Association between the bone turnover markers and the gynecologic factors among Moroccan women

Abstract

Background:The action of bone cells on the bone mineral density can be highlighted from their enzymatic activities, by the bone alkaline phosphates (BAP) and the Cross Laps-telopeptide terminal of the collagen type 1 (β-CTX). They are reliable to explore the activity of bone turnover. We aim to put in perspective the association between gynecological factors and the concentration of bone turnover markers (BTMs) among Moroccan women.Methods: This is a cross-sectional study of 125 women from February to April 2015. A randomized sample was made. The biochemical parameters of bone metabolism concerned serum calcium, 25 hydroxyvitamin D (25OHD), parathyroid hormone (PTH), phosphorus , BAP and β-CTX. All data related to gynecologic, sociodemographic and anamnesis parameters was collected by standardized questionnaire.Result: Among 125 women, 64(51.42) were menopausal, the mean BAP was 22.1±7.6 ng/L, the median of the interval between successive births "IBSB" and of β-CTX were 36.0 [24.0-58.0] months, 368.5 [237.0-504.8]ng/L. A positive correlation was observed between the β-CTX and IBSB (r=0.2,p=0.05). The BAP concentration was higher in menopausal women (p<0.001). The linear regression showed that 12% of BAP concentration was associated to the menopause (R 2 =0.12, p=0.001) but no associated factors was founded with concentration of β-CTX. Conclusion:Our study shows that the menopause is associated factor with concentration of BAP and IBSB is correlated with the concentration of β-CTX. Keywords IntroductionThe bone remodeling is a complex physiological process during which the osteoclasts, cells of bone resorption, and the osteoblasts, cells of bone formation, act in sequential and coupled frequencies to destruct and renew the bone matrix. The objective of this physiological process is to lead an adequate bone mineral density (BMD) depending on the age and the sex (1). This bone remodeling process is under the action of several factors such as biological mediators, cited the vitamin D and the calcium, also under the action of sexual hormones and under the action of some external parameters related to the lifestyle of the person (1, 2).The action of these cells on the bone can be highlighted from their enzymatic activities by the biochemical markers of bone turnover: Bone Alkaline Phosphatase (BAP) and C-telopeptide Terminal Collagen type 1 (β-CTX). The BAP is an enzyme of the bone formation specific to the osteoblasts whereas the β-CTX is an enzyme of bone resorption specific to the osteoclasts (2). The use of these enzymes are reliable to their non invasive exploration of bone turnover (3), they allow in association with the bone densitometry to estimate the loss of bone and to monitor the response of therapeutic effect of several bone diseases (4).The trend to establish a link between markers and BMD was also subject to research among Moroccan researchers (5,6). Yet, to our knowledge, no study so far in Morocco has been undertaken to study the associated factors with the concentration of biochemical of bo...