Association between 25(OH)D3 and Estrogens in Iraqi Postmenopausal Osteoporotic Women with Type 2 Diabetes
Abstract
Background: Osteoporosis (OP) is a skeletal condition marked by reduced bone mass, deteriorated bone tissue microarchitecture, and an increase in fragility fractures. An important public health issue impacting millions of people, primarily postmenopausal women, is osteoporosis. Age, body mass index (BMI), smoking, alcohol usage, physical activity, prolonged calcium and vitamin D consumption, pregnancy interval, age of pregnancy, multiple births, age of menarche, and menopause status are additional factors associated with postmenopausal osteoporosis. Osteoporosis and diabetes mellitus are two common medical disorders that are becoming more prevalent in the elderly.
Objective: To study the association between [25(OH)D3], estrogens, parathyroid hormone (PTH), total alkaline phosphatase (ALP) activity, bone mineral density in postmenopausal women with and without type 2 diabetic patients with osteoporosis and compared with healthy postmenopausal women.
Methods: A cross-sectional study was conducted on 60 postmenopausal women with osteoporosis with age ranged between 55-75 years, divided into 30 of type 2 diabetic women and 30 without type 2 diabetes mellitus, the third group include 50 apparently healthy postmenopausal woman. Patients with osteoporosis were randomly selected from the fragility examination unit of Al-Hussein Medical Hospital, Kerbala health directorates / Kerbala - Iraq between Nov., 2021 to June, 2022. From each sample the body mass index (BMI) was measured, 5 ml of venous whole blood was placed in gel tube and centrifuge at 3000 x g for 10 min. to obtained the serum and kept until the time of determination of [25(OH)D3], parathyroid hormone (PTH), estradiol by immunoassay analysis using Cobas e411 analyzer. total alkaline phosphatase activity was determined by chemistry analyzer Smart 120T/H. T-score and bone mineral density by Dual energy X-ray absorptiometry scan (DEXA) at lumbar spine regions (L1–L4 vertebrae) which confirmed postmenopausal osteoporosis.
Result: For the first classification: the result of BMI (kg/m2) showed there was non-significant difference between T2DM PMOP patients (28.8 ± 4.69) and control (30.34 ± 4.69). Age (year) and estrogen (pg/ml) showed a significant difference between them (62.8 ± 6.90) vs (56.40 ± 7.47) and (28.05 ± 8.16) vs (26.34 ± 4.92) respectively. The levels of PTH (pg /ml) a non-significant differences (84.63 ± 28.1) vs (85.18 ± 28.83), and total ALP activity (U /L) showed significant difference (228.76 ± 45.8) vs (206.58 ± 39.9). In the second classification: the result of BMI (kg/m2) showed there was non-significant difference between non T2DM PMOP patients (28.5 ± 4.60) and control (30.34 ± 4.69). Age (years) showed a significant difference between them (62.25 ± 7.8 year) vs (56.40 ± 7.47 year). E2 (pg /ml) showed a non-significant difference between them (24.78 ± 8.22) vs (26.34 ± 4.92). The 25(OH)D3 (ng /ml) and ALP (U /L) showed a non-significant difference (22.19 ± 11.46) vs (19.89 ± 9.67), (0.56 ± 0.19) vs (0.46 ± 0.1). PTH (pg /ml) showed significant difference (66.39 ± 28.19) vs (85.19 ± 28.84).
Conclusion: According to this study, postmenopausal women with type 2 diabetes have considerably to have lower T-score values and a higher incidence of osteoporosis. Vitamin D deficiency is high in both diabetic and non-diabetic women but the deficiency was more prevalence among postmenopausal T2DM women (76.67%) compared to the non-diabetic postmenopausal women (63.33%).
