ÖZET

Amaç:

Postmenopozal kadınlarda kemik mineral yoğunluğunu (KMY) etkileyen çeşitli faktörler vardır. Bu çalışmanın amacı, postmenopozal osteoporozu (PMO) olan kadınlarda antropometrik özellikler ile KMY arasındaki ilişkileri değerlendirmektir.

Gereç ve Yöntem:

Katılımcıların yaş, menopoz yaşı, sigara içme alışkanlığı, ek hastalıkları, eğitim durumu ve medeni durumu gibi demografik özellikleri kaydedildi. Boy, kilo, vücut kitle indeksi (VKİ), bel kalça oranı (BKO), dominant elin parmak oranı (2P:4P), iskelet kası kütle indeksi (İKKİ), el ve uyluk çevreleri gibi antropometrik özellikler ölçüldü. L1-L4’e ek olarak femur boyun (FB), femur total (FT) T-skorları, serum kalsiyum ve 25(OH) D vitamini seviyeleri not edildi.

Bulgular:

Bu çalışmaya PMO’lu toplam 181 kadın dahil edildi (ortalama yaş 62,78±7,81 yıl, menopoz yaşı 45,69±5,58 yıl ve VKİ 27,24±4,87 kg/m²). Katılımcıların %64,6’sının en az bir sistemik hastalığı vardı ve %71,8’i sigara kullanmıyordu. Serum kalsiyum ve 25(OH) D vitamini ortalama değerleri sırasıyla 9,71±0,73 mg/dL ve 26,22±15,34 ng/mL idi. Ağırlık ve VKİ, L1-L4 total, FB ve FT’deki T-skorları ile anlamlı pozitif korelasyon gösterdi. Uyluk çevresi ve İKKİ, FB ve FT’de T-skorları ile anlamlı korelasyon gösterirken, el çevresi sadece FB’de T-skoru ile koreleydi. Öte yandan, T-skorları ile diğer antropometrik ölçümler (boy, BKO, 2P:4P) arasında bir korelasyon bulunmadı.

Sonuç:

Bu bulgular, kilosu ve VKİ’si düşük olan hastaların lomber omurga ve femurda daha düşük T-skorlarına sahip olduğunu göstermiştir. Ek olarak, uyluk çevresi ve İKKİ, femur T-skorları ile pozitif korelasyon gösterdi. Postmenopozal kadınlarda osteoporoz riskini belirlemede bu antropometrik ölçümlerin rolünü ortaya çıkarmak için daha ileri araştırmalar gereklidir.

References

Kirazlı Y, Atamaz Çalış F, El Ö, Gökçe Kutsal Y, Peker Ö, Sindel D, et al. Updated approach for the management of osteoporosis in Turkey: a consensus report. Arch Osteoporos 2020;15:137.

Türkiye Endokrinoloji ve Metabolizma Derneği Osteoporoz ve Metabolik Kemik Hastalıkları Tanı ve Tedavi Kılavuzu. Bayt Bilimsel Araştırmalar Basın Yayın ve Tanıtım Ltd Sti; 2020.

Brown JP. Long-Term Treatment of Postmenopausal Osteoporosis. Endocrinol Metab (Seoul) 2021;36:544-52.

Kanis JA, Cooper C, Rizzoli R, Reginster JY; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2019;30:3-44.

Camacho PM, Petak SM, Binkley N, Diab DL, Eldeiry LS, Farooki A, et al. American Association of Clinical Endocrinologists/ American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis-2020 Update.. Endocr Pract 2020;26(Suppl 1):1-46.

Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay ET AL. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int 2014;25:2359-81.

Anthamatten A, Parish A. Clinical Update on Osteoporosis. J Midwifery Womens Health 2019;64:265-75.

Miller PD. Management of severe osteoporosis. Expert Opin Pharmacother 2016;17:473-88.

https://www.osteoporosis.foundation/facts-statistics/epidemiology-of-osteoporosis-and-fragility-fractures

Arazi H, Eghbali E, Saeedi T, Moghadam R. The Relationship of Physical Activity and Anthropometric and Physiological Characteristics to Bone Mineral Density in Postmenopausal Women. J Clin Densitom 2016;19:382-8.

Gnudi S, Sitta E, Fiumi N. Relationship between body composition and bone mineral density in women with and without osteoporosis: relative contribution of lean and fat mass. J Bone Miner Metab 2007;25:326-32.

Parm Ü, Tamm AL, Aasmäe T, Liiv K, Orav A, Jaansoo E, et al. Regular and Long-Term Effects of a Commercial Diet on Bone Mineral Density. Dietetics 2022;1:78-87.

Aghaei Meybodi H, Hemmat-Abadi M, Heshmat R, Rezaei Homami M, Madani S, Ebrahimi M, et al. Association between Anthropometric Measures and Bone Mineral Density: Population-Based Study. Iran J Public Health 2011;40:18-24.

Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995;854:1-452.

Lee RC, Wang Z, Heo M, Ross R, Janssen I, Heymsfield SB. Total-body skeletal muscle mass: development and cross-validation of anthropometric prediction models. Am J Clin Nutr 2000;72:796-803.

Hasani-Ranjbar S, Jafari-Adli S, Payab M, Qorbani M, Ahanjideh F, Keshtkar A, et al. Association of Osteoporosis with Anthropometric Measures in a Representative Sample of Iranian Adults: The Iranian Multicenter Osteoporosis Study. Int J Prev Med 2019;10:157.

Kim KC, Shin DH, Lee SY, Im JA, Lee DC. Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women. Yonsei Med J 2010;51:857-63.

Murat S, Dogruoz Karatekin B, Demirdag F, Kolbasi EN. Anthropometric and Body Composition Measurements Related to Osteoporosis in Geriatric Population. Medeni Med J 2021;36:294-301.

Yoo J, Lee BJ. Anthropometric, biochemical, and nutritional risk factors for osteoporosis in Korean adults based on a large cross-sectional study. PLoS One 2021;16:e0261361.

Akdeniz N, Akpolat V, Kale A, Erdemoglu M, Kuyumcuoglu U, Celik Y. Risk factors for postmenopausal osteoporosis: anthropometric measurements, age, age at menopause and the time elapsed after menopause onset. Gynecol Endocrinol 2009;25:125-9.

Kim B, Kim GM, Kim E, Park J, Isobe T, Mori Y, et al. The Anthropometric Measure ‘A Body Shape Index’ May Predict the Risk of Osteoporosis in Middle-Aged and Older Korean People. Int J Environ Res Public Health 2022;19:4926.

Soltani A, Larijani B, Khashayar P, Rezaei Hemami M, Fakhari S. The relationship between anthropometric parameters and bone mineral density in an Iranian referral population. Acta Med Iran 2014;52:505-10.

De Laet C, Kanis JA, Odén A, Johanson H, Johnell O, Delmas P, et al. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 2005;16:1330-8.

Chang CS, Chang YF, Wang MW, Chen CY, Chao YJ, Chang HJ, et al. Inverse relationship between central obesity and osteoporosis in osteoporotic drug naive elderly females: The Tianliao Old People (TOP) Study. J Clin Densitom 2013;16:204-11.

Premaor MO, Pilbrow L, Tonkin C, Parker RA, Compston J. Obesity and fractures in postmenopausal women. J Bone Miner Res 2010;25:292-7.

Kim DH, Lim H, Chang S, Kim JN, Roh YK, Choi MK. Association between Body Fat and Bone Mineral Density in Normal-Weight Middle-Aged Koreans. Korean J Fam Med 2019;40:100-5.

Compston JE, Watts NB, Chapurlat R, Cooper C, Boonen S, Greenspan S, et al. Obesity is not protective against fracture in postmenopausal women: GLOW. Am J Med 2011;124:1043-50.

Gnudi S, Sitta E, Lisi L. Relationship of body mass index with main limb fragility fractures in postmenopausal women. J Bone Miner Metab 2009;27:479-84.

Cashdan E. Waist-to-hip ratio across cultures: tradeoffs between androgen-and estrogen-dependent traits. Curr Anthropol 2008;49:1099-107.

Fenton A. Weight, Shape, and Body Composition Changes at Menopause. J Midlife Health 2021;12:187-92.

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 Suppl 1:S73-6.

Zheng Z, Cohn MJ. Developmental basis of sexually dimorphic digit ratios. Proc Natl Acad Sci U S A 2011;108:16289-94.

Lee SH, Gong HS. Measurement and Interpretation of Handgrip Strength for Research on Sarcopenia and Osteoporosis. J Bone Metab 2020;27:85-96.

Wu N, Li X, Mu S, Fu Q, Ba G. Handgrip strength is positively associated with bone mineral density in middle and aged adults: results from NHANES 2013-2014. Arch Osteoporos 2021;16:121.

Prakash KO, Choudhary R, Singh G. Lean Body Mass, Body Fat Percentage, and Handgrip Strength as Predictors of Bone Mineral Density in Postmenopausal Women. J Midlife Health 2021;12:299-303.

Kim SW, Lee HA, Cho EH. Low handgrip strength is associated with low bone mineral density and fragility fractures in postmenopausal healthy Korean women. J Korean Med Sci 2012;27:744-7.

Li K, Hewson DJ, Duchêne J, Hogrel JY. Predicting maximal grip strength using hand circumference. Man Ther 2010;15:579-85.

Postmenopozal Osteoporozu Olan Kadınlarda Kemik Mineral Yoğunluğu ile Antropometrik Ölçümler Arasındaki İlişkilerin Değerlendirilmesi

ÖZET

References