Paper Title
Accumulated Homocysteine in Iraqi Osteoporotic Female via Novel Immuno-Enzymological Pathways and its Influence on Estrogen

Abstract
Objective: Osteoporosis is a systemic chronic pathology of bone characterized by deterioration of bone tissue, decreased bone mineral density and loss of bone mass because of a defect in the balance between osteoblasts and osteoclasts. Previous studies dealt with the interaction between skeleton and the immune responses in the light of inflammation but the mechanism was not understood. The aim of the present study is to investigate the relationship among homocycteine, estrogen and osteoporosis on the basis of immunological and oxidative alterations via exact mechanism, and also to examine the biochemical action of folic acid on homocysteine , estrogen and alkaline phosphatase. Materials and Methods: Fifty (50) Iraqi postmenopausal female with osteoporosis were enrolled in the present study , (25) of them were newly diagnosed and not taken any treatment yet (G2) , the other (25) were under treatment with folic acid (5mg/day) for three months (G3). Homocysteine (Hcys) , estrogen levels and alkaline phosphatase (ALP) activity were measured in the sera of patients and also in the sera of (25) healthy postmenopausal subjects in the same range of age as a control group (G1). Results: Data of the present study have revealed that homocysteine level was highly significant increase in sera of (G2) compared with (G1) , highly significant decrease was shown in sera of (G3) compared with (G2) , the difference between (G3) and (G1) was not significant. Estrogen level was highly significant decrease in (G2) and (G3) compared with (G1) but there was no significant difference between (G2) and (G3). Moreover , alkaline phosphatase activity was highly significant increase in (G2) and (G3) compared with (G1) but its activity was not significant increased in sera of (G3) compared with (G2). Conclusions: This study has elucidated for the first time a novel immuno-enzymological mechanism for accumulated homocyeteine in Iraqi osteoporotic female. Also , the present study highlights the role of homocysyeine as a potent prooxidant. Interestingly , this study is the first reporting an inverse relationship between homocysteine and estrogen in Iraqi osteoporotic female because of the inhibitory effect of the reactive sulfhydryl group to aromatase , both increased homocysteine and decreased estrogen levels together could be a good biochemical marker of osteoporosis. Besides , this study gives a good enzymological clarification regarding folic acid action on alkaline phosphatase. Keywords – Osteoporosis, Homocysteine, Estrogen, Alkaline Phosphatase, Immune System