ÖZET
Amaç:
Bu çalışmanın amacı, postmenopozal kadınlarda osteoporoz, metabolik sendrom (MetS) ve fiziksel aktivite (PA) düzeyi arasındaki ilişkiyi araştırmaktır. Sekonder amacı ise MetS tanısı olan ve olmayan postmenopozal kadınların yaşam kalitesini değerlendirmektir.
Gereç ve Yöntem:
Bu çalışmaya 115 postmenopozal kadın katılmıştır. Femur boynu ve lomber omurga kemik mineral yoğunluğu (KMY) ve biyokimyasal parametreler ölçülmüştür. MetS, Yetişkin Tedavi Paneli III ve Ulusal Kolesterol Eğitim Programı tarafından belirlenen kriterler kullanılarak teşhis edilmiştir. PA seviyesi, Uluslararası Fiziksel Aktivite Anketi Kısa Formu (IPAQ-SF) kullanılarak belirlenmiştir. Avrupa Osteoporoz Vakfı Yaşam Kalitesi Anketi (QUALEFFO-41) sağlıkla ilgili yaşam kalitesini (HRQoL) değerlendirmek için kullanılmıştır.
Bulgular:
Dünya Sağlık Örgütü sınıflamasına göre 66 (%57,3) kadında osteoporoz, 49 (%43,7) kadında osteopeni vardır. Otuz iki kadında (%27,8) MetS mevcuttur. IPAQ-SF’ye göre 27 (%23,5) kadın inaktif, 74 (%64,3) kadın minimal aktif, 14 (%12,2) kadın oldukça aktiftir. Postmenopozal kadınlarda MetS ile PA düzeyi arasında istatistiksel olarak anlamlı bir ilişki saptanmamıştır (p>0,05). MetS grubu ile non-MetS grubu arasında kemik mineral yoğunluğu (KMY) ölçümlerinde istatistiksel olarak anlamlı fark bulunmuştur (p<0,05). Ayrıca QUALEFFO-41 skorları iki grup arasında benzerdir (p>0,05).
Sonuç:
Postmenopozal kadınlarda MetS’nin omurga ve kalçada daha fazla KMY ile ilişkili olması MetS’nin kemik üzerine koruyucu etkisi olduğunu göstermektedir. Bununla birlikte, MetS olan ve olmayan postmenopozal kadınlar arasında PA düzeyi ve HRQoL benzerdir.
References
1
Melton LJ 3rd, Chrischilles EA, Cooper C, Lane AW, Riggs BL. Perspective. How many women have osteoporosis? J Bone Miner Res 1992;7:1005-10.
2
Cooper C, Campion G, Melton LJ 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992;2:285-9.
3
Tuzun S, Eskiyurt N, Akarirmak U, Saridogan M, Senocak M, Johansson H, et al. Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int 2012;23:949-55.
4
Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, et al; Scientific Advisory Council of Osteoporosis Canada. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 2010;182:1864-73.
5
Ross PD. Osteoporosis. Frequency, consequences, and risk factors. Arch Intern Med 1996;156:1399-411.
6
Levis S, Lagari VS. The role of diet in osteoporosis prevention and management. Curr Osteoporos Rep 2012;10:296-302.
7
Keaveny TM, Kopperdahl DL, Melton LJ 3rd, Hoffmann PF, Amin S, Riggs BL, et al. Age-dependence of femoral strength in white women and men. J Bone Miner Res 2010;25:994-1001.
8
Troy KL, Mancuso ME, Butler TA, Johnson JE. Exercise Early and Often: Effects of Physical Activity and Exercise on Women’s Bone Health. Int J Environ Res Public Health 2018;15:878.
9
Gómez-Cabello A, Ara I, González-Agüero A, Casajús JA, Vicente-Rodríguez G. Effects of training on bone mass in older adults: a systematic review. Sports Med 2012;42:301-25.
10
Compston J, Cooper A, Cooper C, Gittoes N, Gregson C, Harvey N, et al; UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 2017;12:43.
11
Yasein N, Shroukh W, Hijjawi R. Serum vitamin D and the metabolic syndrome among osteoporotic postmenopausal female patients of a family practice clinic in Jordan. Adv Clin Exp Med 2015;24:245-50.
12
Abbasi M, Farzam SA, Mamaghani Z, Yazdi Z. Relationship between metabolic syndrome and its components with bone densitometry in postmenopausal women. Diabetes Metab Syndr 2017;11:73-6.
13
He D, Xi B, Xue J, Huai P, Zhang M, Li J. Association between leisure time physical activity and metabolic syndrome: a meta-analysis of prospective cohort studies. Endocrine 2014;46:231-40.
14
Edwardson CL, Gorely T, Davies MJ, Gray LJ, Khunti K, Wilmot EG, et al. Association of sedentary behaviour with metabolic syndrome: a meta-analysis. PLoS One 2012;7:e34916.
