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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(06): 804-808
DOI: 10.1055/s-0041-1726065
Artigo Original
Trauma

Evaluation of Hormonal Influence in Patients with Fractures Attributed to Osteoporosis[*]

Article in several languages: português | English
Danila Malheiros-Souza 
1   Departamento de Ciências Biológicas, Laboratório de Imunologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
,
Leonardo Franco Pinheiro Gaia 
1   Departamento de Ciências Biológicas, Laboratório de Imunologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
,
Fausto Fernandes de Almeida Sousa 
1   Departamento de Ciências Biológicas, Laboratório de Imunologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
,
Pedro Ivo Ferreira Favaro 
1   Departamento de Ciências Biológicas, Laboratório de Imunologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
,
Virmondes Rodrigues 
1   Departamento de Ciências Biológicas, Laboratório de Imunologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
,
Denise Bertulucci Rocha Rodrigues 
1   Departamento de Ciências Biológicas, Laboratório de Imunologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
2   Laboratório de Imunobiologia, Universidade de Uberaba, Uberaba, MG, Brasil
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Abstract

Objective The present study aims to evaluate the influence of hormonal levels of vitamin D, calcitonin, testosterone, estradiol, and parathyroid in patients with fractures attributed to osteoporosis when compared with young patients with fractures resulting from high-impact accidents.

Methods Blood samples were collected from 30 elderly patients with osteoporosis-attributed fractures (T-score ≤ -2.5) (osteoporotic group), and from 30 young patients with fractures resulting from high-impact accidents (control group). Measurement of 1,25-hydroxyvitamin D (Kit Diasorin, Saluggia, Italy), calcitonin (Kit Siemens, Tarrytown, NY, USA), testosterone, estradiol, and parathyroid hormone (Kit Beckman Couter, Indianapolis, IN, United States) was performed using a chemiluminescence technique. Data were inserted into a Microsoft Excel (Microsoft Corp., Armonk, WA, USA) spreadsheet and analyzed using Statview statistical software. Results showing non-normal distribution were analyzed with nonparametric methods. The Mann-Whitney test was applied for group comparison, and a Spearman test correlated hormonal levels. Statistical significance was set at p < 0.05. All analyzes compared gender and subjects with and without osteoporosis.

Results Women with osteoporosis had significantly lower levels of estradiol and vitamin D (p = 0.047 and p = 0.0275, respectively). Men with osteoporosis presented significantly higher levels of parathyroid hormone (p = 0.0065). There was no significant difference in testosterone and calcitonin levels.

Conclusion Osteoporosis patients presented gender-related hormonal differences. Women had significantly lower levels of estradiol and vitamin D, whereas men had significantly higher parathyroid hormone levels, apparently impacting the disease.

Keywords

osteoporosis - hormones - estradiol - calcitonin - parathyroid hormone

Authors contributions

All authors contributed to the conception and design of the study. The study was designed by Rodrigues V. e Rodrigues D. B. R. Gaia, L. F. P., Sousa F. F. A., Favaro, P. I. and Malheiros-Souza D. collected the material, prepared the database, and performed the statistical analyzes. Malheiros-Souza D. and Rodrigues D. B. R. wrote the manuscript and revised it. Rodrigues V. revised the manuscript.


* Study developed at the Immunology Laboratory, Department of Biological Sciences, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.




Publication History

Received: 05 August 2020

Accepted: 01 December 2020

Article published online:
27 August 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 Zaidi M. Skeletal remodeling in health and disease. Nat Med 2007; 13 (07) 791-801
    CrossrefPubMedGoogle Scholar
  • 2 Charles JF, Coury F, Sulyanto R. et al. The collection of NFATc1-dependent transcripts in the osteoclast includes numerous genes non-essential to physiologic bone resorption. Bone 2012; 51 (05) 902-912
    CrossrefPubMedGoogle Scholar
  • 3 Udagawa N, Takahashi N, Yasuda H. et al. Osteoprotegerin produced by osteoblasts is an important regulator in osteoclast development and function. Endocrinology 2000; 141 (09) 3478-3484
    CrossrefPubMedGoogle Scholar
  • 4 Breckon JJ, Papaioannou S, Kon LW. et al. Stromelysin (MMP-3) synthesis is up-regulated in estrogen-deficient mouse osteoblasts in vivo and in vitro. J Bone Miner Res 1999; 14 (11) 1880-1890
    CrossrefPubMedGoogle Scholar
  • 5 Silva BC, Bilezikian JP. Parathyroid hormone: anabolic and catabolic actions on the skeleton. Curr Opin Pharmacol 2015; 22: 41-50
    CrossrefPubMedGoogle Scholar
  • 6 Damien E, Price JS, Lanyon LE. Mechanical strain stimulates osteoblast proliferation through the estrogen receptor in males as well as females. J Bone Miner Res 2000; 15 (11) 2169-2177
    CrossrefPubMedGoogle Scholar
  • 7 Gui Y, Duan Z, Qiu X. et al. Multifarious effects of 17-β-estradiol on apolipoprotein E receptors gene expression during osteoblast differentiation in vitro. Biosci Trends 2016; 10 (01) 54-66
    CrossrefPubMedGoogle Scholar
  • 8 Kousteni S, Han L, Chen JR. et al. Kinase-mediated regulation of common transcription factors accounts for the bone-protective effects of sex steroids. J Clin Invest 2003; 111 (11) 1651-1664
    CrossrefPubMedGoogle Scholar
  • 9 Wiren KM, Toombs AR, Semirale AA, Zhang X. Osteoblast and osteocyte apoptosis associated with androgen action in bone: requirement of increased Bax/Bcl-2 ratio. Bone 2006; 38 (05) 637-651
    CrossrefPubMedGoogle Scholar
  • 10 Adams JS. Vitamin D as a defensin. J Musculoskelet Neuronal Interact 2006; 6 (04) 344-346
    PubMedGoogle Scholar
  • 11 Chen H, Gilbert LC, Lu X. et al. A new regulator of osteoclastogenesis: estrogen response element-binding protein in bone. J Bone Miner Res 2011; 26 (10) 2537-2547
    CrossrefPubMedGoogle Scholar
  • 12 Weaver CM, Alexander DD, Boushey CJ. et al. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int 2016; 27 (01) 367-376
    CrossrefPubMedGoogle Scholar
  • 13 Bischoff-Ferrari HA, Conzelmann M, Dick W, Theiler R, Stähelin HB. [Effect of vitamin D on muscle strength and relevance in regard to osteoporosis prevention]. Z Rheumatol 2003; 62 (06) 518-521
    CrossrefPubMedGoogle Scholar
  • 14 Kousteni S, Bellido T, Plotkin LI. et al. Nongenotropic, sex-nonspecific signaling through the estrogen or androgen receptors: dissociation from transcriptional activity. Cell 2001; 104 (05) 719-730
    PubMedGoogle Scholar
  • 15 Fink HA, Ewing SK, Ensrud KE. et al. Association of testosterone and estradiol deficiency with osteoporosis and rapid bone loss in older men. J Clin Endocrinol Metab 2006; 91 (10) 3908-3915
    CrossrefPubMedGoogle Scholar
  • 16 Al-Daghri NM, Aziz I, Yakout S. et al. Inflammation as a contributing factor among postmenopausal Saudi women with osteoporosis. Medicine (Baltimore) 2017; 96 (04) e5780
    CrossrefPubMedGoogle Scholar
  • 17 Martin TJ, Sims NA. Osteoclast-derived activity in the coupling of bone formation to resorption. Trends Mol Med 2005; 11 (02) 76-81
    CrossrefPubMedGoogle Scholar