Osteoporosis, vertebral fractures and metabolic syndrome in postmenopausal women

BMC Endocrine Disorders

Aziza Mounach¹  Imad Ghozlani¹  Siham Sadni¹  Salwa El Mrahi¹  Asmaa Rezqi¹  Abdellah El Maghraoui¹ 

[1] Rheumatology Department, Military Hospital Mohammed V, PO Box: 1018, Rabat, Morocco

关键词: Vertebral fractures;    Women;    Osteoporosis;    Dual-energy X-ray absorptiometry (DXA);    Vertebral fracture assessment (VFA);    Metabolic syndrome;   

Others  :  1084737
DOI  :  10.1186/1472-6823-14-93

 received in 2014-01-17, accepted in 2014-12-01,  发布年份 2014

【 摘 要 】

Background

The combined effect of the metabolic syndrome (MS) risk factors on bone health has led to controversial results and it is still not clear whether this effect is protective or detrimental. The study aimed to examine the association between MS and bone mineral density (BMD), osteoporosis, and vertebral fractures (VFs) among ambulatory older postmenopausal women.

Methods

270 post-menopausal women with a mean age of 61.0 years ± 7.8 (50 to 90) with no prior known diagnosis of osteoporosis were recruited. BMD and Lateral vertebral fracture assessment (VFA) images were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative approach and morphometry.

Results

The MS as defined by the NCEP-ATP III was present in 62 women (23.0%). According to the WHO classification, 82 had osteoporosis at any site (30.4%). VFs were identified in 116 (43.0%): 80 (29.6%) had grade 1 and 36 (13.3%) had grade 2 or 3. Women with MS had a significantly higher BMD and lower prevalence of osteoporosis (17.7% vs. 34.1%) than those without MS. No significant statistical difference was noted in prevalence of VFs (14.5 vs. 13.0%). There were significantly less women with MS among the group of osteoporotic women (13% vs. 27%; p = 0.018). Conditional regression binary analysis assessing the presence of osteoporosis as the dependent variable showed that women with a MS had a significant 71% decrease in the odds of being osteoporotic by BMD compared with women who had not MS accounting for age, BMI, number of parities and years since menopause.

Conclusion

Women with MS had higher BMD at the hip and spine, suggesting a protective effect of MS on bone. However, the prevalence of VFs was similar between women with or without MS.

