Yıl: 2012 Cilt: 18 Sayı: 1 Sayfa Aralığı: 8 - 12 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Effects of reproductive factors on bone mineral densitometry

Öz:
Amaç: Postmenopozal kadınlarda reprodüktif faktörlerin kemik mineral yoğunluğu (BMD) üzerine etkilerini tespit etmek amaçlandı. Gereç ve Yöntemler: Çalışmaya lomber vertebra (L1-4) (LS) ve femur boyun (FN) düzeyinde BMD (gr/cm²) ölçümleri yapılmış olan 1196 postmenopazal kadın dahil edildi. Hastaların demografik, reprodüktif özellikleri ve vücut kütle indeksi (BMI) (kg/m²) belirlendi. BMD ile ilişkili faktörleri belirlemede çoklu regresyon analizi kullanıldı. Bulgular: Hastalarda ortalama yaş 59,97±8,56, ağırlık 73,49±13,06 kg, VKİ 29,25±5,22 kg/m², adet yaşı 14,00±1,64, doğum sayısı 4,22±2,09, toplam emzirme süresi 60,77±38,80 ay, günlük emzirme sayısı 8,23±3,91, menapoz yaşı 47,12±4,22, menopoz süresi 12,80±9,10 yıl, LS BMD 0,993±0,171 gr/cm², FN BMD 0,844±0,14 gr/cm² idi. Hastalarda LS BMD ve FN BMD değerleri ile yaş, menopoz süresi, toplam emzirme süresi, günlük emzirme sayısı arasında negatif korelasyon saptandı. LS ve FN BMD değerleri ile, ağırlık ve BMI skorları arasında pozitif korelasyon saptandı Yine LS ve FN BMD değerleri ile adet yaşı ve doğum sayısı arasında negatif korelasyon saptandı. Lineer basamak regresyon analizlerinde, ağırlık (p<0,001), günlük emzirme sayısı (p<0,001), menapoz sonrası geçen süre (p<0,001), toplam emzirme süresi (p<0,012), ilk adet yaşı (p<0,007) LS BMD için, ağırlık (p<0,001), menapoz sonrası geçen süre (p<0,001) ve günlük emzirme sayısı (p<0,001) FN BMD için en önemli belirleyiciler olarak bulundu. Sonuç: Postmenopozal dönemdeki kadınlarda LS ve FN BMD, reprodüktif faktörler ile ilişkili gözükmektedir. Bu nedenle postmenopozal kadınlarda osteoporoz risk faktörleri değerlendirirken reproduktif faktörlerde dikkate alınmalıdır. (Türk Os te opo roz Dergisi 2012;18:8-12)
Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Reproduktif faktörlerin kemik mineral dansitometresi üzerine etkileri

Öz:
Aim: To determine the effects of reproductive factors on bone mineral density (BMD) in postmenopausal women. Materials and Methods: A total of 1196 postmenopausal women with BMD (g/cm2) measurements at lumbar vertebra (LS) and femur neck (FN) were enrolled. Demographic, reproductive characteristics and Body Mass Index (BMI) of patients were defined. In order to define BMD related factors, multiple regression analysis was employed. Results: Main results were as follows: mean age= 59.97±8.56 yrs; weight= 73.49±13.06 kg; BMI= 29.25±5.22kg/m², age of menarche= 14.00±1.64 yrs; number of deliveries 4.22±2.09; total breastfeeding duration= 60.77±38.80 months; number of breastfeeding per day= 8.23±3.91; menopausal age= 47.12±4.22 yrs; duration of menopause= 12.80±9.10 yrs; LS BMD= 0.993±0.171 gr/cm2; FN BMD 0.844±0.14 gr/cm2. There were negative correlations between LS BMD and FN BMD values and age, menopause duration, total breastfeeding duration, and number of breastfeeding per day. There were positive correlations between LS and FN BMD values, and weight and BMI scores. Additionally, there were negative correlations between LS and FN BMD values, and age of menarche and number of deliveries. In linear stage regression analysis, weight, number of breastfeeding per day, postmenopausal duration, duration of total breastfeeding and age of menarche were defined as the most significant predictors for LS BMD, whereas weight, postmenopausal duration and number of breastfeeding per day were defined as the most significant predictors for FN BMD. Conclusion: LS and FN BMD in postmenopausal women are related to reproductive factors, so reproductive factors should also be considered in the evaluation of risk factors in postmenopausal women. (Turkish Journal of Osteoporosis 2012;18:8-12)
Anahtar Kelime:

Konular: Genel ve Dahili Tıp
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Umay E, Tamkan U, Gundogdu I, Umay S, Çakcı A. Osteoporoz Risk Faktörlerinin Kemik Mineral Yoğunluğuna Etkisi. Türk Osteoporoz Dergisi 2011;17:44-50.
