Contribution of bone turnover markers (BTMs) and vitamin D to bone health in Iranian elderly women

Safoora Gharibzadeh; Noushin Fahimfar; Samira Goudarzi; Hossein Yarmohammadi; Farideh Razi; Patricia Khashayar; Gita Shafiee; Ramin Heshmat; Nahid Moradi; Mahnaz Sanjari; Kazem Khalagi; Alireza Raeisi; Iraj Nabipour; Bagher Larijani; Afshin Ostovar

doi:10.1007/s40200-024-01436-0

Contribution of bone turnover markers (BTMs) and vitamin D to bone health in Iranian elderly women

J Diabetes Metab Disord. 2024 Jun 6;23(2):1871-1877. doi: 10.1007/s40200-024-01436-0. eCollection 2024 Dec.

Authors

Safoora Gharibzadeh¹, Noushin Fahimfar^{2

3}, Samira Goudarzi⁴, Hossein Yarmohammadi², Farideh Razi⁵, Patricia Khashayar⁶, Gita Shafiee⁷, Ramin Heshmat⁷, Nahid Moradi², Mahnaz Sanjari², Kazem Khalagi^{2

8}, Alireza Raeisi^{9

10}, Iraj Nabipour¹¹, Bagher Larijani¹², Afshin Ostovar^{2

3}

Affiliations

¹ Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General Hospital, Leicester, LE5 4PW UK.
² Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
³ School of Public Health, Department of Epidemiology and Biostatistics, Tehran University of Medical Science, Tehran, Iran.
⁴ Master of Statistics and Machine Learning, Linköping University, Linköping, Sweden.
⁵ Metabolomics and Genomics Research, Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁶ Center for Microsystems Technology, Imec and Ghent University, Ghent, Zwijnaarde, Belgium.
⁷ Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁸ Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁹ School of Medicine, Department of Internal Medicine, Tehran University of Medical Science, Tehran, Iran.
¹⁰ School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
¹¹ The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
¹² Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

PMID: 39610511
PMCID: PMC11599691 (available on 2025-06-06)
DOI: 10.1007/s40200-024-01436-0

Abstract

Purpose: While only a few postmenopausal women exhibit biochemical signs of hypovitaminosis D, it has been shown that vitamin D insufficiency has detrimental effects on the overall skeleton mineralization, bone turnover rate, and may be a significant risk factor for osteoporosis and fracture. We evaluated the concurrent effect of Vitamin D levels and biochemical markers of bone turnover on bone health of postmenopausal women.

Methods: The present study was conducted within the framework of the Bushehr Elderly Health (BEH) program, a population-based prospective cohort study being conducted in Bushehr, a southern province of Iran. In summary, 400 persons from participants of the second stage were selected; serum bone turnover markers (bone-specific alkaline phosphatase (bALP), amino-terminal procollagen propeptides of type I collagen (P1NP), osteocalcin (OC), tartrate-resistant acid phosphatase isoenzyme 5b (TRAP)) and vitamin D were measured. Vitamin D deficiency was defined as serum 25(OH) D below 20 ng/ml, and Bone health was considered in terms of Osteoporosis and degraded bone microarchitecture.

Results: The number of partially or significantly degraded microstructure based on TBS was higher than the number of osteoporotic women based on BMD. Women with higher CTX levels were more prone to being degraded microarchitecture. Although we couldn't find any association between vitamin D deficiency and bone health, when we considered the vitamin D levels in univariable modelling, the effect of it was significant.

Conclusions: In this study, only CTX was found to be significantly correlated with TBS while BMD was associated with CTX, OC, and TRAP.

Keywords: Bone health; Bone turnover markers (BTMs); Bushehr elderly health (BEH) program; Osteoporosis; Trabecular bone score (TBS); Vitamin D deficiency.

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