The Relationship Between Bone Turnover Makers And Bone Mineral Density In Postmenopausal Women Between 50 And 60 Years Of Age With Fracture

Objective1. To investigate the changes of bone metabolism markers in postmenopausal women between 50 and 60 years of age with fractures,to provide theoretical basis for the prevention and treatment of postmenopausal women osteoporosis fracture ?2. To investigate the change of 25 hydroxy vitamin D3 level and its relationship with BMD, bone turnover markers in postmenopausal women between 50 and 60 years of age with fractures in shanghai pudong area.Methods1. A total of 60 cases of postmenopausal women between 50 and 60 years of age(average: 56.7 ± 3.3) with fractures treated in Shanghai Pudong New Area Gongli hospital from July 2014 to June 2015 were selected. The cases were divided into two groups by years after postmenopause, including 30 cases of 0-5 years(average: 54.5 ± 3.3) after postmenopause, 30 cases of 5-10 years(average: 58.8 ± 0.9) after postmenopause. All the patients were measured height, weight, and bone metabolism markers, including 25 hydroxy vitamin D3(25-OH D3), bone isoenzyme of alkaline phosphatase(BALP), Osteocalcin(OC), C-terminal crosslinking telopeptides of type I collagen(s-CTX), Type I procollagen carboxy-terminal peptide(PICP), and N-terminal crosslinking telopeptides of type I collagen(u-NTX). The differences in general and bone metabolism between the two groups were analyzed.2. A total of 90 cases of postmenopausal women between 50 and 60 years of age(average: 56.7 ± 3.34) with fractures treated in our hospital from July 2014 to September 2015 were selected. The BMD was measured in different parts of the lumbar and femoral by dual energy X-ray absorptiometry produced by GE medical system in USA. The cases were divided into three groups by BMD, including osteoporosis group, osteopenia group and normal group. All the patients were measured height, weight, and bone metabolism markers, including 25 hydroxy vitamin D3, bone isoenzyme of alkaline phosphatase(BALP), Osteocalcin(OC), C-terminal crosslinking telopeptides of type I collagen(s-CTX), Type I procollagen carboxy-terminal peptide(PICP), and N-terminal crosslinking telopeptides of type I collagen(u-NTX).Result1.Serum levels of 25-hydroxy vitamin D3 in 5-10 years after postmenopause group decreased significantly compared with 0-5 years after postmenopause group(p<0.05).Serum levels of 25-hydroxy vitamin D3 in 0-5 years after postmenopause group was 43.36 ± 11.41nmol/L,while in 5-10 years after postmenopause group was 32.87 ± 12.55nmol/L. There is no significant difference in serum bone alkaline phosphatase, osteocalcin, C-terminal crosslinking telopeptides of type I collagen, Type I procollagen carboxy-terminal peptide, and N-terminal crosslinking telopeptides of type I collagen between 0-5 years and 5-10 years after postmenopause groups(p> 0.05). Serum levels of bone alkaline phosphatase in 0-5 years after postmenopause group was 12.49 ± 4.38 nmol/L, while in 5-10 years after postmenopause group was 13.36 ± 3.37 nmol/L;Serum levels of osteocalcin in 0-5 years after postmenopause group was 15.60 ± 6.99 nmol/L,while in 5-10 years after postmenopause group was 18.18 ± 5.60 nmol/L; Serum levels of C-terminal crosslinking telopeptides of type I collagen in 0-5 years after postmenopause group was 59.28 ± 8.57 nmol/L,while in 5-10 years after postmenopause group was 50.62 ± 7.51 nmol/L;Serum levels of Type I procollagen carboxy-terminal peptide in 0-5 years after postmenopause group was 0.57 ± 0.09 nmol/L,while in 5-10 years after postmenopause group was 0.59 ± 0.08 nmol/L;Serum levels of N-terminal crosslinking telopeptides of type I collagen in 0-5 years after postmenopause group was 766.08 ± 47.76 nmol/L,while in 5-10 years after postmenopause group was 823.08 ± 47.43 nmol/L?2.Serum level of 25-hydroxy vitamin D3 decreased with the decrease of BMD(P<0.05). Serum level of 25-hydroxy vitamin D3 decreased with the increase of BALP, OC, s-CTX, PICP and u-NTX(P<0.05). Serum level of 25-hydroxy vitamin D3 decreased with the increase of age(P<0.05).ConclusionThere was a significant positive correlation between 25-hydroxy vitamin D3 and BMD. Meanwhile there was a significant negative correlation between 25-hydroxy vitamin D3 and bone turnover markers(ie.BALP, OC, s-CTX, PICP and u-NTX). Serum 25-hydroxy vitamin D3 level was in the stage of relative lack in our region. Vitamin D3 should be promptly added to postmenopausal women between 50 and 60 years of age in order to prevent and delay the onset of osteoportic fracture.