  • 2. WHO Study Group on Assessment of Fracture Risk and its Application to Screening for Postmenopausal Osteoporosis. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a World Health Organization Study Group. World Health Organ Tech Rep Ser 1994;843:1-129.
  • 3. Poole KES, Compston JE. Osteoporosis and its management. BMJ 2006;333:1251–6.
  • 4. More C, Bettembuk P, Bhattoa HP, Balogh A. The effects of pregnancy and lactation on bone mineral density. Osteoporos Int 2001;12:732-7.
  • 5. Fink HA, Harrison SL, Taylor BC, Cummings SR, Schousboe JT, Kuskowski MA, et al. Differences in Site-Specific Fracture Risk Among Older Womenwith Discordant Results for Osteoporosis at Hip and Spine: the Study of Osteoporotic Fractures. J Clin Densitom 2008;11:250–9.
  • 6. Kroger H, Tuppurainen M, Honkanen R, Alhava E, Saarikoski S. Bone mineral density and risk factors for osteoporosis - a population-based study of 1600 perimenopausal women. Calcif Tissue Int 1994;55:1–7.
  • 7. Ho SC, Chen YM, Woo JL. Educational level and osteoporosis risk in postmenopausal Chinese women. Am J Epidemiol 2005;161:680–90.
  • 8. Çoban SR, Tezel CG, Içagasıoglu A, Baysal NC, Karabulut A, Taskıngül HŞ. 197 Hastada DXA ve Osteoporoz Risk Faktörlerinin Değerlendirilmesi. Evaluation of Dual Energy X Ray Absorbsiometry and Osteoporosis Risk Factors in 197 Patients. Osteoporoz Dünyasından 2007;13:80-2.
  • 9. Holm K, Dan A,Wilbur J; Li S, Walker J. A longitudinal study of bone density in midlife women. Health Care Women Int 2002;23:678–91.
  • 10. Ryan PJ, Blake GM, Fogelman I. Postmenopausal screening for osteopenia. Br J Rheumatol 1992;31:823–8.
  • 11. Mizuno K, Suzuki A, Ino Y, Asada Y, Kikkawa F, Tomoda Y. Postmenopausal bone loss in Japanese women. Int J Gynaecol Obstet 1995;50:33–9.
  • 12. Wehren LE. The epidemiology of osteoporosis and fractures in geriatric medicine. Clin Geriatr Med 2003;19:245-58.
  • 13. Ireland P, Fordtran JS. Effect of dietary calcium and age on jejunal calcium absorption in humans studied by intestinal perfusion. J Clin Invest 1973;52:2672-81.
  • 14. Sinaki M. Osteoporosıs. In:Braddom RL, editor. Physical Medicine and Rehabilitation. 14. th ed. Elsevier, Philadelphia 2011. P.910-33.
  • 15. Ravn P, Hetland ML, Overgaard K, Christiansen C. Premenopausal and postmenopausal changes in bone mineral density of the proximal femur measured by dual-energy x-ray absorptiometry. J Bone Miner Res 1994; 9:1975–80.
  • 16. Waugh EJ, Lam MA, Hawker GA, McGowan J, Papaioannou A, Cheung AM, et al. Perimenopause BMD Guidelines Subcommittee of Osteoporosis Canada. Risk factors for low bone mass in healthy 40–60 year old women: A systematic review of the literature. Osteoporos Int 2009;20:1–21.
  • 17. Aksakal O, Aytan H, Cavkaytar S, Tapısız OL, Gungor T, Ozdal B, Mollamahmutoglu L. Effect of lactation on bone mineral density later in life in Turkish women. Turk J Med Sci 2008;38:329-33.
  • 18. Berenson AB, , Breitkopf CR, Newman JL, Rahman M. Contribution of fat free mass and fat mass to bone mineral density among reproductive-aged women of white, black, and Hispanic race/ethnicity J Clin Densitom 2009;12:200–6.
  • 19. Sarıdogan ME. Osteoporoz Epidemiyolojisi. In: Kutsal YG, editör. Osteoporoz. Güneş Kitabevi: Ankara. 2005. P. 5-36.
  • 20. Aloia JF. The gain and loss of bone in the human life cycle. Adv Nutr Res 1994;9:1-33.
