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Abstract
Bone density in young women can be regarded as a predictor of osteoporosis risk in postmenopausal period. Hormonal contraception can affect bone density in women during their reproductive period. Although DEXA is considered the gold standard to diagnose the decrease of bone mineral density, it is insensitive in detecting early bone loss. from this point of view, more research works are directed toward bone biochemical markers as non invasive complementary tools that can achieve better results.
The purpose of our work was to study some biochemical markers of bone resorption and formation in young women who were using different contraceptive methods ( DMPA and OCs ) and to correlate the bone biochemical markers with bone mineral density in those women.
This Study was conducted on 90 woman in childbearing period who were classified into 3 groups, group I included 30 women using DMPA, group II included 30 women using oral contraceptive pills containing estrogen and progestin and group III included 30 women currently using no hormonal contraceptives but using IUD (control group).
All cases and controls were subjected to the following investigations:
1- Routine investigations including: a- serum glucose level.
b- Liver and kidney function tests.
2- Special investigations including:
a- Serum degradation products of type I collagen C-telopeptides (?- crossLaps).
b- Serum osteocalcin.
c- Serum bone specific alkaline phosohatase.
d- Serum tartarate resistant acid phosohatase 5b isoenzyme
(TRAP5b).<br e- Serum and urine calcium.
f- Serum and urine phosphorus.
g- Bone mineral density.
Results of the present study revealed that the DMPA group had significantly higher values of serum urinary calcium, TRAP5b, ?- crossLaps and osteocalcin than nonusers but their BMD was lower than nonusers, which suggests that bone resorption exceeded bone formation.As regard the correlation there was highly significant inverse correlation between BMD and ?- crossLaps and significant inverse correlation between BMD and osteocalcin.
In OCs group, results of our study showed significantly lower values of urinary calcium, serum TRAP5b, ?- crossLaps and osteocalcin than non users but their bone density was not different. There was no correlation between BMD and both ?- crossLaps and osteocalcin. This suggests that although both markers of bone resorption and formation were both depressed, the net balance was similar to that on women not using hormonal contraception.