Evaluating the Role of Bone Turnover Markers in Diagnosing and Monitoring Osteoporosis: A Cross-Sectional Study
Abstract
Background: Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration, leading to increased fracture risk. The standard diagnostic tool, Dual-energy X-ray absorptiometry (DXA), measures bone mineral density (BMD) but does not capture the dynamic state of bone remodeling. Bone turnover markers (BTMs) reflect the rate of bone formation and resorption and may offer complementary diagnostic and prognostic information. Methods: A single-center, cross-sectional study was conducted on 150 postmenopausal women aged 50–75. Participants were categorized into three groups based on WHO T-score criteria: Healthy Controls (n=50, T-score > -1.0), Osteopenia (n=50, T-score between -1.0 and -2.5), and Osteoporosis (n=50, T-score ≤ -2.5). Fasting morning serum samples were collected and analyzed for P1NP and CTX-I levels using electrochemiluminescence immunoassays. BMD was measured at the lumbar spine and femoral neck by DXA. Data were analyzed using one-way ANOVA with Tukey's post-hoc test. Results: The mean age of participants was significantly higher in the osteoporosis group (65.8 ± 6.1 years) compared to the osteopenia (61.2 ± 5.5 years) and control groups (58.4 ± 4.9 years) (p < 0.001). Serum P1NP levels were significantly elevated in the osteoporosis group (80.5 ± 21.2 ng/mL) compared to both the osteopenia group (55.3 ± 15.8 ng/mL) and the control group (35.1 ± 10.4 ng/mL) (p < 0.001). Similarly, serum CTX-I levels showed a stepwise increase, with the highest levels in the osteoporosis group (752.1 ± 148.3 ng/L), followed by the osteopenia group (501.7 ± 119.5 ng/L), and the lowest in controls (303.4 ± 82.6 ng/L) (p < 0.001). All pairwise comparisons between the groups for both markers were statistically significant (p < 0.01). Conclusion: Serum levels of P1NP and CTX-I are significantly and progressively elevated in postmenopausal women with osteopenia and osteoporosis compared to healthy controls. These findings support the potential role of BTMs as valuable adjuncts to BMD for identifying individuals with high bone turnover, assessing fracture risk, and potentially monitoring therapeutic response in osteoporosis management.Keywords:
Osteoporosis, Bone Turnover Markers, P1NP, CTX-I, Bone Mineral Density, Diagnosis, PostmenopausaReferences
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