The Role of Biochemical Markers in the Early Detection of Osteoporosis in Women: A Comparative Study from the Western Region of Nepal

摘要

Introduction: Osteoporosis is defined as the reduced bone mass per unit volume of normal mineralized bone that leads to fractures, even with minor trauma. Osteoporotic fractures are a common cause of morbidity and mortality in adult men and women. This silently increasing metabolic bone disease is extensively prevalent in developing countries like Nepal. The objective of our study was to achieve an easy and early detection of osteoporosis in postmenopausal women, detecting the more vulnerable premenopausal women also. Materials and Methods: This was a hospital based, comparative study which was carried out in the Department of Orthopedics of Manipal Teaching Hospital, Pokhara, Nepal, between 31st December 2009 and 31st July 2011. The variables which were collected were age (years), years after menopause (years), BMI (kg/m2), total serum calcium (mmol/L), ionized calcium (mmol/L), phosphorus (mmol/l), total protein (g/dl), albumin (g/dl) and ALP (units/L). The approval for the study was obtained from the institutional research ethical committee. Results: Of the 612 subjects, 306 were pre menopausal and the other 306 were postmenopausal women. The post menopausal women were further categorized into early (132) and late (174) post menopausal women. For all the subjects, the mean values and the p value was calculated with all variables which were taken into our study. There was no significant difference in the mean values of the BMI of the pre-menopausal (24.77± SD2.19) women and those of the post-menopausal women [(24.77± SD1.76) p value (0.99)]. The mean values of serum calcium were moderately reduced in post-menopausal women (2.05± SD0.11) as compared to those in the pre-menopausal women (2.22 ± SD0.20). These were found to be statistically significant (p value 0.001). Conclusion: The bone turnover markers are a better way of the early detection of the high risk women and those in the early phases of osteoporosis when the X-ray and DEXA scan changes are not prominent.