Bone. 2003;33(6):956–9.

Haliloglu B, Aksungar FB, Ilter E, Peker H, Akin FT, Mutlu N, Ozekici U. Relationship between bone mineral density, bone turnover markers and homocysteine, folate and vitamin B12 levels in postmenopausal women. Arch Gynecol Obstet. 2010;281:663-6.

Rumbak I, Zižić V, Sokolić L, Cvijetić S, Kajfež R, Colić Barić I. Bone mineral density is not associated with homocysteine level, folate and vitamin B12 status. Arch Gynecol Obstet. 2012;285:991-1000.

Zhang H, Tao X, Wu J. Association of homocysteine, vitamin B12, and folate with bone mineral density in postmenopausal women: a meta-analysis. Arch Gynecol Obstet. 2014;289:1003-9.

Cagnacci A, Bagni B, Zini A, Cannoletta M, Generali M, Volpe A, et al. 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.

Farhat GN, Cauley JA. The link between osteoporosis and cardiovascular disease. Clin Cases Mineral Bone Metabol. 2008;5(1):19-34.

Downloads

Published

2018-08-25

Issue

Section

Original Research Articles