59-05-032 Proceeding

189 Proceedings of the Princess Maha Chakri Sirindhorn Congress imbalance of bone formation and degeneration which can cause the bone and joint diseases in these people. Nevertheless, the attempt for encouraging people to consume the Ca containing foods nowadays are available. In fact, most elderly people still get worse with Ca absorption inside the intestine, because the low level synthesis of vitamin D in these people affect the gain of Ca level in the blood. Most patients in this study could be realized that they have problem with Ca absorption with defect of vitamin D synthesis Figure 2, (d) and Table 1. Then we determine the osteoblastic and osteoclasticmarkers including P1NP and B-cross Laps, respectively. Aging people both male and female will have both abnormal bone cell dynamic that represent by bone markers. Both male and female will have low bone turnover around perimenopause and adropause period. However, female will have high bone turnover with uncoupling effect that means increasing osteoclastic function and decreasing osteoblastic function [8, 9]. The uncoupling effect of bone cell function is much higher than male which the increasing of B-cross Laps and decreasing of P1NP were distinctly observed. The possible explanation is most female patients have low level of their sex hormones which were indicated as menopausal syndrome, Figure 2 (F) and Table 1. Since the rate of osteoclastic function is shorter three times than osteoblastic function. Estrogen normally inhibits the osteoclastic function, so the reduction of estrogen will increase uncoupling effect because the bone formation could not compensate the status of osteoclastic function which is important condition for osteoporosis in women. In contrast, most male patients normally have low bone turnover with low level of P1NP and low level of B-cross Laps. This suggested that the bone metabolism in male is less dangerous than female. In addition, the reduction level of sex hormones productionwere seen in both patients.The free testosterone level significantly decrease in male patient as well as the reduction of estrogen in female patients, Figure 2 (e-f) Table 1. In male patients, the free testosterone reduction was identified as sex hormone deficiency about 75% as well as more than 90%of female patients could be found the dramatically decreasing of estrogen and P4 which were possibly indicated as menopausal syndrome. The low level of estrogen and P4 in patients could be concerned that they may suffered with other consequence symptoms such as osteoporosis that we have already discussed. In addition, most hormones in this study are the steroid hormone family which are synthesized from the similar origin compound as cholesterol (Figure 3). In pregnenolone metabolism, the first reaction after the cleavage of cholesterol by enzyme is the precursor for progesterone, aldosterone and glucocorticoids synthesis. Another part of reaction, DHEA is converted from pregnenolone which is precursor for testosterone and estrogen synthesis. From this information, many types of hormone were significantly identified as lower than normal condition. The Hormone deficiency and metabolic disorder either occur in elderlymale and female patients as the consequence steps. Unfortunately, most patients have been diagnosed lately, so the disease progression have already taken place inside the body. Therefore, the early screening and diagnosis of hormone imbalance are very essential for people which help them to improve their lifestyles and use the effective treatments for their sickness as possible.