Association of subclinical cartilage degradation with bone density and trace elements in premenopausal and postmenopausal women with osteopenia and osteoporosis.

INTRODUCTION

Osteoporosis and osteopenia are major health problems in women, particularly after menopause, and may share pathogenic mechanisms with early osteoarthritic changes. This study evaluated the relationship between bone fragility, oxidative stress, inflammation, trace element imbalance, and subclinical cartilage degradation in Iraqi women.

MATERIALS AND

METHODS

A total of 120 women aged 24-75 years were enrolled and classified into three groups: control (n = 40), osteopenia (n = 40), and osteoporosis (n = 40) based on BMD and T-scores measured by DEXA. Serum zinc, copper, ferritin, CRP, total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), and cartilage-related biomarkers (Coll2-1NO2, COMP, MMP-3) were determined.

RESULTS

Osteopenic and osteoporotic women had significantly lower BMC, BMD, and T-scores, and higher TOS, OSI, CRP, ferritin, and copper, with reduced zinc and TAC compared with controls. Postmenopausal women with osteoporosis showed marked increases in Coll2-1NO2, COMP, and MMP-3. MMP-3 correlated positively with age in both osteopenic and osteoporotic women, while zinc showed a protective inverse association with Coll2-1NO2. Logistic regression identified zinc deficiency, copper excess, oxidative stress markers, and cartilage biomarkers as independent predictors of osteoporosis, with TOS, OSI, and MMP-3 also predicting osteopenia.

CONCLUSIONS

Zinc deficiency, copper excess, oxidative stress imbalance, and elevated cartilage degradation markers were associated with reduced bone density, particularly in postmenopausal women with osteoporosis. These findings suggest a possible link between bone fragility and subclinical cartilage degradation; however, given the cross-sectional design and modest sample size, these markers should be interpreted as associated biochemical indicators rather than validated biomarkers for risk prediction or early detection.