Primary research

Stress Factors Increase Osteoporosis: A ComparativeAssessment of Osteocalcin and Cortisol Levels in Menopausal Women

Osteoporosis, a consequence of menopause in the biological cycle of women, emerges with the conclusion of reproductive capabi lities.
Hormonal changes during this phase contribute to the development of the disease. The study evaluated the relationship between stres s,
salivary cortisol levels, and osteocalcin, in postmenopausal women with osteoporosis.

The study involved a total of 30 postmenopausal volunteers diagnosed with osteoporosis. Stress levels were assessed using the NIH
stress score system to evaluate cortisol levels. Saliva and blood samples were analyzed using the LC-MS/MS and ELISA methods.
Samples were collected from the participants during the 1st week and in the 2nd week after they were informed about their diagnosis. Statistical analyses, including the Wilcoxon Signed Rank test, paired samples t-tests, and correlation analyses, were conducted using IBM SPSS Statistics 21.0. A significance level of p<0.05 was considered.

In comparing stress scores between the first/second weeks, a statistically significant difference was observed (z=4.795,p<0.001),
indicating a higher mean stress score in the second week. Cortisol levels showed a significant increase from the 1st week(27.58±3.97) to
the 2nd week (29.99±2.44)(t=4.412,p<0.001). Osteocalcin values exhibited a significant difference between the 1st week(21.04±0.98) and
the 2nd week (24.22±1.44)(t=9.656, p<0.001). Examining participant variations, the mean difference in stress scores was 7.73±2.23, the
mean difference in cortisol levels was 2.41±2.99, and the mean difference in osteocalcin levels was 3.18±1.81. A weak positive
statistically significant relationship was found between stress score difference and cortisol difference (r=0.363, p=0.049). In contrast, an
intermediate-level positive statistically significant relationship was observed between osteocalcin difference and cortisol difference
(r=0.586, p=0.001). Findings demonstrate the intricate relationships between stress, cortisol levels, and osteocalcin.

Contrary to some existing findings, our study suggests that menopause, as a stress -inducing factor, leads to an increase in bone
metabolism markers, including cortisol. Insights contribute to a more comprehensive understanding of the interplay between stress,
hormonal changes, and osteoporosis in postmenopausal women.