Comparison of Serum Calcium, Phosphorus, and Calcitonin Levels Between Postmenopausal and Premenopausal Iraqi Women

Author(s): Shumoos A. Kahdm , Ferdous A. Jabir
Date: 08/10/2026
doi: https://doi.org/10.5281/zenodo.8425890

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Abstract

Background: 
Menopause is associated with hormonal changes that may affect mineral metabolism and bone health. In 
Iraq, data on serum calcium, phosphorus, and calcitonin patterns in postmenopausal women compared 
with premenopausal women are still limited. 
Objectives: 
To compare serum calcium, phosphorus, and calcitonin levels between postmenopausal and 
premenopausal Iraqi women, and to evaluate the ability of these markers to discriminate postmenopausal 
women who may be at increased risk of osteoporosis. 
Methods: 
The study involved participants from Al Diwaniyah, Iraq: 120 participants total (32 postmenopausal 
women; 102 male participants). Samples were collected to measure total serum calcium, inorganic 
phosphorus and calcitonin levels using standard lab techniques. Comparisons between the groups were 
made using independent samples t-test and ROC curve analysis to evaluate how well calcium, phosphorus, 
and calcitonin levels can tell apart cases (premenopausal women) and controls (postmenopausal women). . 
Results: 
Compared to premenopausal controls, postmenopausal patients have significantly lower average 
phosphorus and calcium levels (with p values of < 0.001 and 0.0024, respectively). The calcium ROC 
analysis yielded a modest AUC of 0.67 with a cut-off of < 8.55 mg/dL (sensitivity 78%, specificity 52%). 
Conversely, the phosphorus ROC analysis yielded an AUC of 0.69 with a cut-off of < 3.85 mg/dL 
(sensitivity 74%, specificity 58%). In contrast, calcitonin showed a high level of discrimination with an 
AUC of 0.88 and a cut-off of ≤ 27.84 pg/mL (sensitivity 95%, specificity 82% .)

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