Öz
Amaç
Postmenopozal kadınlarda menopoz yaşı, osteoproz ve sarkopeni arasındaki ilişkiyi incelemektir.
Gereç ve Yöntem
Bu kesitsel çalışmaya 128 postmenopozal kadın dahil edildi. Sarkopeni tanısı yaşlılarda sarkopeni üzerine Avrupa çalışma grubu kriterlerine göre konarken osteoporoz tanısı çift enerjili X-ışını absorpsiyometri ile kondu. Sarkopeni, menopoz yaşı ve osteoporoz arasındaki ilişkiler ki-kare testleri, tek yönlü ANOVA ve standart/kısıtlanmış ikili lojistik regresyon kullanılarak incelendi.
Bulgular
Katılımcıların %19,5’inde (n=25) muhtemel sarkopeni saptanırken, %21,1’inde (n=27) ise sarkopeni tespit edildi. Osteoporoz sıklığı, sarkopeni olmayanlarda (%19,7), muhtemel sarkopeni olanlarda (%48,0) ve sarkopeni olanlarda (%82,0) idi. Menopoz yaşı ortalaması, sarkopeni olan bireylerde muhtemel sarkopeni olan ve sarkopeni olmayan bireylere kıyasla anlamlı olarak daha düşüktü (sırasıyla 41,4, 45,0 ve 46,0 yıl; p<0,001). Kısıtlanmış çok değişkenli ikili lojistik regresyon analizinde, kronolojik yaş ve vücut kitle indeksi kontrol altına alındığında, osteoporoz sarkopeni ile istatistiksel olarak anlamlı olmayan sınırda bir ilişki gösterdi [olasılık oranı (OR): 3,59; %95 güven aralığı (GA): 0,96-14,76; p=0,058]. Diğer yandan, erken menopoz yaşı ile sarkopeni arasında ise istatistiksel olarak anlamlı bağımsız bir ilişki bulundu [OR (%95 GA): 0,89 (0,78-0,99), p=0,041].
Sonuç
Postmenopozal kadınlarda erken menopoz yaşı ile sarkopeni arasında bağımsız bir ilişki saptanırken, osteoporoz ve sarkopeni arasındaki ilişkinin istatistiksel ve klinik önemini daha net ortaya koymak için büyük örneklemli sağlam çalışmalara ihtiyaç vardır.
Anahtar Kelimeler:
Menopoz yaşı, osteoporoz, postmenopozal kadın, sarkopeni
Kaynaklar
1
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al.; Writing group for the European working group on sarcopenia in older people 2 (EWGSOP2), and the extended group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:16-31.
2
Yeung SSY, Reijnierse EM, Pham VK, Trappenburg MC, Lim WK, Meskers CGM, et al. Sarcopenia and its association with falls and fractures in older adults: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2019;10:485-500.
3
Liu P, Hao Q, Hai S, Wang H, Cao L, Dong B. Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: a systematic review and meta-analysis. Maturitas. 2017;103:16-22.
4
Petermann-Rocha F, Balntzi V, Gray SR, Lara J, Ho FK, Pell JP, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2022;13:86-99.
5
Li M, Yan X, Wu R, Liao Y, Zhang J, Ye Y, et al. Prevalence and diagnostic strategies for sarcopenia in menopausal and non-menopausal women: a cross-sectional comparative study. Int J Womens Health. 2025;17:1887-412.
6
Burger HG, Hale GE, Dennerstein L, Robertson DM. Cycle and hormone changes during perimenopause: the key role of ovarian function. Menopause. 2008;15:603-12.
7
Naser B, Castelo-Branco C, Meden H, Minkin MJ, Rachoń D, Beer AM, Pickartz S. Weight gain in menopause: systematic review of adverse events in women treated with black cohosh. Climacteric. 2022;25:220-227.
8
Ji MX, Yu Q. Primary osteoporosis in postmenopausal women. Chronic Dis Transl Med. 2015;1:9-13.
9
Geraci A, Calvani R, Ferri E, Marzetti E, Arosio B, Cesari M. Sarcopenia and menopause: the role of estradiol. Front Endocrinol (Lausanne). 2021;12:682012.
10
Lovejoy JC, Champagne CM, de Jonge L, Xie H, Smith SR. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008;32:949-58.
11
Patel S, Homaei A, Raju AB, Meher BR. Estrogen: The necessary evil for human health, and ways to tame it. Biomed Pharmacother. 2018;102:403-11.
12
Buckinx F, Aubertin-Leheudre M. Sarcopenia in menopausal women: current perspectives. Int J Womens Health. 2022;14:805-19.
13
Vallejo MS, Blümel JE, Chedraui P, Tserotas K, Salinas C, Rodrigues MA, et al. Association of muscle disorders in late postmenopausal women according to the type of experienced menopause. Menopause. 2024;31:641-6.
14
de Matos O, de Castro Lenardt BC, Yamaguishi T, Souza MC, de Lima IC, Furlan G, et al. Influence of the age at menopause onset on sarcopenia in postmenopausal women: based on the FNIH consensus classification for sarcopenia. European Gynecology and Obstetrics. 2023;5:93-7.
15
Fugiel J, Ignasiak Z, Skrzek A, Sławińska T. Evaluation of relationships between menopause onset age and bone mineral density and muscle strength in women from South-Western Poland. Biomed Res Int. 2020;2020:5410253.
16
Shieh A, Karlamangla AS, Karvonen-Guttierez CA, Greendale GA. Menopause-related changes in body composition are associated with subsequent bone mineral density and fractures: study of women’s health across the nation. J Bone Miner Res. 2023;38:395-402.
17
Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011;40:423-9.
18
Xie X, Kolthoff N, Bärenholt O, Nielsen SP. Validation of a leg-to-leg bioimpedance analysis system in assessing body composition in postmenopausal women. Int J Obes Relat Metab Disord. 1999;23:1079-84.
19
Feng Q, Bešević J, Conroy M, Omiyale W, Lacey B, Allen N. Comparison of body composition measures assessed by bioelectrical impedance analysis versus dual-energy X-ray absorptiometry in the United Kingdom Biobank. Clin Nutr ESPEN. 2024;63:214-25.
20
Yamada Y, Nishizawa M, Uchiyama T, Kasahara Y, Shindo M, Miyachi M, Tanaka S. Developing and validating an age-independent equation using multi-frequency bioelectrical impedance analysis for estimation of appendicular skeletal muscle mass and establishing a cutoff for sarcopenia. Int J Environ Res Public Health. 2017;14:809.
21
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al.; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412-23.
22
Siris ES, Adler R, Bilezikian J, Bolognese M, Dawson-Hughes B, Favus MJ, et al. The clinical diagnosis of osteoporosis: a position statement from the national bone health alliance working group. Osteoporos Int. 2014;25:1439-43.
23
Park SH, Lee YS. The diagnostic accuracy of the berg balance scale in predicting falls. West J Nurs Res. 2017;39:1502-25.
24
Sahin F, Yilmaz F, Ozmaden A, Kotevolu N, Sahin T, Kuran B. Reliability and validity of the Turkish version of the Berg balance scale. J Geriatr Phys Ther. 2008;31:32-7.
25
Shafiee G, Keshtkar A, Soltani A, Ahadi Z, Larijani B, Heshmat R. Prevalence of sarcopenia in the world: a systematic review and meta- analysis of general population studies. J Diabetes Metab Disord. 2017;16:21.
26
Yılmaz A, Şentürk Durmuş N, Yıldız Y, Beşışık Yılmaz Z, Alkaç Ç, Can B, et al. Sarcopenia and sarcopenic obesity in postmenopausal women: a cross-sectional study in Türkiye. Climacteric. 2026: 29:61-6.
27
Collins BC, Arpke RW, Larson AA, Baumann CW, Xie N, Cabelka CA, et al. Estrogen regulates the satellite cell compartment in females. Cell Reports. 2019;28:1568-81.e6.
