REFRAMING OSTEOPOROSIS AS A “HUMAN” RATHER THAN “FEMALE” DISEASE: INSIGHTS FROM GENDER-COMPARATIVE BIOMARKER ANALYSIS
DOI:
https://doi.org/10.22159/ajpcr.2026v19i4.58588Keywords:
Osteoporosis,, Fracture, Gender bias, Bone turnover markers, T-scoreAbstract
Objectives: To compare bone turnover markers (BTM) (C-terminal telopeptide of type I collagen [CTX] and procollagen type I N-terminal propeptide [P1NP]), femoral neck T-scores, and biochemical parameters (calcium, vitamin D, and parathyroid hormone [PTH]) between males and females, and to evaluate their association with fracture history in an age-matched cohort.
Methods: This cross-sectional study included 100 age-matched adults (50 men and 50 women) from Mullana, Haryana. Serum calcium, vitamin D, PTH, CTX, and P1NP were measured using standardized assays. Bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry (DXA). Group comparisons were performed using Student’s t-test or Mann–Whitney U test as appropriate. Correlations were assessed using Spearman’s rank correlation coefficient.
Results: No statistically significant gender differences were observed in calcium, vitamin D, PTH, CTX, or P1NP levels (all p≥0.05). CTX and P1NP showed strong negative correlations with T-score (r=−0.73 and −0.68, p<0.001), while calcium and vitamin D showed moderate positive correlations (r=0.55 and 0.58, p<0.001). CTX and P1NP demonstrated excellent diagnostic performance for osteoporosis. Fracture history was significantly associated with lower T-scores but not with individual biochemical markers.
Conclusion: Biochemical and densitometric profiles were broadly comparable between sexes. While BTMs reflect disease severity, DXA-derived BMD remains central for fracture risk stratification. Observed disparities in clinical outcomes between men and women likely reflect healthcare practice patterns rather than inherent biological differences. Longitudinal studies are needed to establish causality.
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