15
Prevention and management of osteoporosis. World Health Organ Tech Rep Ser 2003;921:1-164.
16
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143-421.
17
Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381-95.
18
Lee PH, Macfarlane DJ, Lam TH, Stewart SM. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act 2011;8:115.
19
Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, Tokgozoglu L. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills 2010;111:278-84.
20
Quality of life in patients with vertebral fractures: validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis. Osteoporos Int 1999;10:150-60.
21
Kozan O, Oguz A, Abaci A, Erol C, Ongen Z, Temizhan A, Celik S. Prevalence of the metabolic syndrome among Turkish adults. Eur J Clin Nutr 2007;61:548-53.
22
Silva HG, Mendonça LM, Conceição FL, Zahar SE, Farias ML. Influence of obesity on bone density in postmenopausal women. Arq Bras Endocrinol Metabol 2007;51:943-9.
23
Lindsay R, Cosman F, Herrington BS, Himmelstein S. Bone mass and body composition in normal women. J Bone Miner Res 1992;7:55-3.
24
Grundy SM. Metabolic syndrome update. Trends Cardiovasc Med 2016;26:364-73.
25
Wang Q, Zhang X, Fang L, Guan Q, Gao L, Li Q. Physical Activity Patterns and Risk of Type 2 Diabetes and Metabolic Syndrome in Middle-Aged and Elderly Northern Chinese Adults. Hindawi Journal of Diabetes Research 2018:1-8
26
Kazaz İ, Angin E, Kabaran S, İyigün G, Kirmizigil B, Malkoç M. Evaluation of the physical activity level, nutrition quality, and depression in patients with metabolic syndrome: Comparative study. Medicine (Baltimore) 2018;97:e0485.
27
Frugé AD, Byrd SH, Fountain BJ, Cossman JS, Schilling MW, Gerard P. Increased physical activity may be more protective for metabolic syndrome than reduced caloric intake. An analysis of estimated energy balance in U.S. adults: 2007-2010 NHANES. Nutr Metab Cardiovasc Dis 2015;25:535-40.
28
Petersen CB, Nielsen AJ, Bauman A, Tolstrup JS. Joint association of physical activity in leisure and total sitting time with metabolic syndrome amongst 15,235 Danish adults: a cross-sectional study. Prev Med 2014;69:5-7.
29
Biver E, Salliot C, Combescure C, Gossec L, Hardouin P, Legroux-Gerot I, Cortet B. Influence of adipokines and ghrelin on bone mineral density and fracture risk: a systematic review and meta-analysis. J Clin Endocrinol Metab 2011;96:2703-13.
30
Koh JM, Khang YH, Jung CH, Bae S, Kim DJ, Chung YE, et al. Higher circulating hsCRP levels are associated with lower bone mineral density in healthy pre- and postmenopausal women: evidence for a link between systemic inflammation and osteoporosis. Osteoporos Int 2005;16:1263-71.
31
Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res 2005;96:939-49.
32
von Muhlen D, Safii S, Jassal SK, Svartberg J, Barrett-Connor E. Associations between the metabolic syndrome and bone health in older men and women: the Rancho Bernardo Study. Osteoporos Int 2007;18:1337-44.
33
Hwang DK, Choi HJ. The relationship between low bone mass and metabolic syndrome in Korean women. Osteoporos Int 2010;21:425-31.
34
Chin KY, Wong SK, Ekeuku SO, Pang KL. Relationship Between Metabolic Syndrome and Bone Health - An Evaluation of Epidemiological Studies and Mechanisms Involved. Diabetes Metab Syndr Obes 2020;13:3667-90.
35
Zhou J, Zhang Q, Yuan X, Wang J, Li C, Sheng H, et al. Association between metabolic syndrome and osteoporosis: a meta-analysis. Bone 2013;57:30-5.
36
Xue P, Gao P, Li Y. The association between metabolic syndrome and bone mineral density: a meta-analysis. Endocrine 2012;42:546-54.
37
Association between metabolic syndrome and bone loss at various skeletal sites in postmenopausal women: a 3-year retrospective longitudinal study. Osteoporos Int 2013;24:2243-52.
38
Lopez-Garcia E, Guallar-Castillón P, Garcia-Esquinas E, Rodríguez-Artalejo F. Metabolically healthy obesity and health-related quality of life: A prospective cohort study. Clin Nutr 2017;36:853-60.
39
Wilson S, Sharp CA, Davie MW. Health-related quality of life in patients with osteoporosis in the absence of vertebral fracture: a systematic review. Osteoporos Int 2012;23:2749-68.
40
Saboya PP, Bodanese LC, Zimmermann PR, Gustavo AD, Assumpção CM, Londero F. Metabolic syndrome and quality of life: a systematic review. Rev Lat Am Enfermagem 2016;24:e2848.
