Bone Mineral Density Study in Postmenopausal Women with Metabolic Syndrome
Keywords:
metabolic syndrome, bone mineral density, body mass index, postmenopausal womenAbstract
Objectives: To compare bone mineral density (BMD) in postmenopausal women with and without metabolic syndrome (MS) and evaluate the association of the MS components with BMD.
Materials and Methods: The cross-sectional study evaluated postmenopausal women aged between 45 to 65 years old, who visited Srinagarind Hospital, Khon Kaen University between May 2015 and February 2016. MS is diagnosed according to NCEP ATP III 2005 criteria. BMD was measured at the femoral neck, lumbar spine, and total hip by dual-energy X-ray absorptiometry.
Results: A total of 125 postmenopausal women with MS and 125 without MS were enrolled. Mean age±SD was 57.9±4.2 and 56.6±4.1 years, respectively. Postmenopausal women with MS had significantly higher BMD compared to those without MS in age-adjusted analysis. Futher adjustment for BMI, there was no difference in BMD between both groups. In a multiple linear regression analysis, BMI was a significant positive predictor of BMD at all sites, while DM was a significant positive predictor of total hip BMD.
Conclusion: The higher BMD in the MS group may be affected mainly by the influence of MS’s contributing factors, such as BMI. The significant positive predictors for BMD in postmenopausal women were not only BMI but also DM, which may be partly attributable to the increase in BMI.
References
Consensus Development Conference: diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 1991;90(1):107–10. doi.org/10.1016/0002-9343(91)90512-v.
Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 1993;94(6):646–50. doi.org/10.1016/0002-9343(93)90218-e.
Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 1994;843:1-129. PMID: 7941614.
Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int 2014;25(10):2359-81. doi.org/10.1007/s00198-014-2794-2.
Lee WY, Park JS, Noh SY, Rhee EJ, Sung KC, Kim BS, et al. C-reactive protein concentrations are related to insulin resistance and metabolic syndrome as defined by the ATP III report. Int J Cardiol 2004;97(1):101-6. doi.org/10.1016/j.ijcard.2003.08.016.
Wilson PW, D'Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 2005;112(20):3066-72. doi.org/10.1161/CIRCULATIONAHA.105.539528.
Wellen KE, Hotamisligil GS. Inflammation, stress, and diabetes. J Clin Invest 2005;115(5):1111-9. doi.org/10.1172/JCI25102.
Jilka RL, Hangoc G, Girasole G, Passeri G, Williams DC, Abrams JS, et al. Increased osteoclast development after estrogen loss: mediation by interleukin-6. Science 1992;257(5066):88-91. doi.org/10.1126/science.1621100.
Bertolini DR, Nedwin GE, Bringman TS, Smith DD, Mundy GR. Stimulation of bone resorption and inhibition of bone formation in vitro by human tumour necrosis factors. Nature 1986;319(6053):516-8. doi.org/10.1038/319516a0.
Roodman GD. Role of cytokines in the regulation of bone resorption. Calcif Tissue Int 1993;53 (Suppl 1):S94-8. doi.org/10.1007/BF01673412.
Jeon YK, Lee JG, Kim SS, Kim BH, Kim SJ, Kim YK, et al. Association between bone mineral density and metabolic syndrome in pre- and postmenopausal women. Endocr J 2011;58 (2):87-93. doi.org/10.1507/endocrj.k10e-297.
Kim HY, Choe JW, Kim HK, Bae SJ, Kim BJ, Lee SH, et al. Negative association between metabolic syndrome and bone mineral density in Koreans, especially in men. Calcif Tissue Int. 2010;86(5):350-8. doi.org/10.1007/s00223-010-9347-2.
Indhavivadhana S, Rattanasrithong P. The relationship between bone mineral density and metabolic syndrome in peri- and post-menopausal Thai women. Arch Gynecol Obstet 2015;292(5):1127-33. doi.org/10.1007/s00404-015-3698-x.
El Maghraoui A, Rezqi A, El Mrahi S, Sadni S, Ghozlani I, Mounach A. Osteoporosis, vertebral fractures and metabolic syndrome in postmenopausal women. BMC Endocr Disord 2014;14:93. doi.org/10.1186/1472-6823-14-93.
Hernández JL, Olmos JM, Pariente E, Martínez J, Valero C, García-Velasco P, et al. Metabolic syndrome and bone metabolism: the Camargo Cohort study. Menopause 2010;17 (5):955-61. doi.org/10.1097/gme.0b013e3181e39a15.
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):1337-44. doi.org/10.1007/s00198-007-0385-1.
