The effect of hormonal alterations on bone turnover markers in women with surgical and natural menopause

Abstract

Objective: In surgical and natural menopause, bone turnover alterations due to estrogen deficiency result in osteoporosis. In the present study, the effect of hormonal alterations on bone turnover markers in women with surgical and natural menopause was planned. Material and Methods: Sixty women with natural menopause and 60 women with surgical menopause applied to menopause clinic of Maltepe Medical Faculty were included study. Serum follicle stimulating hormone (FSH), estradiol (E2), dehydroepiandrosterone sulphate (DHEAS), cortisole, bone-spesific alkaline phosphatase (BAP), paratyroid hormone (PTH), collagen C-telopeptite (CTX) and calcium (Ca) levels were measured. Results: Serum PTH, CTX, E2 and DHEAS levels were higher in women with natural menopause. In women with surgical menopause, serum BAP, cortisole and Ca levels were higher than those with natural menopause. However, these differences were not statistically significant. Serum BAP levels were positively correlated with age, serum cortisole and CTX (r=0.308p=0.004; r=0.301 p=0.023; r=0.302p=0.005; respectively). Serum CTX levels were positively correlated with serum PTH levels (r=0.271 p=0. Oil). While serum PTH levels were positively correlated with age and years since menopause (r=0.381 p=00001; r=0.318p=0.015; respectively), it was negatively correlated with BMI (r=-2.33 p=0.032). Serum DHEAS levels were negatively correlated with age and years since menopause (r=-0.220 p=0.041; r—-0.291 p=0.030; respectively). Conclusion: We concluded that, except estrogen deficiency, there may be various factors for osteoporosis in cases with natural and surgical menopause.

Keywords

• Menopause,Charybdotoxin,Parathyroid Hormone,Follicle Stimulating Hormone,Estradiol,Alkaline Phosphatase

Doğal ve cerrahi menopoz olgularındaki hormonal değişimin kemik döngüsüne etkisi

Öz

Amaç: Hem doğal hem de cerrahi menopozda özellikle östrojen eksikliğine bağlı olarak kemik döngüsü değişmekte ve osteoporoz olasılığı artmaktadır. Bu çalışmada doğal ve cerrahi menopozda meydana gelen hormonal değişikliklerin kemik döngüsü belirteçleri üzerine etkilerinin araştırılması planlandı. Materyal ve Metod: Maltepe Üniversitesi Tıp Fakültesi Menopoz Polikliniği 'ne başvuran 60 doğal menopozlu ve 60 cerrahi menopozlu hasta çalışmaya alındı. Serum folikül stimulan hormon (FSH), östradiol (E2), dehidroepiandrosteron sülfat (DHEAS), kortizol, kemik-spesifık alkalen fosfataz (BAP), paratiroid hormon (PTH), kollajen C-telopeptit (CTX) ve kalsiyum (Ca) düzeyleri ölçüldü. Bulgular: Doğal menopozlu kadınlarda serum PTH, CTX, E2 ve DHEAS seviyeleri; cerrahi menopozlu kadınlarda ise serum BAP, kortizol ve Ca seviyeleri artmış olarak bulunmasına rağmen, her iki grup arasında anlamlı farklılık tespit edilmedi. Serum BAP seviyesinin yaş, serum kortizol ve CTX parametreleri ile pozitif kor ele olduğu gözlendi (sırasıyla r=0.308p=0.004; r=0.301 p=0.023; r=0.302p=0.005). Serum CTXseviyeleri PTH ile pozitif korele bulundu (r=0.271 p=0.011). Serum PTH seviyelerinin ayrıca yaş ve menopoz süresi ile pozitif korele olduğu saptanırken (sırasıyla r=0.381 p=00001; r=0.318 p=0.015), BMI ile PTH arasında ise negatif korelasyon bulundu (r=-2.33 p=0.032). Serum DHEAS seviyeleri ise yaş ve menopoz süresi ile negatif korele bulundu (sırasıyla r=-0.220p=0.041; r=-0.291 p=0.030). Sonuç: Doğal ve cerrahi menopozda oluşan osteoporoz riskinin altında östrojen eksikliği dışında pek çok faktörün olduğunu düşünmekteyiz.

Anahtar Kelimeler

• Menopoz,Karibdotoksin,Paratiroid hormonu,Folikül uyarıcı hormon,Östradiol,Alkalin fosfataz

Kaynakça

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