Relationship Between Biochemical Parameters and Bone Mineral Density in Postmenopausal Women of Karachi, Pakistan

Authors

DOI:

https://doi.org/10.36283/ziun-pjmd14-2/011

Keywords:

Bone Mineral Density, Menopause, Hypertensive, Diabetic, Osteoporosis

Abstract

 Background: Postmenopausal Osteoporosis is a significant public health concern, primarily due to estrogen decline, leading to metabolic changes and vasomotor symptoms. Common comorbidities in postmenopausal women include Diabetes Mellitus and Hypertension. This study aimed to assess the relationship between bone mineral density (BMD) and biochemical parameters in postmenopausal women to identify risk factors for osteoporosis and fractures.

Methods: This analytical cross-sectional study was conducted at a tertiary care hospital in Karachi from November 2023 to June 2024. After ethical approval, 150 postmenopausal women were enrolled and categorized into Normotensive, Non-Diabetic Hypertensive, and Hypertensive Diabetic (n=50 each). Investigated parameters included plasma glucose, HbA1c, lipid profile, and BMD. Data were analyzed using SPSS version 22.0. Pearson correlation assessed relationships between T-scores, Z-scores, and lipid parameters, with statistical significance set at p<0.05.

Results: Mean FBS, HbA1c, and total cholesterol were significantly higher in hypertensive diabetic women (p=0.0001). BMD analysis showed significantly lower T and Z-scores in hypertensive diabetic women (p=0.0001). Significant correlations were observed between Z-score and triglycerides (p=0.008) in normotensive women, T-score and Z-score (p=0.000) in hypertensive women, and T-score and triglycerides (p=0.011) in hypertensive diabetic women. Osteoporosis (76%) and fracture risk (64%) were significantly higher in hypertensive diabetic women (p=0.0001).

Conclusion: Hypertensive diabetic postmenopausal women exhibit significantly lower BMD, higher glucose and cholesterol levels, and increased fracture risk, underscoring their heightened osteoporosis susceptibility.

Author Biographies

  • Madiha Soban, Karachi Institute of Medical Sciences/National University of Medical Sciences

    Assistant Professor, Department of Biochemistry 

  • Razeen Fahad, Karachi Institute of Medical Sciences/ National University of Medical Sciences

    Senior Lecturer, Department of Biochemistry 

  • Fauzia Perveen, Liaquat College of Medicine and Dentistry, Jinnah Sindh Medical University

    Assistant Professor, Department of Biochemistry

  • Tahira Assad,  Karachi Institute of Medical Sciences/National University of Medical Sciences 

     Professor  & Head, Department of  Pharmacology 

  • Amina Raza, Liaquat National Medical College, Jinnah Sindh Medical University

    Assistant Professor, Department of  Biochemistry 

     

     

  • Fasiha Fatima, Karachi Institute of Medical Sciences/National University of Medical Sciences

    Associate Professor, Department  of Biochemistry

References

Camacho PM, Petak SM, Binkley N, Diab DL, Eldeiry LS, Farooki A, et al. American Association of Clinical Endocrinologists/American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis—2020 update. Endocrine Practice. 2020; 26:1-46. doi:org/10.4158/GL-2020-0524SUPPL.

Alay I, Kaya C, Cengiz H, Yildiz S, Ekin M, Yasar L. The relation of body mass index, menopausal symptoms, and lipid profile with bone mineral density in postmenopausal women. Taiwanese Journal of Obstetrics and Gynecology. 2020;59(1): 61-6.doi: org/10.1016/j.tjog.2019.11.009

Irsik DL, Bollag WB, Isales CM. Renal Contributions to Age Related Changes in Mineral Metabolism. Journal of Bone and Mineral Research Plus. 2021;5(10):e10517.doi:org/10.1002/jbm4.10517

Muraduzzaman S, Begum S, Ali S, Sultana S, Saiedullah M, Alam F. Association between Bone Mineral Density and Hypertension in Postmenopausal Women. European Journal of Medical and Health Sciences. 2021;3(4):116-20.doi:10.24018/ejmed.2021.3.4.980.

Hampson G, Elder GJ, Cohen-Solal M, Abrahamsen B. A review and perspective on the assessment, management and prevention of fragility fractures in patients with osteoporosis and chronic kidney disease. Endocrine. 2021;73(3):509-29. doi:org/10.1007/s12020-021-02735-9.

Al-Hariri M, Aldhafery B. Association of hypertension and lipid profile with osteoporosis. Scientifica. 2020;2020(1):7075815.doi:org/10.1155/2020/7075815.

Chai H, Ge J, Li L, Li J, Ye Y. Hypertension is associated with osteoporosis: a case-control study in Chinese postmenopausal women. BMC Musculoskeletal Disorders. 2021;22:1-7. Doi:org/10.1186/s12891-021-04124-9.

Ranatunga S, Kulkarni B, Kinra S, Ebeling PR, Zengin A. Sex-specific associations between markers of arterial stiffness and bone mineral density in Indian men and women. Bone. 2023;169:116686.doi:org/10.1016/j.bone.2023.116686.

Cipriani C, Colangelo L, Santori R, Renella M, Mastrantonio M, Minisola S, et al. The interplay between bone and glucose metabolism. Frontiers in endocrinology. 2020;11:122.doi:org/10.3389/fendo.2020.00122.

