title: Low serum osteoprotegerin levels in premenopausal infertile women with low bone density: an association of relevance?
abstract: OBJECTIVE
  To evaluate if the levels of the central regulators of osteoclast activity, osteoprotegerin (OPG) and receptor activator for nuclear factor kappaB-ligand (RANk-L), correlate with bone mineral density (BMD) parameters in premenopausal infertile women.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Academic infertility practice.
  
  
  METHODS
  82 Infertile, but otherwise healthy, premenopausal women< 42 years age presenting for routine care.
  
  
  METHODS
  BMD assessment; serum samples (cycle days 1 to 3), questionnaire addressing demographics, medical, social, family, and personal histories.
  
  
  METHODS
  BMD categorized as "Low" (Z <or= -1.0) or "Normal" (Z > -1.0); Biomarkers of bone metabolism (BAP, TRAP, NTX, OPG, RANK-L) and ovarian reserve (FSH, estradiol).
  
  
  RESULTS
  The prevalence of low BMD was 23% (19/82). Significantly lower levels of OPG were observed in association with low BMD compared with normal BMD (1.37 +/- 0.57 versus 2.0 +/- 1.05 pMol/L). Multivariable logistic regression analyses revealed low OPG levels as independent predictors of low BMD after adjusting for parameters known to influence bone density.
  
  
  CONCLUSIONS
  We demonstrate an independent relationship between low circulating levels of OPG and low BMD in premenopausal healthy, albeit infertile, women.
authors.affiliation: Reproductive Biology and Medicine Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Norian
authors.forename: Gohar
authors.initials: G
authors.lastname: Zeitlian
authors.forename: Goli
authors.initials: G
authors.lastname: Adel
authors.forename: Ruth G
authors.initials: RG
authors.lastname: Freeman
authors.forename: Nanette F
authors.initials: NF
authors.lastname: Santoro
authors.forename: Lubna
authors.initials: L
authors.lastname: Pal
mesh_terms: D015502:Absorptiometry, Photon; D000135:Acid Phosphatase / Q000097:blood; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D024042:Collagen Type I / Q000097:blood; D003430:Cross-Sectional Studies; D015536:Down-Regulation; D004958:Estradiol / Q000097:blood; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000000981:diagnostic imaging; D007527:Isoenzymes / Q000097:blood; D016015:Logistic Models; D053244:Osteoprotegerin / Q000097:blood*; D010455:Peptides / Q000097:blood; D017697:Premenopause / Q000097:blood*; D053245:RANK Ligand / Q000097:blood; D011795:Surveys and Questionnaires; D000071681:Tartrate-Resistant Acid Phosphatase
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D043373:Follicle Stimulating Hormone, Human; D007527:Isoenzymes; D053244:Osteoprotegerin; D010455:Peptides; D053245:RANK Ligand; C506030:TNFRSF11B protein, human; C505688:TNFSF11 protein, human; C052929:collagen type I trimeric cross-linked peptide; D004958:Estradiol; D000469:Alkaline Phosphatase; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase