STUDY OF CALCITROPIC HORMONES IN POSTMENOPAUSAL WOMEN AND THERAPEUTIC RESPONSES TO ESTROGEN CALCIUM AND VITAMIN D SUPPLEMENTATION

Abstract

Background: A range of techniques, such as histomorphometry, densitometry, calcium flux measurement, and estimate of biochemical bone markers, can be used to assess the status of the skeleton. Histomorphometry is an invasive, costly, time-consuming procedure that can only be performed on a single bone site. Densitometry is accurate and noninvasive, but it takes a long time to detect changes. Technically, measuring calcium fluxes is tough. Biochemical indicators of bone remodelling, on the other hand, are noninvasive and respond to intervention more quickly than densitometry. Biochemical bone markers can be found in the blood or urine and represent the process of bone remodelling. There are three types of byproducts produced during the creation of new bone: (a) enzymes or proteins released by bone cells participating in the remodelling process, (b) breakdown products formed during the resorption of old bone, and (c) byproducts generated during the resorption of old bone.

Aim: Study of biochemical markers of calcitropic hormones in postmenopausal women and therapeutic responses to estrogen, calcium and vitamin D supplementation.

Material and Method: Over a period of six months 150 women were recruited, to study. Among 150 subjects, 100 women had normal hepatic and renal function and were euthyroid. These 100 subjects were divided into two groups based on their menstruation. The women who have cessation of menstruation were included into study or post menopause group and the women who have regular menstrual cycles were considered as control or pre menopause group.

Results: The biochemical markers of bone resorption such as serum TRAP, urine free hydroxyproline and urine free deoxypyridinoline levels were significantly elevated in postmenopausal women. Also, the levels of urinary calcium and the indices of calcium/creatinine ratio were elevated in postmenopausal women over control group. Highly elevated levels of follicle stimulating hormone and luteinizing hormone and highly declined levels of estradiol were observed in postmenopausal women. The serum 25-hydroxy vitamin D levels were found to be insufficient in both control and study groups. However, the parathyroid status was found be in the normal range and were identical in both groups in the background of insufficient vitamin D status and deficient calcium intake.

Conclusion: The further extensive studies are required to arrive at final definite conclusions, regarding the therapeutic approach in postmenopausal women of Central India. Speculations were made at many instances where the situation demanded, and of course, speculations are inevitable in any scientific study to pave the way for further investigation. For instance, the estimation of interleukins, interferon and other cytokines, which influence bone turn over would be more useful in understanding overall spectrum of bone remodeling.

Keywords: vitamin D, TRAP, calcitropic, estrogen and calcium