Bone mineral density study and biochemical markers of bone turnover in premature ovarian failure
Iulia Bistriceanu1, Magda Elvira Preda1, Marian Bistriceanu2, Liliana Putinelu3, Simona Bondari2 & Aurora Covei1
Objectives: The premature ovarian failure (the poor ovaries syndrome) is characterized by the ovaries inability to normally sexualize, due to a poor sexoidogenetic device (low gonocyte population).
Analysis of subjective and objective clinical criteria of patients with premature ovarian failure, early diagnosis of the premature ovarian failure, establish the etiology of premature ovarian through basal and dynamic hormones evaluation, assesment of profilactic and therapeutical measures.
Methods: We studied 31 cases of attenuated premature ovarian failure, aged 2033. Plasma levels of the two bone turnover markers (Osteocalcin and CrossLaps) were evaluated using ELISA method. To all patients the bone mineral density (BMD) was measured by dual X-ray absorbtion (DXA) at lumbar spine, by antero-posterior incidence, and the hip.
Results: Osteocalcin ranged values of 29.4±8.3 ng/ml in 18 cases, comparable to those of postmenopausal women. In sevene cases osteocalcin limits were 16.8±7.6 ng/ml (as in premenopausal stage), in contrast to six patients with normal values (below 14 ng/ml). CrossLaps plasma levels showed values ranging 0.151±1.230 ng/ml in 14 patients) similar to those in postmenopausal women, nine patients had similar values to those of premenopausal (0.115±0.210 ng/ml), and eight cases had normal values (0.110±0.522 ng/ml). Measurement of BMD revealed osteoporosis in 15 cases osteopenia at seven patients and nine having normal BMD.
Conclusions: In premature ovarian failure, assessment of BMD and bone turnover biochemical markers must be done regularly (12 times per year) in order to identify patients who rapidly lose bone mass leading to increased risk of osteoporosis. Oestro-progestative substitution should be the first therapeutic attitude in premature ovarian failure so as to prevent osteoporosis as well as metabolic and visceral involvements.