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Relationship between bone turnover biomarkers, mandibular bone mineral density, and systemic skeletal bone mineral density in premenopausal and postmenopausal Indian women

Makker, Annu PhD1,2; Singh, Man Mohan PhD, DSc, FNASc1,3; Mishra, Geetanjali PhD1,4; Singh, Balendra Pratap MDS5; Jain, Girish Kumar PhD6; Jadhav, Satyawan PhD6

doi: 10.1097/gme.0b013e31823dbbf7
Original Articles

Objective Postmenopausal osteoporosis is one of the most common metabolic bone disorders. Osteoporosis is reported to cause bone loss in the alveolar processes of maxilla and mandible, which provide bony framework for tooth anchorage. However, the association between systemic osteoporosis and oral health remains controversial. Available evidence suggests that Indian women have lower peak bone mass than their Western/other Asian counterparts. The present study evaluated the relationship between mandibular bone mineral density (mBMD), systemic skeletal BMD, and bone metabolism in premenopausal and postmenopausal Indian women.

Methods One hundred twenty-four premenopausal and 247 postmenopausal healthy women were included in the study. The BMD of the body of mandible, radius ultradistal, total hip, femur neck, and lateral spine were measured using dual-energy x-ray absorptiometry. Serum and urine biomarkers were determined using commercial kits.

Results Univariate regression analysis followed by stepwise multivariate regression analysis to obtain the best fit model demonstrated the BMD of radius ultradistal, serum inorganic phosphorus, estradiol, and sex hormone–binding globulin as significant predictors of mBMD in premenopausal women. The BMD of femur neck, serum ionized calcium, bone-specific alkaline phosphatase, osteocalcin, and urine total pyridinoline were significantly associated with mBMD in postmenopausal women. The significant association between mBMD and number of teeth present was observed in the whole group of premenopausal and postmenopausal women.

Conclusions Varied predictors of mBMD were observed in premenopausal and postmenopausal women. The results suggest that the screening for these biomarkers and serum ionized calcium should be useful (1) to assess the status of mBMD particularly in women requiring surgical dental intervention that include bone manipulation and (2) for early detection and management of women with the risk of developing osteoporosis.

Best fit model was obtained to demonstrate predictors of mandibular bone mineral density (mBMD) in premenopausal and postmenopausal Indian women. Screening for biomarkers should be useful to assess mBMD status.

From the 1Division of Endocrinology, Central Drug Research Institute, Lucknow, India; 2Postgraduate Department of Pathology, CSM Medical University, Lucknow, India; 3Saraswati Dental College & Hospital, Faizabad Road, Lucknow, India; 4Department of Zoology, University of Lucknow, Lucknow, India; 5Department of Prosthodontics, CSM Medical University, Lucknow, India; and 6Division of Pharmacokinetics & Metabolism, Central Drug Research Institute, Lucknow, India.

Received September 12, 2011; revised and accepted October 18, 2011.

Funding/support: This study received financial support from the Ministry of Health and Family Welfare, Government of India. A.M. thanks the Department of Science and Technology, Government of India, for the award of fellowship under their Women Scientist Scheme, and M.M.S. thanks the Indian Council of Medical Research, New Delhi, India, for appointment as Emeritus Medical Scientist.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Man Mohan Singh, PhD, DSc, FNASc, Saraswati Dental College & Hospital, Faizabad Road, Lucknow, India. E-mail:

©2012The North American Menopause Society