Serum Receptor Activator of Nuclear Factor-κβ Ligand and Osteoprotegerin Levels and Ratio in Correlation with Bone Mineral Density
Abstract
Osteoporosis is a disorder represented by manifestations of low bone mass, decreased bone tissue, and disrupted bone
microarchitecture. The diagnosis of osteoporosis so far has been based on fracture manifestations after minimal trauma or
by detecting low Bone Mineral Density (BMD). Measurement of Receptor Activator of Nuclear Factor-κβ Ligand (RANKL)
and Osteoprotegerin (OPG) levels has opened the discourse of a more specific assessment of osteoblast and osteoclast
regulation. The RANKL/OPG ratio can represent resorption and bone formation more significantly when correlated with
BMD features. This study aimed to analyze the correlation between serum RANKL and OPG levels and ratio with BMD. A total
of 58 post-menopausal females from 13 elderly in Integrated Community Health Care Surabaya and Sidoarjo were enrolled.
Data were collected by recording age, onset of menarche, onset of menopause, and Body Mass Index (BMI). Serum RANKL
and OPG levels were evaluated using sandwich ELISA from Elabscience®. The RANKL/OPG ratio was obtained from the ratio
between measured RANKL and OPG levels in serum. The proximal femur and lumbar spine BMDs were measured using
Hologic® Discovery™ QDR™ Dual-Energy X-ray Absorptiometry (DEXA). Pearson's correlation test in this study showed no
significant correlation between BMD and RANKL levels (lumbar: p=0.203; hip: p=0.283). The insignificant result was also
shown in the correlation between BMD and OPG levels (lumbar: p=0.412; hip: p=0.617). A significant result between lumbar
BMD and RANKL/OPG ratio was only found in the osteopenia subjects (p=0.001). The RANKL/OPG ratio had a significant
correlation only with osteopenia-BMD in post-menopausal females. Therefore, it could be used as supporting data in
osteoporosis screening.
Keywords
Full Text:
PDFReferences
Sözen, T, Özı şı k, L, Başaran, NC. An overview and
management of osteoporosis. European Journal of
Rheumatology, 2017; 4: 46-56.
Mithal A, Kaur P. Osteoporosis in Asia: A call to action.
Curr Osteoporos Rep, 2012; 10: 245–7.
Kementerian Kesehatan Republik Indonesia. Data &
kondisi penyakit osteoporosis di Indonesia. Jakarta,
Pusat Data dan Informasi Kementerian Kesehatan
Republik Indonesia, 2015, 2-6.
Sheu A, Diamond T. Bone mineral density: Testing for
osteoporosis. Aust Prescr, 2016; 39: 35-91.
G a r n e r o P . B i o m a r k e r s f o r o s t e o p o r o s i s
management–utility in diagnosis, fracture risk
prediction, and therapy monitoring. Journal of
Endocrine Disorders, Mol Diag Ther, 2008; 12(3):
-70.
Sennels HP, Jacobsen S, Jensen T, Hansen MS,
Ostergaard M, et al. Biological variation and reference
intervals for circulating osteopontin, osteoprotegerin,
total soluble receptor activator of nuclear factor kappa
B ligand and high-sensitivity C-reactive protein. Scand
J Clin Lab Invest, 2007; 67: 821–35.
Khosla S. Mini review: The OPG/RANKL/RANK system.
Endocrinol, 2001; 142: 5050–55.
Boyce BF, Xing L. Biology of RANK, RANKL, and
osteoprotegerin. Arthritis Research & Therapy, 2007;
(S1): 1689-1697.
World Health Organization. Body mass index–BMI.
h t t p : / / w w w . e u r o . w h o . i n t / e n / h e a l t h - t o p i c s /
disease-prevention/nutrition/a-healthy-lifestyle/
body-mass-index-bmi (Updated on Nov, 2019).
World Health Organization. WHO scientific group on
the assessment of osteoporosis at primary health care
level. Brussel-Belgium, Summary Meeting Report,
; 2.
Elabscience®. Manual book-human sRANKL (soluble
receptor activator of nuclear factor-kB ligand) ELISA
th Kit, 7 Ed., USA, Elabscience®, 2017; 1-11.
E l a b s c i e n c e ® . M a n u a l b o o k - h u m a n O P G
t h (osteoprotegerin) ELISA Kit, 7 Ed., USA,
Elabscience®, 2017; 1-11.
Trofimov S, Pantsulaia I, Kobyliansky E, Livshits G.
Circulating levels of receptor activator of
nuclear factor-kB ligand/osteoprotegerin/
macrophage-colony stimulating factor in a
presumably healthy human population. European
Journal of Endocrinology, 2004; 150: 305–11.
