Comparison of The factors related to Inflammation, Oxidative Stress, and Body Composition Analysis between Postmenopausal Women with and without Primary Osteoporosis: Aa Case Control Study

Abstract

Abstract: Introduction: Osteoporosis is a common disease with a systemic disorder in bone mass that leads to fractures. There is a direct link between osteogeny deficiency during menopause and the progression of osteoporosis. Oxidative stress and inflammatory factors are among the risk factors raised in osteoporosis. The balance of oxidative status is disturbed not only with age but also with low levels of 17-beta oestradiol, which acts as an antioxidant. Another risk factor for bone loss is body composition parameters. This study was done to compare the oxidative stress and inflammatory biomarkers, and body composition parameters in postmenopausal women aged 50-65 years with and without normal bone mineral density (BMD). Methods: An observational case-control study was administrated from July 2018 to January 2019 in the health care centres in Tabriz. Among 850 randomly selected eligible postmenopausal women, 120 women with normal and 120 without normal BMD (osteopenia-osteoporosis) were selected based on the densitometry data obtained from the dual-energy X-ray absorptiometry method after ruling out the secondary causes. Data collection tools included demographic, obstetric, anthropometric questionnaires, a sheet for recoding laboratory tests including inflammatory and oxidative stress factors. Body composition data were analysed using a body composition analyser. Superoxide dismutase activity, serum levels of total antioxidant capacity, malondialdehyde, interleukin-6, tumor necrosis factor alpha, high sensitivity C-reactive protein were measured by biochemical methods. Data were analysed using descriptive and analytical statistics including Chi-square, Mann-Whitney, independent t-test, logistic regression adjuster for confounders in SPSS 21 software. Results: There were significant differences between the two groups in age, menopausal age, and education. According to the binary logistic regression model adjusted for confounders, the higher levels of malondialdehyde (OR: 1.50; 95% CI: 1.07 to 2.11, p=0.019) and high sensitivity C-reactive protein (OR: 1.50; 95% CI: 1.07 to 2.11, p=0.019) associated significantly with the higher odds of having low-BMD. The higher body fat mass (OR: 0.85; 95% CI: 0.78 to 0.92, p<0.001), soft lean mass (OR: 0.92; 95% CI: 0.87 to 0.98, p=0.014), lean body mass (OR: 0.85; 95% CI: 0.807 to 0.90, p<0.001), visceral fat mass (OR: 0.57; 95% CI: 0.40 to 0.81, p=0.002), BMI (OR: 0.78; 95% CI: 0.71 to 0.85, p<0.001), and minerals (OR: 0.16; 95% CI: 0.06 to0.37, p<0.001) associated with the lower odds of having low-BMD . Conclusions: The higher serum levels of malondialdehyde and high sensitivity C-reactive protein increased the risk of low-BMD. In contrast, the higher quantitative of body composition components except for body water showed protective effects against BMD. Future studies are recommended to investigate the exact mechanisms in this regard and other risk factors.