DOI: 10.47582/jompac.1973564 ISSN: 2717-7505

Independent associations of parathyroid hormone, vitamin D, and metabolic parameters with regional bone mineral density and osteoporosis

Süleyman Baş, Mustafa Can Şenoymak, Murat Yeniçeri, Kadem Arslan, Sercan Kiremitçi, Alpaslan Tanoğlu
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Aims: Osteoporosis is a systemic disease characterized by reduced bone mineral density (BMD) and increased fracture risk. Although numerous factors influencing bone health have been identified, the independent effects of vitamin D, parathyroid hormone (PTH), and metabolic parameters on BMD at different anatomical sites remain incompletely understood. This study aimed to evaluate the associations between lumbar spine and femoral neck BMD and vitamin D, PTH, and metabolic parameters, and to identify factors independently associated with osteoporosis.Methods: This retrospective, cross-sectional study included 281 individuals aged 50 years and older who had undergone DXA based BMD measurement. Demographic, clinical, and biochemical data were retrieved from patient records. BMD was assessed at the lumbar spine (L1–L4) and femoral neck. Correlation and multivariable linear regression analyses were performed to identify factors associated with BMD. Independent predictors of osteoporosis (T-score ≤−2.5) were examined using multivariable logistic regression. Results: Osteoporosis was detected in 19.6% of participants. Age and female gender were independently associated with osteoporosis, while higher BMI was independently associated with lower odds of osteoporosis. In multivariable analyses, BMI and gender were independently associated with lumbar spine BMD, whereas age, BMI, gender, and PTH were the independent determinants of femoral neck BMD. PTH was negatively associated with femoral neck BMD only, and no independent association was found between vitamin D levels and either BMD or osteoporosis. Conclusion: The factors influencing BMD differ by anatomical site. The site-specific association of PTH with femoral neck BMD underscores the importance of considering regional differences in osteoporosis assessment, and suggests that PTH may warrant closer attention as a parameter in clinical evaluation.

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