Investigation of Macrophage Erythroblast Attacher as New Protein and its Association with Vitamin D3 Levels among Hypertensive and Normotensive Osteoporosis Postmenopausal of Iraqi Women

Background: Aged postmenopausal women have the greatest incidence rates of osteoporosis (OP), which is an increasing global health problem. The OP and fractures have a significant negative impact on a senior's quality of life and place a heavy financial and emotional strain on the patients and their family. The fundamental cause of all forms of OP is a lack of balance among bone formation and bone resorption. Osteopenia is a clinical term for a decline in Bone mineral density (BMD) that is below normal reference levels but not quite low enough to be diagnosed as osteoporotic. Hypertension (HTN) and OP are serious non-communicable public health issues due to the aging population and changing lifestyles. According to a number of studies, major risk factors for osteoporosis include age, gender, smoking, coronary heart disease, diabetes, essential hypertension, low estrogen levels, and others. Most minerals, including calcium (Ca) and magnesium (Mg), are necessary for good health. The second most common intracellular cation is magnesium, which is the fourth most common cation in the body. Regarding its physiological function, magnesium is necessary for a variety of enzymatic processes. Magnesium is required for vitamin D3 activation. Serious organ dysfunctions can result from abnormally high or low amounts of either of these nutrients. Zinc, which functions as a local regulator of an osteoblast to establish the bony framework for organic matrix synthesis, is one of the minerals and trace elements found in abundance in bone. Erythroblast attachment to macrophages is mediated by the membrane protein known as macrophage erythroblast attacher (MAEA). This includes granulocyte-macrophage colony-forming units, which are the monocytes of osteoclasts, and it plays a significant role in hematopoiesis in bone marrow. Aims: The present work aimed to associate between a new MAEA protein, vitamin D3, and BMD in hypertensive and normotensive postmenopausal as control group. Materials and Methods: We performed this case control study in department of chemistry and biochemistry, college of medicine by enrolling 80 subjects, (40) hypertensive postmenopausal women that have aged ranged between (56-86) years, and (40) normotensive postmenopausal women as control group, aged ranged between (50-76) years. All Patients had been in spontaneous menopause for at least, one year. In each subject we measured serum 25(OH)D3 level which determined by Cobas e 411 Analyzer System and serum total Mg, Ca, Zn and phosphorus which were analyzed by chemistry analyzer smart 120T/H, deionized water was used as a blank solution, Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of serum MAEA. Body mass index (BMI) was calculated for each patient, and postmenopausal osteoporosis (PMOP) was validated using a dual energy x-ray absorptiometry scan (DEXA) in the lumbar spine regions (L1-L4 vertebrae). Result: T-scor and BMD were significantly lower in hypertensive postmenopausal women when compared with control group (-3.11 ± 0.5 vs -1.61 ± 0.40), (0.70 ± 0.1 vs 0.86 ± 0.04 g/cm2), P. value <0.05, while BMI was non-significant in hypertensive postmenopausal women when compared with control group (30.02 ± 4.23 vs 30.34 ± 4.64 kg/m2) P. value>0.05. Magnesium and 25(OH)D3 were significant lower in hypertensive postmenopausal women compared with control group (2.21 ± 0.22 vs 2.31 ± 0.16 mg/dl), (26.67 ± 7.51 vs 31.03 ± 8.65 ng/ml), P. value<0.05. The MAEA protein was non-significant lower in hypertensive postmenopausal women when compared with control group (111.58 ± 29.06 vs 121.87 ± 23.15 pg/ml), P. value>0.05. Zinc was non-significant lower in hypertensive postmenopausal women when compared with control group (81.89 ± 13.15 vs 83.02 ± 7.43 µg/dl), P. value>0.05. Conclusions: The study indicated that low magnesium is risk factors for osteoporosis in postmenopausal Iraqi women. Based on the results, hypertension assessment should be considered in postmenopausal women to prevent osteoporosis. This further supports the view that there is a biological link between the hypertension and osteoporosis. The 25(OH)D3 has positive correlated with the MAEA protein level. MAEA protein function in bone metabolism need to be studied in future research.