Investigation of the relationship between sphingosine 1-phosphate and bone turnover marker levels and fracture risk in postmenopausal osteoporosis

Aim: The aim of this study is to investigate the relationship between the S1P (sphingosine 1-phosphate) molecule and fracture risk, bone turnover markers, and the osteoporosis quality of life scale in postmenopausal osteoporosis patients. Secondarily, it aims to compare these relationships in patients receiving and not receiving pharmacological treatment. Materials and Methods:Our study was designed as a cross-sectional study. The study included 48 female patients diagnosed with postmenopausal osteoporosis who met the exclusion criteria and 48 healthy women in the postmenopausal period without osteoporosis. The patient group was divided into two groups: those receiving pharmacological treatment and those not receiving pharmacological treatment. Sociodemographic data, including age, body mass index, occupation, and physical activity level, were recorded for all participants. All participants were asked the history questions in the Fracture Risk Assessment Tool (FRAX), and fracture risk results were calculated by adding the Dual Energy X-ray Absorptiometry (DEXA) results. The responses of all participants to the QUALEFFO-41 questionnaire were recorded, and subscale and total scores were calculated. Serum PINP (Procollagen Type I N-Propeptide), CTX (Type I Collagen C-Terminal Telopeptide), and S1P levels were measured using the ELISA method. Results: The groups were homogeneously distributed in terms of age, occupation, BMI, and physical activity (p>0.05). There were significant differences between the patient and control groups in terms of Pain, Daily living activities, Mobility, General health subscales, and QUALEFFO-41 score (p<0.05). There was a significant difference between the three groups in terms of PINP and CTX (p<0.05). No significant difference was observed between the control and treatment groups for S1P (p>0.05). However, there was a significant difference between the groups receiving and not receiving pharmacological treatment (p<0.05). There was a positive correlation between S1P and the FRAX-Hip score in the group of patients receiving pharmacological treatment. In the group not receiving pharmacological treatment, there was a positive correlation between S1P and both FRAX-Hip and FRAX-MOF. The relationship between S1P and PINP was insignificant for all three groups (p>0.05). Conclusion:The significant elevation of S1P levels in the group not receiving medication compared to the group receiving medication suggests that this molecule may play a role in the etiopathogenesis of postmenopausal osteoporosis. Furthermore, the positive correlation between S1P and the Pain subscale may reflect this in the clinical setting. Keywords: CTX, FRAX, Postmenoposal Osteoporosis, QUALEFFO-41, Sphingosine 1 Phosphate