Biomarkers for impending risk of osteoporosis in premenopausal women

Objective: To compare ‘cytokines’ and ‘bone turnover markers’ in pre- and post-menopausal women and identify their relationship with bone mineral density (BMD) in both groups. Study Design: A cross-sectional study. Place and Duration of Study: Department of Biological & Biomedical Sciences, The Aga Khan University, Karachi, Pakistan, from June 2017 to August 2019. Methodology: Groups comprised of healthy premenopausal and postmenopausal women from the general population belonging to different ethnic groups and socio-economic status. Serum cytokines and bone turnover markers were assessed by solid-phase immunoassays, BMD (gm /cm²)] measurement was performed by dual-energy X-ray absorptiometry at the hip, lumbar spine, and proximal femur. Results were interpreted as a sum of T scores calculated by BMD of the above-mentioned sites. Results: Cytokines and bone turnover markers were significantly high in post-menopausal women (p<0.001). A negative correlation (r = 0.32) of TNF α with BMD (total T scores) observed in premenopausal women was found to be significant, however, no significant association of BMD was detected in post-menopausal women. Conclusion: There is an increase in the production of cytokines and bone turnover markers after menopause. TNF-α follows this usual pattern of increase in post-menopausal women and can predict impending bone loss and osteopenia in premenopausal females. Therefore, estimation of this cytokine in pre-menopausal women can give a fair indication of a decline in BMD, bone health, and risk of future osteoporosis.