28
Messier V, Rabasa-Lhoret R, Barbat-Artigas S, Elisha B, Karelis AD, Aubertin-Leheudre M. Menopause and sarcopenia: a potential role for sex hormones. Maturitas. 2011;68:331-6.
29
Kirk B, Zanker J, Duque G. Osteosarcopenia: epidemiology, diagnosis, and management—the role of physical activity. J Cachexia Sarcopenia Muscle. 2021;12:1443-59.
30
Alexander NB, Schultz AB, Ashton-Miller JA, Gross MM, Giordani B. Muscle strength and rising from a chair in older adults. Muscle Nerve Suppl. 1997;5:S56-9.
31
Jette AM, Jette DU. Functional and behavioral consequences of sarcopenia. Muscle Nerve Suppl. 1997;5:S39-41.
32
Schultz AB, Ashton-Miller JA, Alexander NB. What leads to age and gender differences in balance maintenance and recovery? Muscle Nerve Suppl. 1997;5:S60-4.
33
Maltais ML, Desroches J, Dionne IJ. Changes in muscle mass and strength after menopause. J Musculoskelet Neuronal Interact. 2009;9:186-97.
34
Carville SF, Rutherford OM, Newham DJ. Power output, isometric strength and steadiness in the leg muscles of pre- and postmenopausal women; the effects of hormone replacement therapy. Eur J Appl Physiol. 2006;96:292-8.
35
Cooper R, Mishra G, Clennell S, Guralnik J, Kuh D. Menopausal status and physical performance in midlife: findings from a British birth cohort study. Menopause. 2008;15:1079-85.
36
Calmels P, Vico L, Alexandre C, Minaire P. Cross-sectional study of muscle strength and bone mineral density in a population of 106 women between the ages of 44 and 87 years: relationship with age and menopause. Eur J Appl Physiol Occup Physiol. 1995; 70:180-6.
37
Greising SM, Baltgalvis KA, Lowe DA, Warren GL. Hormone therapy and skeletal muscle strength: a meta-analysis. J Gerontol A Biol Sci Med Sci. 2009;64A:1071-81.
38
Bassey EJ, Mockett SP, Fentem PH. Lack of variation in muscle strength with menstrual status in healthy women aged 45-54 years: data from a national survey. Eur J Appl Physiol. Occup Physiol 1996;73:382-6.
39
Greeves JP, Cable NT, Luckas MJ, Reilly T, Biljan MM. Effects of acute changes in oestrogen on muscle function of the first dorsal interosseus muscle in humans. J Physiol. 1997;500:265-70.
40
Coll PP, Phu S, Hajjar SH, Kirk B, Duque G, Taxel P. The prevention of osteoporosis and sarcopenia in older adults. J Am Geriatr Soc. 2021;69:1388-98.
41
Clynes MA, Gregson CL, Bruyère O, Cooper C, Dennison EM. Osteosarcopenia: where osteoporosis and sarcopenia collide. Rheumatology (Oxford). 2021;60:529-37.
42
Greco EA, Pietschmann P, Migliaccio S. Osteoporosis and sarcopenia increase frailty syndrome in the elderly. Front Endocrinol (Lausanne). 2019;10:255.
43
He H, Liu Y, Tian Q, Papasian CJ, Hu T, Deng HW. Relationship of sarcopenia and body composition with osteoporosis. Osteoporos Int. 2016;27:473-82.
44
Petermann-Rocha F, Ferguson LD, Gray SR, Rodríguez-Gómez I, Sattar N, Siebert S, et al. Association of sarcopenia with incident osteoporosis: a prospective study of 168,682 UK biobank participants. J Cachexia Sarcopenia Muscle. 2021;12:1179-88.
45
Abidin NZ. Comparison of muscle, bone and fat indices between stages of sarcopenia in postmenopausal Malaysian women. Malays J Med Sci. 2023;30:91-105.