Widodo H, Anisa FN, Lianti D. Relationship of physical
activity, diet, and age menarche with age menopause
at elderly Posyandu working area Puskesmas
Pekauman Banjarmasin. Advances in Health Science
Research, 2017; 6: 566–74.
Ahuja M. Age of menopause and determinants of
menopause age: A PAN India survey by IMS. J Mid-life
Health, 2016; 7: 126–31.
Gold EB. The timing of the age at which natural
menopause occurs. Obstet Gynecol Clin N Am, 2011;
: 425–40.
Lambrinoudaki I, Tsouvalas E, Vakaki M, Kaparos G,
Stamatelopoulos K, et al. Osteoprotegerin, soluble
receptor activator of nuclear f
Holecki M, Zahorska-Markiewicz B, Janowska J,
Nieszporek T. The influence of weight loss on
serum osteoprotegerin concentration in obese
perimenopausal women. Obesity, 2007; 15(8):
–9.
Dimitri P, Wales JK, Bishop N. Adipokines, bonederived
factors and bone turnover in obese
children; Evidence for altered fat-bone signaling
resulting in reduced bone mass. Bone, 2011;
(2): 189–96.
actor-KB ligand, and
subclinical atherosclerosis in children and
adolescents with type 1 diabetes mellitus.
International Journal of Endocrinology, 2013;
: 1-8.
Hsu YH, Venners SA, Terwedow HA, Feng Y, Niu
T, Li Z, et al. Relation of body composition, fat
mass, and serum lipids to osteoporotic fractures
and bone mineral density in Chinese men and
women. Am J Clin Nutr, 2006; 83: 146–54.
Ahmad EA, Abbas M, Amir R, Mohammad S. The
relationship between body weight, Body Mass
Index (BMI) and Bone Mineral Density (BMD) of
the lumbar spine and femoral neck in
professional cyclist of Iran and tour de France.
Iranian Journal of Health and Physical Activity,
; 4: 67–71.
Iqbal SI, Morch LS, Rosenzweig M, Dela F. The
outcome of bone mineral density measurements
on patients referred from general practise.
Journal of Clinical Densitometry, 2005; 8: 178-82.
Nabipour I, Larijani B, Vahdat K, Assadi M, Jafari
SM, et al. Relationships among serum receptor
of nuclear factor-JB ligand, osteoprotegerin,
high-sensitivity C-reactive protein, and bone
mineral density in post-menopausal women:
osteoimmunity versus osteoinflammatory. The
Journal of the North American Menopause
Society, 2009; 16(5): 950–5.
Kim SJ, Yang WG, Cho E, Park E. Relationship
between weight, body mass index, and bone
mineral density of lumbar spine in women. J
Bone Metab, 2012; 19: 95–102.
F a h r l e i t n e r - P a m m e r A , D o b n i g H ,
Piswanger-Soelkner, C. Osteoprotegerin serum
levels in women: correlation with age, bone
mass, bone turnover, and fracture status. Wien
Klin Wochenschr, 2003; 115: 291–7.
Mendez JP, Mejia DR, Pedraza J, Vazquez RMC,
Soriano R, et al. Bone mineral density in
post-menopausal Mexican-Mestizo women with
normal body mass index, overweight, or obesity.
Menopause, 2013; 20: 568–72.
Bolotin HH. DXA in-vivo BMD methodology: An
erroneous and misleading research and clinical
gauge of bone mineral status, bone fragility, and
bone remodeling. Bone, 2007; 41: 138–54.
Brown SE. Osteoporosis: Snap, crackle, and pop
some pills. Northeast Florida Med, 2006; 57: 14-20.
Shanthi JC, McLeod W, Kennedy L, McLeod K.
Osteoporosis health beliefs among younger and
older men and women. Health Educ Behav, 2008;
(5): 721–33.
Pietschmann P, Rauner M, Sipos W, Schindl
KK. Osteoporosis: An age-related and
gender-specific disease a mini-review.
Gerontology, 2009; 55: 3-12.
Liu JM, Zhao HY, Ning G, Zhao YJ, Chen Y, et al.
Relationships between the changes of serum
levels of OPG and RANKL with age, menopause,
bone biochemical markers and bone mineral
density in Chinese women aged 20-75. Calcif
Tissue Int, 2005; 76: 1–6.
Ginaldi L, Di Benedetto MC, De Martinis M.
Osteoporosis, inflammation, and aging. Immun
Ageing, 2005; 2: 14.
Gallagher JC. Advances in bone biology and new
treatments for bone loss. Maturitas, 2008; 60:
–9.
DOI: http://dx.doi.org/10.24293/ijcpml.v27i1.1627
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
