Evaluation of salivary bone turnover markers and vitamin D as non-invasive, early predictive indicators of bone health in pre-, peri-, and post-menopausal women.

BACKGROUND

Menopause adversely affects bone health, often going unnoticed. Salivary biomarkers may provide a non-invasive approach to assess bone turnover and oral health changes across menopausal stages. AIM: To evaluate salivary bone turnover markers—alkaline phosphatase (ALP), osteocalcin, and vitamin D3—in pre-, peri, and postmenopausal women, and explore their association with oral health.

METHODS

A cross-sectional study was conducted among 150 women: premenopausal (n = 50), perimenopausal (n = 50), and postmenopausal (n = 50). Salivary ALP, osteocalcin, and vitamin D3 were measured using Enzyme linked immuno sorbent assay (ELISA). Oral health status was assessed through hard tissue changes (decayed, missing, calculus and mobility) and soft tissue changes. Salivary calcium and phosphorus levels were also estimated.

RESULTS

Postmenopausal women showed significantly lower salivary osteocalcin (685.16 ± 248.91; 855.87 ± 351.39; cohens d = 0.56;p < 0.05)and vitamin D3 (137.35 ± 58.34;110 ± 45.6; cohens d = 0.52;p < 0.01)compared to perimenopausal women, while ALP levels did not differ significantly among peri (10.54 ± 2.58)and postmenopausal group(8.95 ± 3.94; cohens d = 0.48;p = 0.09). Salivary calcium and phosphorus were reduced in peri- and postmenopausal women(p < 0.001). Poor oral health correlated positively with duration of menopause(r = 0.7;p = 0.0038), whereas vitamin D3 showed a negative correlation(r=-0.6; p = 0.0038).

CONCLUSION

Salivary vitamin D3 and osteocalcin, along with oral tissue changes, vary significantly with menopausal stage, while ALP remains unchanged. These findings highlight the potential of salivary biomarkers as early, non-invasive indicators for detecting bone loss and mitigating postmenopausal health consequences.