  • 21. Forsmo S, Schei B, Langhammer A, Forsén L. How do reproductive and lifestyle factors influence bone density in distal and ultradistal radius of early postmenopausal women? The Nord-Trøndelag Health Survey, Norway. Osteoporos Int 2001;12:222-9.
  • 22. Zhang Y, Liu P, Deng H. The impact of reproductive and menstrual history on bone mineral density in Chinese women. J Clin Densitom 2003;6:289–96
  • 23. Osei-Hyiaman D, Satoshi T, Ueji M, Hideto T, Kano K. Timing of menopause, reproductive years, and bone mineral density: a crosssectional study of postmenopausal Japanese women. Am J Epidemiol 1998;148:1055-61.
  • 24. Hagemans ML, van der Schouw YT, de Kleijn MJ, van Staveren WA, Pop VJ, Leusink GL, et al. Indicators for the total duration of premenopausal endogenous estrogen exposure in relation to BMD. Hum Reprod 2004;19:2163-9.
  • 25. Gerdhem P, Obrant K. Bone mineral density in old age: the influence of age at menarche and menopause. J Bone Miner Metab 2004;22:372–5.
  • 26. Matkovic V, Heaney RP. Calcium balance during human growth: evidence for threshold behavior. Am J Clin Nutr 1992;55:992-6.
  • 27. Lenora J, Lekamwasam S and Karlsson MK. Effects of multiparity and prolonged breast-feeding on maternal bone mineral density: a community-based cross-sectional study. BMC Women's Health 2009;9:19.
  • 28. Sadat-Ali M, Al-Habdan I, Al-Mulhim AA, El-Hassan AY. Effect of parity on bone mineral density among postmenopausal Saudi Arabian women. Saudi Med J 2005;26:1588-90.
  • 29. Fox KM, Magaziner J, Sherwin R, Scott JC, Plato CC, Nevitt M, Cummings S. Reproductive correlates of bone mass in elderly women. Study of Osteoporotic Fractures Research Group. J Bone Miner Res 1993;8:901–8.
  • 30. Melton LJ III, Bryant SC, Wahner HW, O’Fallon WM, Malkasian GD, Judd HL, Riggs BL. Influence of breastfeeding and other reproductive factors on bone mass later in life. Osteoporosis Int 1993;3:76–83.
  • 31. Allali F, Maarufi H, El Aichaoui S, Khazani H, Saoud B, Benyahya B, Abouqal R, Hajjaj- Hassouni N. Influence of parity on bone mineral density and peripheral fracture risk in Moroccan postmenopausal women. Maturitas 2007;57:392–8.
  • 32. Gur A, Nas K, Cevik R, Sarac AJ, Ataoglu S, Karakoc M. Influence of number of pregnancies on bone mineral density in postmenopausal women of different age groups. J Bone Miner Metab 2003;21:234–41.
  • 33. Nguyen TV, Jones G, Sambrook PN, White CP, Kelly PJ, Eisman JA. Effects of estrogen exposure and reproductive factors on bone mineral density and osteoporotic fractures. J Clin Endocrinol Metab 1995;80:2709-14.
  • 34. Sowers M. Pregnancy and lactation as risk factors for subsequent bone loss and osteoporosis. J Bone Miner Res 1996;11:1052-60.
  • 35. Kalkwarf HJ, Specker BL. Bone mineral changes during pregnancy and lactation http://www.ncbi.nlm.nih.gov/pubmed?term=Kalkwarf HJ%2C Specker BL. Bone mineral changes during pregnancy and lactation. Endocrine. 2002%3B17(1)%3A49-53. - # Endocrine 2002;17:49-53.
  • 36. Sowers M, Randolph J, Shapiro B, Jannaush M. A prospective study of bone density and pregnancy after an extended period of lactation with bone loss. Obstet Gynaecol 1995;85:285–9.
  • 37. Prentice A, Jarjou LM, Cole TJ, Stirling DM, Dibba B, Fairweather-Tait S. Calcium requirements of lactating Gambian mothers: effects of a calcium supplement on breast milk calcium concentration, maternal bone mineral content, and urinary calcium excretion. Am J Clin Nutr 1995;62:58–67.
  • 38. Kalkwarf HJ, Specker BL. Bone mineral loss during lactation and recovery after weaning. Obstet Gynaecol 1995;86:26–32.
  • 39. Hansen MA, Riis BJ, Overgaard K, Hassager C, Christiansen C. Potential risk factors for development of postmenopausal osteoporosisexamined over a 12-year period. Osteoporos Int 1991;1:95-102.
