Investigation of the role of zonulin, a biomarker of intestinal permeability, in the development of postmenopausal osteoporosis

Postmenopausal osteoporosis, which is a common public health problem for women today and is included in the screening program in our country, basically occurs with the loss of the effect of the estrogen hormone. Zonulin is an intestinal absorption marker involved in the control of gastrointestinal absorption. With the increase in intestinal permeability, it causes a decrease in the absorption of calcium, magnesium and many other minerals, vitamins and enzymes from the intestine. Affecting intestinal permeability; it is known that malabsorption of minerals such as calcium and phosphorus is among the risk factors for the development of osteoporosis. Therefore, in this study; we aimed to investigate the role of zonulin, a biomarker of intestinal permeability, in the development of postmenopausal osteoporosis in postmenopausal women over 65 years of age. A total of 152 female patients over the age of 65 who were in the postmenopausal period were included in our study. Demographic and laboratory data of all patients were recorded from the patient system at their admission. DEXA was taken. Patients were divided into three groups according to DEXA results: osteoporosis (n=50), osteopony (n=51), and healthy control (n=51). A 5 ml blood sample was taken from each patient and zonulin level was measured in the biochemistry laboratory. In the data obtained, no significant difference was detected between the groups in biochemistry, hormone, hemogram and zonulin results. There was a difference between the healthy group and the patient group (p = 0.009, Bonferroni test) and the intermediate group (p = 0.049, Bonferroni test) in terms of weight and body mass index. A negative correlation was detected between zonulin and parathormone (r=-0.524, p<0.001) in the patient group. In the healthy group, a positive correlation was found between zonulin and calcium (r=0.299, p=0.033), and a negative correlation was found between zonulin and magnesium (r=-0.319, p=0.023). No study has previously been found in the literature regarding the relationship between osteoporosis and serum zonulin in humans, and in our study, no pathophysiological relationship was found between them and zonulin. The limitations of our study include the fact that the patients had previously used medical treatments containing vitamin D and calcium prescribed from external health institutions and the small number of the patient group. Further center-based studies on larger patient groups are needed on this subject. Key words: Osteoporosis, intestinal calcium absorption, zonulin