Correlation between Reproductive Hormonal Level and Osteoporosis among Women in Mongolia

Unentsatsral Lkhagvasuren, Sarantuya Jav, Battogtokh Zagdsuren

Abstract


Background: Postmenopausal osteoporosis is the most common bone metabolic disease associated with low bone mineral density (BMD) and osteopathic fragility fractures, which can lead to significant morbidity. The objective of this study was to investigate the relationship between serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels and bone mineral density (BMD) across the stages of menopause in Mongolian women.

Methods: Two hundred sixty participants aged 50.1±4.4 years were enrolled in the study. Blood samples were obtained from each participant and analyzed using ELISA. Data were first stratified and analyzed by bone mineral density status (osteoporotic, osteopenic, and normal) and then by menopause status. Between group differences were analyzed using t-tests, and correlations were assessed using the Spearman rank order test, with Bonferonni correction. The data were analyzed using Statistical Package Statistical Software version 20.0 (SPSS Inc., Chicago, IL). Significance was set at p<0.05.

Results: The mean menopausal age was 48.4±3.4, which is comparable to the Mongolian population mean menopausal age. The mean serum estradiol level in the normal BMD group was 18.3±13.1 pg/ml and  15.8±10.7 pg/ml in the osteoporotic group. The mean serum FSH in the normal BMD group was 54.5±44.1 pg/ml and 81.3±34.2 pg/ml in the osteoporotic group. The mean serum LH level in the normal BMD group was 53.1±41.2 and 75.1±26.1 pg/ml in the osteoporotic group. The mean T and Z score were lower in the osteoporotic group. FSH and LH levels significantly differed across menopause stages in that those who were post-menopausal had higher levels compared to those who were pre- or peri-menopausal. Both hormones, FSH and LH, showed weak negative correlations with BMD level, but not E2. There were significant negative correlations between FSH and Speed of Sound (SOS) (r=-0.16; p<0.01), and  between osteoporosis with age (r=-0.30, p<0.05) and number of childbirths (r=-0.14 p<0.05).

Discussion: Osteoporosis is a significant problem with associations to hormone levels in post-menopausal women. In our study, mean serum estradiol levels decreased with age, and the mean FSH and LH levels were higher in women of later menopausal stage. Further study is warranted to investigate the bone related studies to establish better statistical references among Mongolian women. 


Keywords


osteoporosis; post-menopausal women; reproductive hormone; menopause; Mongolia

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References


Darba J, Kaskens L, Perez-Alvarez N, Palacios S, Neyro JL, Rejas J. Disability-adjusted-life-years losses in postmenopausal women with osteoporosis: a burden of illness study. BMC Public Health. 2015;15:324.

Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2013;24(1):23-57.

WHO. Assessment of osteoporosis at primary health care level. Summary Meeting Report 2004; http://www.who.int/chp/topics/Osteoporosis.pdf.

McKiernan FE, Berg RL, Linneman JG. The utility of BMD Z-score diagnostic thresholds for secondary causes of osteoporosis. Osteoporos Int. 2011;22(4):1069-1077.

Kanis JA, Melton LJ, 3rd, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res. 1994;9(8):1137-1141.

Moon R, Cooper, C, Harvey, NC. Osteoporosis: Pathophysiology and Epidemiology. The Duration and Safety of Osteoporosis Treatment: Springer International Publishing; 2016:1-16.

Keating NL, Cleary PD, Rossi AS, Zaslavsky AM, Ayanian JZ. Use of hormone replacement therapy by postmenopausal women in the United States. Ann Intern Med. 1999;130(7):545-553.

Cauley JA, Seeley DG, Ensrud K, Ettinger B, Black D, Cummings SR. Estrogen replacement therapy and fractures in older women. Study of Osteoporotic Fractures Research Group. Ann Intern Med. 1995;122(1):9-16.

Boroňová I BJ, Kľoc J, Tomková Z, Petrejčíková E, Mačeková S, Blaščáková MM. Analysis of OPG Gene Polymorphism T245G (rs3134069) in Slovak Postmenopausal Women. Analysis. 2014;2(12859).

Soules MR, Sherman S, Parrott E, et al. Stages of Reproductive Aging Workshop (STRAW). J Womens Health Gend Based Med. 2001;10(9):843-848.

Heinemann DF. Osteoporosis. An overview of the National Osteoporosis Foundation clinical practice guide. Geriatrics. 2000;55(5):31-36; quiz 39.

Chin KY, Ima-Nirwana S. Calcaneal quantitative ultrasound as a determinant of bone health status: what properties of bone does it reflect? Int J Med Sci. 2013;10(12):1778-1783.

WHO. Prevention and management of osteoporosis. Report of a WHO Scientific Group. . Geneva: World Health Organization;2003.

Palacios S, Henderson VW, Siseles N, Tan D, Villaseca P. Age of menopause and impact of climacteric symptoms by geographical region. Climacteric. 2010;13(5):419-428.

Ulziinorov G. The Relationship between Menopause Symptoms and the Quality of life of Women in Ulaabaatar City, Mongolia. Mahidol University: Institute for Population and Social Research;2009.

Mithal A, Kaur P. Osteoporosis in Asia: a call to action. Curr Osteoporos Rep. 2012;10(4):245-247.

Wu X YS, Zhang H, Xie H, Luo X, Peng Y, Liao E, et al. Early bone mineral density decrease is associated with FSH and LH, not estrogen. Clinica Chimica Acta. 2013;415:69-73.

Xu Z WA, Wu X, Zhang H, Sheng Z, Wu X, Liao E. Relationship of age-related concentrations of serum FSH and LH with bone mineral density, prevalence of osteoporosis in native Chinese women. Clinica Chimica Acta. 2009;400(1-2):8-13.

Adambekov S, Kaiyrlykyzy A, Igissinov N, Linkov F. Health challenges in Kazakhstan and Central Asia. J Epidemiol Community Health. 2016;70(1):104-108.




DOI: http://dx.doi.org/10.5195/cajgh.2015.239

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