  • 40. Kritz-Silverstein D, Barrett-Connor E, Hollenbach KA. Pregnancyand lactation as determinants of bone mineral density in postmenopausal women. Am J Epidemiol 1992;136:1052-9.
  • 41. Jones G, Scott FS. A cross-sectional study of smoking and bone mineral density in premenopausal parous women: effect of body mass index, breast feeding and sports participation. J Bone Miner Res 1999;14:1628-33.
  • 42. Gur A, Nas K, Cevik R, Sarac AJ, Ataoglu S, Karakoc M. Influence of duration of breastfeeding on bone mass in postmenopausal women of different age groups. J Bone Miner Metab 2003;21:234-41.
  • 43. Dursun N, Akin S, Dursun E, Sade I, Korkusuz F. Influence of duration of total breast-feeding on bone mineral density in a Turkish population: does the priority of risk factors differ from society to society? Osteoporos Int 2006;17:651-5.
APA YILMAZ H, ERKİN G, POLAT DEMİR H, KÜÇÜKSEN S, SALLI A, UĞURLU H (2012). Effects of reproductive factors on bone mineral densitometry. , 8 - 12.
Chicago YILMAZ Halim,ERKİN Gülten,POLAT DEMİR Halime Almula,KÜÇÜKSEN SAMI,SALLI Ali,UĞURLU Hatice Effects of reproductive factors on bone mineral densitometry. (2012): 8 - 12.
MLA YILMAZ Halim,ERKİN Gülten,POLAT DEMİR Halime Almula,KÜÇÜKSEN SAMI,SALLI Ali,UĞURLU Hatice Effects of reproductive factors on bone mineral densitometry. , 2012, ss.8 - 12.
AMA YILMAZ H,ERKİN G,POLAT DEMİR H,KÜÇÜKSEN S,SALLI A,UĞURLU H Effects of reproductive factors on bone mineral densitometry. . 2012; 8 - 12.
Vancouver YILMAZ H,ERKİN G,POLAT DEMİR H,KÜÇÜKSEN S,SALLI A,UĞURLU H Effects of reproductive factors on bone mineral densitometry. . 2012; 8 - 12.
IEEE YILMAZ H,ERKİN G,POLAT DEMİR H,KÜÇÜKSEN S,SALLI A,UĞURLU H "Effects of reproductive factors on bone mineral densitometry." , ss.8 - 12, 2012.
ISNAD YILMAZ, Halim vd. "Effects of reproductive factors on bone mineral densitometry". (2012), 8-12.
APA YILMAZ H, ERKİN G, POLAT DEMİR H, KÜÇÜKSEN S, SALLI A, UĞURLU H (2012). Effects of reproductive factors on bone mineral densitometry. Türk Osteoporoz Dergisi, 18(1), 8 - 12.
Chicago YILMAZ Halim,ERKİN Gülten,POLAT DEMİR Halime Almula,KÜÇÜKSEN SAMI,SALLI Ali,UĞURLU Hatice Effects of reproductive factors on bone mineral densitometry. Türk Osteoporoz Dergisi 18, no.1 (2012): 8 - 12.
MLA YILMAZ Halim,ERKİN Gülten,POLAT DEMİR Halime Almula,KÜÇÜKSEN SAMI,SALLI Ali,UĞURLU Hatice Effects of reproductive factors on bone mineral densitometry. Türk Osteoporoz Dergisi, vol.18, no.1, 2012, ss.8 - 12.
AMA YILMAZ H,ERKİN G,POLAT DEMİR H,KÜÇÜKSEN S,SALLI A,UĞURLU H Effects of reproductive factors on bone mineral densitometry. Türk Osteoporoz Dergisi. 2012; 18(1): 8 - 12.
Vancouver YILMAZ H,ERKİN G,POLAT DEMİR H,KÜÇÜKSEN S,SALLI A,UĞURLU H Effects of reproductive factors on bone mineral densitometry. Türk Osteoporoz Dergisi. 2012; 18(1): 8 - 12.
IEEE YILMAZ H,ERKİN G,POLAT DEMİR H,KÜÇÜKSEN S,SALLI A,UĞURLU H "Effects of reproductive factors on bone mineral densitometry." Türk Osteoporoz Dergisi, 18, ss.8 - 12, 2012.
ISNAD YILMAZ, Halim vd. "Effects of reproductive factors on bone mineral densitometry". Türk Osteoporoz Dergisi 18/1 (2012), 8-12.