title: Bone Turnover Markers for Osteoporosis Status Assessment at Baseline in Postmenopausal Pakistani Females.
abstract: OBJECTIVE
  To assess bone turnover status in osteopenic and osteoporotic postmenopausal females.
  
  
  METHODS
  Cross-sectional analytical study.
  
  
  METHODS
  The Aga Khan University Hospital, Karachi, from January to December 2013.
  
  
  METHODS
  Across-sectional study was conducted on 203 postmenopausal females undergoing bone mineral density testing (BMD) by DXAscan. Patients with clinical history of any disorder or medications affecting bone turnover were excluded. Bone turnover was assessed with osteocalcin and β-CTx. Data was analyzed by SPSS version 19.
  
  
  RESULTS
  Mean age of the participants was 54 ±4.66 years with a mean BMI of 28.7 ±5.5 kg/m2. Mean β-CTx (0.28 ±0.24 ng/ml) and osteocalcin (21.5 ±10.6 ng/ml) levels were within the normal reference range. Subjects were grouped into normal (26.6%), osteopenic (44.8%), and osteoporotic (28.6%) based on the t-scores. Serum levels of osteocalcin and β-CTx between normal, osteopenic, and osteoporotic groups were not significantly different. β-CTx was negatively and significantly associated with only lumber spine BMD (r = -0.13, p=0.04). Positive association (< 0.0001) was noted between both markers in normal, osteopenic, and osteoporotic females. However, association of these markers with BMD in the 3 groups were not found. Multivariate linear regression showed a positive and significant effect of BMI on BMD (β= 0.332, p= < 0.0001). β-CTx had negative but significant effect on BMD (β= -0.155, p= 0.018) of postmenopausal women.
  
  
  CONCLUSIONS
  Association between baseline levels of BTM and rate of bone loss is variable and site dependent. β-CTx correlates better with BMD. However, role of osteocalcin in postmenopausal osteoporosis is uncertain and needs further investigation.
authors.affiliation: Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi.
authors.forename: Syed Talha
authors.initials: ST
authors.lastname: Naeem
authors.affiliation: Department of Radiology, The Aga Khan University Hospital, Karachi.
authors.forename: Riffat
authors.initials: R
authors.lastname: Hussain
authors.affiliation: Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Raheem
authors.affiliation: Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi.
authors.forename: Imran
authors.initials: I
authors.lastname: Siddiqui
authors.affiliation: Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi.
authors.forename: Farooq
authors.initials: F
authors.lastname: Ghani
authors.affiliation: Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi.
authors.forename: Aysha Habib
authors.initials: AH
authors.lastname: Khan
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic; D016723:Bone Remodeling / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood*; D015663:Osteoporosis, Postmenopausal / Q000097:blood* / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000097:blood*; D010154:Pakistan / Q000453:epidemiology; D017698:Postmenopause / Q000097:blood*; D015995:Prevalence; D012044:Regression Analysis; D016103:Spinal Fractures / Q000097:blood / Q000209:etiology
chemical_list: D015415:Biomarkers; D015675:Osteocalcin