Low Aromatase Activity and Estradiol/Sex Hormone Binding Globulin Ratio are Associated with Total Hip Bone Mineral Density and the Presence of Osteoporosis: A Study in Chinese Postmenopausal Women

Abstract

Several groups have reported the important role of estradiol (E₂) and testosterone (T) in postmenopausal osteoporosis (PMOP). Because aromatase catalyzes the conversion of T to E₂, the purpose of this study was to determine the influence of aromatase activity on the bone mineral density (BMD) in postmenopausal women. A total of 344 postmenopausal women were selected for this study. Serum E₂, T, sex hormone-binding globulin (SHBG), calcium (Ca), alkaline phosphatase (ALP), C-terminal telopeptide of type I collagen (CTX), and procollagen type I amino-terminal propeptide (PINP) were examined. The E₂/T was positively associated with total hip BMD and PINP (p<0.05). When E₂/T was divided into quartiles, participants in lower quartiles of E₂/T were likely to have higher PINP and lower BMD (p<0.05). The prevalence of osteoporosis significantly increased as E₂/T ratio decreased. The receiver operating characteristic (ROC) curves were constructed for serum E₂, free E₂ index (FEI), and E₂/T, to assess their diagnostic accuracy in PMOP. The overall area under the curve (AUC) were 0.83 (95% CI=0.77–0.88) for E₂, 0.87 (95% CI=0.8₂–0.92) for FEI, and 0.89 (95% CI=0.85–0.94), respectively. In conclusion, the study suggests that in postmenopausal women, aromatase activity could be an important determinant of skeletal health. The women with lower aromatase activity may have greater likelihood of PMOP and the E₂/T was expected to be a valuable indicator for the prediction of PMOP and to monitor the process of osteoporosis.

Key words

aromatase activity - bone mineral density - postmenopausal osteoporosis

^* These authors contributed equally to this work

• References

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