Calcium and Phosphate Status in Postmenopausal and Premenopausal Women in SharqElneel Locality.

Abstract Menopause is a normal, natural transition in the life, there are many changes occur during this period. This cross-section study, conducted to determine the calcium and phosphate level in Sudanese postmenopausal women compared to premenopausal women in period from March to May 2017. Fifty samples were collected from postmenopausal women without diseases, and thirty premenopausal women without disease, as control group, were informed about study and verbal consent from participants was obtained. 3ml of venous blood was collected in heparin containers, plasma was separated and investigated for calcium and phosphate levels (using a semi automated selectra analyzer, and biosystem analyzer). And statistical package for social science (SPSS), computer program version 18 was used for data processing. This study shows that, a significant elevation in calcium and phosphate levels in postmenopausal women compared to premenopausal women.Calcium (mean+SD:2.5+0.30mmolL, versus2.22+0.0.23mmolL. p.value=0.00. Phosphate (mean+SD: 1.12+ 0.23mmolL, versus 0.93+0.16mmolL. P. value =0.00). Pearson correlation shows that,there is an insignificant positive correlation between the number of birth and level of phosphate (r=0.008 and p. value=0.6). And there is a significant positive correlation between the number of birth and the level of calcium: (r=0.044 and p. value=0.01), in postmenopausal women. There is an insignificant negative correlation between duration of menstruation and levels of calcium and phosphate in two groups. For postmenopausal women: Calcium (r=0.003 and p.value=0.7). Phosphate (r=0.071 and p.value=0.06). For premenopausal women: Calcium (r=0.086 and p.value=0.16). Phosphate (r=0.013 and p.value=0.5). From this study we conclude that, calcium and phosphate levels are affected by menopause, due to many changes that occurring during these years of age.

Contents

NO Title Pages

1 Dedication I

2 Acknowledge II

3 Abstract III

IV مستخلص الدراسة 4

5 Content V

6 List of tables VIII

7 List of figures IX

CHAPTER ONE

1.1 Introduction 1

1.2 Rationale 2

1.3 Objectives 3

CHAPTER TWO

2 Literature review 3

2.1 Menopause 3

2.1.1 Causes of Menopause 7

2.1.2 Stages of menopause 7

2.1.2.1 Premenopuse 7

2.1.2.2 Perimenopause 7

2.1.2.3 Postmenopause 8

2.1.3 Management and treatment 8

2.1.3.1 Hormone replacement therapy 8

2.1.3.2 Other therapies 9

2.2 Estrogen 10

2.2.1 Biological function of estrogen 10

2.3 Osteoporosis 11

2.4 Calcium 12

2.4.1 Function of calcium 12

2.4.2 Normal range of calcium 14

2.4.3 Absorption from intestine 14

VI

2.4.4 The kidney role 14

2.4.5 The role of bone 15

2.4.6 Pathology 15

2.4.6.1 Hypocalcaemia 16

2.4.6.1.1 Sign and symptoms 16

2.4.6.1.2 Diagnosis and treatment 16

2.4.6.2 Hypercalcaemia 16

2.4.6.2.1 Sign and symptoms 17

2.4.6.2.2 Diagnosis and treatment 17

2.5 Phosphate 18

2.5.1 Function of phosphate 18

2.5.2 Normal range of phosphate 18

2.5.3 Regulation of phosphate metabolism 19

2.5.4 Pathology 19

2.5.4.1 Hypophosphateamia 19

2.5.4.1.1 Causes 19

2.5.4.1.2 Sign and symptoms 20

2.5.4.1.3 Diagnosis and treatment 20

2.5.4.2 Hyperphosphatemia 20

2.5.4.2.1 Sign and symtoms 21

2.5.4.2.2 Diagnosis 21

2.5.4.2.3 Treatment 22

2.6 Relationship between calcium and phosphate

and estrogen.

22

CHAPTER THREE

3 Material and Method 24

3.1 Material 24

3.1.1 Study approach 24

3.1.2 Study design 24

3.1.3 Target population and study area 24

3.1.4 Sample size 24

3.1.5 Inclusion criteria 24

VII

3.1.6 Exclusion criteria 24

3.1.7 Ethical consideration 24

3.1.8 Data collection 24

3.1.9 Blood sample collection 25

3.2 Method 25

3.2.1 Measurement of blood calcium 25

3.2.1.1 Biochemical measurement and instrument used 25

3.2.1.2 Reagent composition 25

3.2.1.3 Procedure 25

3.2.1.4 calculation 26

3.2.2 Measurement of plasma phosphate 26

3.2.2.1 Biochemical measurement and instrument used 26

3.2.3 Quality control 26

3.2.3 Statistical analysis 26

CHAPTER FOUR

4 Results 28

CHAPTER FIVE

5.1 Discussion 41

5.2 Conclusion 42

5.3 Recommendation 42

References 43

Appendices 51