【 授权许可】

   
2014 El Maghraoui et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Bremer AA, Mietus-Snyder M, Lustig RH: Toward a unifying hypothesis of metabolic syndrome. Pediatrics 2012, 129(3):557-570.
• [2]Expert Panel on Detection E, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III): Executive summary of the third report of the national cholesterol education program (NCEP). JAMA 2001, 285(19):2486-2497.
• [3]Varenna M, Manara M, Galli L, Binelli L, Zucchi F, Sinigaglia L: The association between osteoporosis and hypertension: the role of a low dairy intake. Calcif Tissue Int 2013, 93(1):86-92.
• [4]Ilic K, Obradovic N, Vujasinovic-Stupar N: The relationship among hypertension, antihypertensive medications, and osteoporosis: a narrative review. Calcif Tissue Int 2013, 92(3):217-227.
• [5]Migliaccio S, Greco EA, Fornari R, Donini LM, Lenzi A: Is obesity in women protective against osteoporosis? Diab Metab Syndr Obes Targets Ther 2011, 4:273-282.
• [6]Reid IR: Obesity and osteoporosis. Ann Endocrinol 2006, 67(2):125-129.
• [7]Zhao LJ, Liu YJ, Liu PY, Hamilton J, Recker RR, Deng HW: Relationship of obesity with osteoporosis. J Clin Endocrinol Metab 2007, 92(5):1640-1646.
• [8]Greco EA, Fornari R, Rossi F, Santiemma V, Prossomariti G, Annoscia C, Aversa A, Brama M, Marini M, Donini LM, Spera G, Lenzi A, Lubrano C, Migliaccio S: Is obesity protective for osteoporosis? Evaluation of bone mineral density in individuals with high body mass index. Int J Clin Pract 2010, 64(6):817-820.
• [9]Sealand R, Razavi C, Adler RA: Diabetes mellitus and osteoporosis. Current Diab Rep 2013, 13(3):411-418.
• [10]Montagnani A, Gonnelli S, Alessandri M, Nuti R: Osteoporosis and risk of fracture in patients with diabetes: an update. Aging Clin Exp Res 2011, 23(2):84-90.
• [11]Hernandez JL, Olmos JM, Gonzalez-Macias J: Metabolic syndrome, fractures and gender. Maturitas 2011, 68(3):217-223.
• [12]Esposito K, Chiodini P, Capuano A, Colao A, Giugliano D: Fracture risk and bone mineral density in metabolic syndrome: a meta-analysis. J Clin Endocrinol Metab 2013, 98:3306-3314.
• [13]El Maghraoui A, Rezqi A, Mounach A, Achemlal L, Bezza A, Ghozlani I: Systematic vertebral fracture assessment in asymptomatic postmenopausal women. Bone 2013, 52(1):176-180.
• [14]El Maghraoui A, Rezqi A, Mounach A, Achemlal L, Bezza A, Dehhaoui M, Ghozlani I: Vertebral fractures and abdominal aortic calcification in postmenopausal women. A cohort study. Bone 2013, 56(1):213-219.
• [15]El Maghraoui A, Achemlal L, Bezza A: Monitoring of dual-energy X-ray absorptiometry measurement in clinical practice. J Clin Densitom 2006, 9(3):281-286.
• [16]El Maghraoui A, Do Santos Zounon AA, Jroundi I, Nouijai A, Ghazi M, Achemlal L, Bezza A, Tazi MA, Abouqual R: Reproducibility of bone mineral density measurements using dual X-ray absorptiometry in daily clinical practice. Osteoporos Int 2005, 16(12):1742-1748.
• [17]El Maghraoui A, Guerboub AA, Achemlal L, Mounach A, Nouijai A, Ghazi M, Bezza A, Tazi MA: Bone mineral density of the spine and femur in healthy Moroccan women. J Clin Densitom 2006, 9(4):454-460.
• [18]Genant HK, Wu CY, van Kuijk C, Nevitt MC: Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 1993, 8(9):1137-1148.
• [19]Kerkeni S, Kolta S, Fechtenbaum J, Roux C: Spinal deformity index (SDI) is a good predictor of incident vertebral fractures. Osteoporos Int 2009, 20(9):1547-1552.
• [20]American Diabetes A: Summary of revisions to the 2011 clinical practice recommendations. Diabetes Care 2011, 34(Suppl 1):S3.
• [21]Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY, Scientific Advisory Board of the European Society for C, Economic Aspects of O, Osteoarthritis, the Committee of Scientific Advisors of the International Osteoporosis F: European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2013, 24(1):23-57.
• [22]Beltran-Sanchez H, Harhay MO, Harhay MM, McElligott S: Prevalence and trends of Metabolic Syndrome in the adult US population, 1999–2010. J Am Coll Cardiol 2013, 62:697-703.
• [23]Sidorenkov O, Nilssen O, Brenn T, Martiushov S, Arkhipovsky VL, Grjibovski AM: Prevalence of the metabolic syndrome and its components in Northwest Russia: the Arkhangelsk study. BMC Public Health 2010, 10:23. BioMed Central Full Text
• [24]Maumus S, Marie B, Siest G, Visvikis-Siest S: A prospective study on the prevalence of metabolic syndrome among healthy french families: two cardiovascular risk factors (HDL cholesterol and tumor necrosis factor-alpha) are revealed in the offspring of parents with metabolic syndrome. Diabetes Care 2005, 28(3):675-682.
• [25]Hu G, Qiao Q, Tuomilehto J, Balkau B, Borch-Johnsen K, Pyorala K, Group DS: Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 2004, 164(10):1066-1076.
• [26]Szurkowska M, Szafraniec K, Gilis-Januszewska A, Pach D, Krzentowska A, Szybinski Z, Huszno B: Prevalence of the metabolic syndrome and its components in adult inhabitants of Krakow. Przegl Lek 2006, 63(9):733-737.
• [27]Hildrum B, Mykletun A, Hole T, Midthjell K, Dahl AA: Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the National Cholesterol Education Program: the Norwegian HUNT 2 study. BMC Public Health 2007, 7:220. BioMed Central Full Text
• [28]Grundy SM: Metabolic syndrome: connecting and reconciling cardiovascular and diabetes worlds. J Am Coll Cardiol 2006, 47(6):1093-1100.
• [29]Xue P, Gao P, Li Y: The association between metabolic syndrome and bone mineral density: a meta-analysis. Endocrine 2012, 42(3):546-554.
• [30]Esposito K, Chiodini P, Capuano A, Colao A, Giugliano D: Fracture risk and bone mineral density in metabolic syndrome: a meta-analysis. J Clin Endocrinol Metab 2013, 98(8):3306-3314.
• [31]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(10):1337-1344.
• [32]Kinjo M, Setoguchi S, Solomon DH: Bone mineral density in adults with the metabolic syndrome: analysis in a population-based U.S. sample. J Clin Endocrinol Metab 2007, 92(11):4161-4164.
• [33]Hwang DK, Choi HJ: The relationship between low bone mass and metabolic syndrome in Korean women. Osteoporos Int 2010, 21(3):425-431.
• [34]Ahmed LA, Schirmer H, Berntsen GK, Fonnebo V, Joakimsen RM: Features of the metabolic syndrome and the risk of non-vertebral fractures: the Tromso study. Osteoporos Int 2006, 17(3):426-432.
• [35]Jeon YK, Lee JG, Kim SS, Kim BH, Kim SJ, Kim YK, Kim IJ: Association between bone mineral density and metabolic syndrome in pre- and postmenopausal women. Endocr J 2011, 58(2):87-93.
• [36]Kim BJ, Ahn SH, Bae SJ, Kim EH, Kim TH, Lee SH, Kim HK, Choe JW, Kim SY, Koh JM, Kim GS: Association between metabolic syndrome and bone loss at various skeletal sites in postmenopausal women: a 3-year retrospective longitudinal study. Osteoporos Int 2013, 24(8):2243-2252.
• [37]Esser N, Legrand-Poels S, Piette J, Scheen AJ, Paquot N: Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes. Diabetes Res Clin Pract 2014, 105(2):141-150.
• [38]Montecucco F, Mach F, Pende A: Inflammation is a key pathophysiological feature of metabolic syndrome. Mediat Inflamm 2013, 2013:135984.
• [39]Romeo GR, Lee J, Shoelson SE: Metabolic syndrome, insulin resistance, and roles of inflammation–mechanisms and therapeutic targets. Arterioscler Thromb Vasc Biol 2012, 32(8):1771-1776.
• [40]Ginaldi L, Di Benedetto MC, De Martinis M: Osteoporosis, inflammation and ageing. Immun Ageing 2005, 2:14. BioMed Central Full Text
• [41]Reid IR: Relationships between fat and bone. Osteoporos Int 2008, 19(5):595-606.