Relationship between Bone Mineral Density and Maturity Index in Cervical Smears, Serum Estradiol Levels and Body Mass Index

OBJECTIVES Osteoporosis is a systemic skeletal disease with a consequent increased risk of fracture, decreased quality of life and economic burdens for both the patients and health care system. While Dual energy X-Ray absorptiometry remains the gold standard for assessment of bone mineral density, it cannot be requested for all patients for obvious reasons. By determining other variables that may correlate with osteoporosis, we can identify individuals who may be at risk for osteoporosis earlier. Then, they can be treated at the earlier stages of the disease. In the present study, relationships between bone mineral density, maturity index in cervical smear, serum estradiol level and body mass index were examined. MATERIALS & METHODS The present study performed on 128 women, who had been referred for bone mineral densitometry. Blood samples were obtained for determination of serum estradiol level. Cervical smear was taken for assessment of cell's maturity. Cervical smears were examined by a pathologist and were sorted as atrophic or mature. Body mass index was calculated too. Relationships among Body mass index, serum estradiol level, and maturity index and bone mineral densitometry were analyzed using proper statistical tests. RESULTS Maturity index had significant relationship with T Score in the spine and femoral neck (P<0.001). Significant relationships were found between serum estradiol level and femoral neck T Score (P<0.004) and spine T Score (P<0.008). Also a significant relationship was found between body mass index and bone mineral density. CONCLUSION Pap smear is a routine examination which is performed mainly for screening purposes in gynecology. It is non-invasive, simple and low-priced. Results of current study suggest that women with atrophic cervical smear should be examined more rigorously for osteoporosis. If any patient has atrophic maturity index in her cervical smear, she will be at much higher risk of osteoporosis.