Parsa-Parsi RW. The International code of medical ethics of the World Medical Association. JAMA. 2022;328(20):2018–21.doi:org/10.1001/jama.2022.19697.

Caglayan EK, Engin-Ustun Y, Sari N, Karacavus S, Seckin L, Kara M. Evaluation of bone density measurement in type 2 diabetic postmenopausal women with hypertension and hyperlipidemia. Journal of Menopausal Medicine. 2015 Apr 1;21(1):36-40. http://dx.doi.org/10.6118/jmm.2015.21.1.36

Misra A, Dhurandhar NV. Current formula for calculating body mass index is applicable to Asian populations. Nutrition & diabetes. 2019;9(1):3.doi:org/10.1038/s41387-018-0070-9.

Bai R, Ying X, Shen J, Wu T, Lai X, Wang L, Yu M, Qi X, Mei Y. The visceral and liver fat are significantly associated with the prevalence of hyperuricemia among middle age and elderly people: A cross-sectional study in Chongqing, China. Frontiers in Nutrition. 2022 Oct 13;9:961792. https://doi.org/10.3389/fnut.2022.961792

Dildar S, Imran S, Naz F. Method comparison of particle enhanced immunoturbidimetry (PEIT) with high performance liquid chromatography (HPLC) for glycated hemoglobin (HbA1c) analysis. Clinical Diabetes and Endocrinology. 2021 Dec; 7:1-5. https://doi.org/10.1186/s40842-021-00123-w

Bairaktari E, Hatzidimou K, Tzallas C, Vini M, Katsaraki A, Tselepis A, et al. Estimation of LDL cholesterol based on the Friedewald formula and on apo B levels. Clinical biochemistry. 2000;33(7): 549-55.doi:org/10.1016/S0009-9120(00)00162-4.

Høiberg M, Rubin KH, Hermann A, Brixen K, Abrahamsen B. Diagnostic devices for osteoporosis in the general population: a systematic review. Bone. 2016;92: 58-69.doi: org/10.1016/j.bone.2016.08.011.

Wang YY, Yang S, Chen SW. Relationship between body mass index and pulse pressure in a non-diabetic population: evidence from a multicenter, cross-sectional study. European Review for Medical & Pharmacological Sciences. 2023 Jan 1;27(1). doi:10.5061%2Fdryad.ft8750v.

Kim K-C, Shin D-H, Lee S-Y, Im J-A, Lee D-C. Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women. Yonsei medical journal. 2010;51(6):857-63.doi:10.3349/ymj.2010.51.6.857.

Wu Y, Xing X, Ye S, Chen C, Wang J. Lipid levels related to osteoporosis in patients with type 2 diabetes. Experimental and Clinical Endocrinology & Diabetes. 2019;127(07):468-72.doi:10.1055/a-0735-9361.

Ünal D, Onbaşı K, Kilit TP. Osteoporosis and Related Factors in Patient with Type 2 Diabetes and Prediabetes. Turk J Osteoporos. 2022 Aug 11;28(2):97-103. DOI: 10.4274/tod.galenos.2021.15807

Cavati G, Pirrotta F, Merlotti D, Ceccarelli E, Calabrese M, Gennari L, et al. Role of advanced glycation end-products and oxidative stress in type-2-diabetes-induced bone fragility and implications on fracture risk stratification. Antioxidants. 2023;12(4):928.doi:org/10.3390/antiox12040928.

Shahen V, Gerbaix M, Koeppenkastrop S, Lim S, McFarlane K, Nguyen AN, et al. Multifactorial effects of hyperglycaemia, hyperinsulinemia and inflammation on bone remodelling in type 2 diabetes mellitus. Cytokine & growth factor reviews. 2020;55:109-18.doi:org/10.1016/j.cytogfr.2020.04.001.

Du Y-J, Liu N-N, Zhong X, Pan T-R. Risk factors for nonalcoholic fatty liver disease in postmenopausal women with type 2 diabetes mellitus and the correlation with bone mineral density at different locations. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2022: 1925-34.doi:org/10.2147/DMSO.S364804.

Long G, Liu C, Liang T, Zhang Z, Qin Z, Zhan X. Predictors of osteoporotic fracture in postmenopausal women: a meta-analysis. Journal of Orthopaedic Surgery and Research. 2023 Aug 5;18(1): 574.doi:org/10.1186/s13018-023-04051-6.

Chen FP, Fu TS, Lin YC, Fan CM. Risk factors and quality of life for the occurrence of hip fracture in postmenopausal women. Biomed J.2018;41(3):202–8.doi: org/10.1016/j.bj.2018.04.001.

Yoo JE, Shin DE, Han K, Kim D, Yoon JW, Lee DY. Association of female reproductive factors with incidence of fracture among postmenopausal women in Korea. JAMA Netw Open. 2021;4(1): e2030405.doi:10.1001/jamanetworkopen.2020.30405.

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Published

2025-04-13

How to Cite

1.
Soban M, Fahad R, Perveen F, Assad T, Raza A, Fatima F. Relationship Between Biochemical Parameters and Bone Mineral Density in Postmenopausal Women of Karachi, Pakistan. PJMD [Internet]. 2025 Apr. 13 [cited 2025 Jul. 10];14(2):61-7. Available from: https://ojs.zu.edu.pk/pjmd/article/view/3215

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