Association of Bone Turnover Markers with Trabecular Bone Score and Bone Mineral Density among Pre- and Postmenopausal Women: a Study from Sri Lanka

Abstract

Objective: Data on the association between bone turnover markers (BTMs) and BMD/trabecular bone score (TBS) are not available for Sri Lankans. This study evaluated the association of serum BTMs with BMD and TBS among pre- and postmenopausal women. Methods: A descriptive cross-sectional study was conducted in Galle District, Southern Province, Sri Lanka. Community dwelling women aged 20-70 y (n=347) were recruited using multistage stratified random sampling technique. Menopausal status was defined as the presence of amenorrhea for more than 12 consecutive months due to natural causes. BMDs of hip (THBMD), femoral neck (FNBMD), lumbar spine (LSBMD) and total body (TBBMD) were measured by DXA (Hologic Discovery, Bedford, MA, USA). TBS was estimated by TBS iNsight® software. Serum crosslinked C-telopeptide of type I collagen (CTX; bone resorption marker) and procollagen type I N-propeptide (PINP; bone formation marker) were measured using ELISA. Partial correlation (adjusted for possible confounders) was used to assess the correlations. Results: In premenopausal women, CTX showed significant negative correlations with LSBMD, TBBMD and TBS and PINP showed weak but significant negative correlation with LSBMD (Table). In postmenopausal women, CTX showed significant negative correlations with BMDs of all sites and TBS nevertheless, PINP did not show significant correlations with BMDs or TBS. Table: Correlations of BTMs with BMD and TBS according to menopausal status (refer the abstract book).