Park KK, Kim SJ, Moon ES. Association between bone mineral density and metabolic syndrome in postmenopausal Korean women. Gynecol Obstet Invest 2010;69(3):145-52. doi.org/10.1159/000264665.
Shanbhogue VV, Mitchell DM, Rosen C3, Bouxsein ML. Type 2 diabetes and the skeleton: new insights into sweet bones. Lancet Diabetes Endocrinol 2016;4(2):159-73. doi.org/10.1016/S2213-8587(15)00283-1.
Dupuy AM, Jaussent I, Lacroux A, Durant R, Cristol JP, Delcourt C. Waist circumference adds to the variance in plasma C-reactive protein levels in elderly patients with metabolic syndrome. Gerontology 2007;53 (6):329-39. doi.org/10.1159/000103555.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The 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). JAMA. 2001;285(19):2486-97. doi.org/10.1001/jama.285.19.2486.
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112(17):2735-52. doi.org/10.1161/CIRCULATIONAHA.105.169404.
Rhee SY, Yon DK, Kwon MJ, Kim JH, Kim JH, Bang WJ, et al. Association between metabolic syndrome and osteoporosis among adults aged 50 years and older: using the National Health Information Database in South Korea. Arch Osteoporos. 2022;17(1):124. doi.org/10.1007/s11657-022-01161-2.
Xue P, Gao P, Li Y. The association between metabolic syndrome and bone mineral density: a meta-analysis. Endocrine 2012;42(3):546-54. doi.org/10.1007/s12020-012-9684-1.
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(1):30-5. doi.org/10.1016/j.bone.2013.07.013.
Hao J, Yin L, Wang Y, Li W. Association between Metabolic Syndrome and Osteoporosis: A Systematic Review and Meta-Analysis. Int J Endocrinol. 2021;2021:6691487. doi.org/10.1155/2021/6691487.
Hetemäki N, Savolainen-Peltonen H, Tikkanen MJ, Wang F, Paatela H, Hämäläinen E, et al. Estrogen Metabolism in Abdominal Subcutaneous and Visceral Adipose Tissue in Postmenopausal Women. J Clin Endocrinol Metab. 2017;102(12):4588-95. doi.org/10.1210/jc.2017-01474.
Zarrabeitia MT, Hernandez JL, Valero C, Zarrabeitia A, Amado JA, Gonzalez-Macias J, et al. Adiposity, estradiol, and genetic variants of steroid-metabolizing enzymes as determinants of bone mineral density. Eur J Endocrinol 2007;156(1):117-22. doi.org/10.1530/eje.1.02318.
Chambers TJ, Evans M, Gardner TN, Turner-Smith A, Chow JW. Induction of bone formation in rat tail vertebrae by mechanical loading. Bone Miner 1993;20(2):167-78. doi.org/10.1016/s0169-6009(08)80025-6.
Guo Y, Wang Y, Liu Y, Wang H, Guo C, Zhang X. Effect of the same mechanical loading on osteogenesis and osteoclastogenesis in vitro. Chin J Traumatol. 2015;18(3):150-6. doi.org/10.1016/j.cjtee.2014.09.004.
Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes--a meta-analysis. Osteoporos Int 2007;18(4):427-44. doi.org/10.1007/s00198-006-0253-4.
Ma L, Oei L, Jiang L, Estrada K, Chen H, Wang Z, et al. Association between bone mineral density and type 2 diabetes mellitus: a meta-analysis of observational studies. Eur J Epidemiol. 2012;27(5):319-32. doi.org/10.1007/s10654-012-9674-x.
Yamagishi S, Nakamura K, Inoue H. Possible participation of advanced glycation end products in the pathogenesis of osteoporosis in diabetic patients. Med Hypotheses. 2005;65(6):1013-5. doi.org/10.1016/j.mehy.2005.07.017.
Vilaca T, Schini M, Harnan S, Sutton A, Poku E, Allen IE, et al. The risk of hip and non-vertebral fractures in type 1 and type 2 diabetes: A systematic review and meta-analysis update. Bone. 2020 Aug;137:115457. doi.org/10.1016/j.bone.2020.115457.
Gilbert MP, Pratley RE. The impact of diabetes and diabetes medications on bone health. Endocr Rev. 2015 Apr;36(2):194-213. doi.org/10.1210/er.2012-1042.
Wang Z, Li Y, Zhou F, Piao Z, Hao J. Effects of Statins on Bone Mineral Density and Fracture Risk: A PRISMA-compliant Systematic Review and Meta-Analysis. Medicine (Baltimore). 2016;95(22):e3042. doi.org/10.1097/MD.0000000000003042.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Srinagarind Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
