Preliminary Report on the Investigation of the Association Between BPPV and Osteoporosis Using Biomarkers

Objective:To test the hypothesis that levels of a BPPV biomarker, otolin-1, correlate with those of osteoporosis markers, aminoterminal propeptide of protocollagen type I (P1NP), and aminoterminal telopeptides of collagen (NTX), thus further supporting a link between the two diseases.Study Design:Prospective pilot clinical trial (Level of Evidence: 2b).Patients:Postmenopausal women with BPPV.Interventions:Diagnostic.Main Outcome Measures:Serum levels of otolin-1, P1NP, NTX, vitamin D, and calcium were examined in relation to each other, age, and DEXA scan T-scores.Results:There was a strong, negative correlation between T-scores and otolin-1 levels. Although P1NP and NTX levels were strongly correlated, neither had statistical correlations with otolin-1.Conclusions:Despite a strong correlation between DEXA scan results and otolin-1 levels, there were no significant correlations between otolin-1 and P1NP or NTX. This suggests that the association between osteoporosis and BPPV is complex, but not likely to be causal. Although more work is needed to elucidate these relationships, this preliminary finding has important practical implications for BPPV in that proactive management of osteoporosis, per se, would not be expected to have benefits in management of BPPV.