Forearm bone mineral density in postmenopausal Indian women: correlation with calcium nutrition

Abstract

Background: Osteoporosis is characterized by low bone mass with micro architectural deterioration of bone tissue leading to enhanced bone fragility, thus increasing the susceptibility to fracture. This study was conducted with the objective of measuring forearm bone mineral density in postmenopausal Indian women and to establish a correlation with indices of calcium nutrition i.e. dietary calcium intake, calcium supplements, serum calcium, serum phosphorus, serum alkaline phosphatase and serum intact parathyroid hormone.Methods: Fifty healthy, ambulatory postmenopausal women were selected and a prospective observational study was conducted to correlate the BMD with indices of calcium nutrition. Patient’s laboratory investigations (serum calcium, serum phosphorous, serum alkaline phosphatase and serum intact parathyroid hormone were done and BMD was assessed with dual-energy X-ray absorptiometry at non-dominant forearm; T-scores and Z-score were derived. Correlation analysis was done to investigate the relationship between indices of calcium nutrition and BMD.Results: The proportion of osteoporosis in forearm was 22%in the deficient group, 60% in the insufficient group and 18% in the sufficient group. Among the study group 15 subjects were osteoporotic by T score mid forearm where as 7 were osteoporotic with T score ultra distal forearm and 11 subjects had osteoporosis with T score total forearm.Conclusions: Out of all the indices of calcium nutrition, the correlation between the serum alkaline phosphatase and T score forearm was statistically significant.

Correlation of biomarkers and bone mineral density for osteoporosis in post-menopausal women

“…In a study conducted by Sharma S et al there was no significant correlation observed between BMD and serum phosphorus. 12 The present study is in accord with the above study showing no significant correlation.…”

“…In study by Sharma S et al, BMD at the level of forearm was measured and the study by Keen RW et al BMD at the level of femoral neck and spine are measured and correlated. 12,13 In our study BMD at the level of lumbar spine and hip were measured using DEXA and authors found no significant correlation between BMD Lumbar spine and BMI and surprisingly significant correlation between BMD Hip and BMI was noted. This difference may be due to heterogenecity of BMD at different areas of body with different rates of osteoclastic activity which will be more in the early years of menopause leading to rapid bone loss at lumbar spine.…”

“…Estimates suggest that of the 230 million Indians expected to be over the age of 50 years in 2015, 20%, i.e., about 46 million, are women with osteoporosis. 5 Measurement of bone mineral density along with other risk factors can potentially improve the identification of osteopenic and osteoporotic women.…”