Menopozal Dönemde Görülen Osteoporozda Kalsiyum ve D Vitaminin Rolü

Ayşenur Özünal; Nural Erzurum Alim

Systematic Reviews and Meta Analysis

Menopozal Dönemde Görülen Osteoporozda Kalsiyum ve D Vitaminin Rolü

Year 2022, Volume: 3 Issue: 1, 46 - 55, 02.02.2022

Ayşenur Özünal Nural Erzurum Alim

Abstract

Osteoporoz, özellikle menopoz sonrası kadınlar için kırık riskinin artması nedeniyle önemli bir toplum sağlığı sorunudur. Menopoz adet döngüsünün bitmesine ve östrojenin sağlığa faydalı etkilerinin yitirilmesine yol açmaktadır. Bu yitirilen etkilerden biri kemik kaybının hızlanmasıdır. Östrojen eksikliği kemik kütlesinin azalmasına ve osteoporoz riskinin artmasına neden olmaktadır. Primer osteoporozun risk faktörlerinden bazıları; 60 yaş üstü ve kadın olmak, menopoza bağlı östrojen kaybı, yetersiz kalsiyum ve D vitamini alımıdır. Yapılan çalışmalarda kalsiyum ve D vitamini takviyesinin osteoporoz sonucu oluşan kırıkların tedavisindeki ve önlenmesindeki etkisi güvenilir olduğu gösterilmektedir. Hem koruyucu önlemlerde hem de tedavide kalsiyum ve D vitamininin yeterli alımı ön plana çıkmaktadır. Osteoporoz oluşumu pek çok farklı nedene bağlı olsa da kadınlar yaşamları boyunca kalsiyum, D vitamini ve tüm besin gruplarından yeterli ve dengeli beslenerek gereksinimlerini karşılayabilecek kadar besin öğesi aldıklarında, osteoporoz gelişim riski en aza indirilebilir.

Keywords

Osteoporoz, Menopoz, Kalsiyum, D vitamini

References

1. Qiu C, Chen H, Wen J, Zhu P, Lin F, Huang B et al. Associations Between Age at Menarche and Menopause With Cardiovascular Disease, Diabetes, and Osteoporosis in Chinese Women. J Clin Endocrinol Metabolis. 2013;98(4):1612–1621.
2. WHO(World Health Organization). Research on the menopause in the 1990s. Report of a WHO Scientific Group, 1996.
3. Caufriez A. Hormonal replacement therapy (HRT) inpostmenopause: a reappraisal. Annales d'Endocrinologie. 2007;68:241-250.
4. Görgel EB, Çakıroğlu FP. Menopoz Döneminde Kadın. Ankara: Ankara Üniversitesi Basımevi, 2007.
5. Bacon JL. The menopausal transition. Obstet Gynecol Clin. 2017;44(2):285-296.
6. Kaplan S. "Postmenopozal osteoporozda risk faktörleri ve korunma yolları." Fırat Sağlık Hizmetleri Dergisi. 2007;2:23-31.
7. Seçginli S. "Kadınların osteoporoza ilişkin bilgi, inanç ve risk faktörlerinin incelenmesi." Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2007;10:77-88.
8. Akbulut A. Krause's Food & The Nutrition Care Process.14. baskı. Ankara Nobel Tıp Kitabevi, 2019.
9. Riggs BL, Parfitt AM. Drugs used to treat osteoporosis: the critical need for a uniform nomenclature based on their action on bone remodeling. J Bone Miner Res. 2005;20:177-184.
10. Rodríguez-Martínez MA. García-Cohen EC. Role of Ca(2+) and vitamin D in the prevention and treatment of osteoporosis. Pharmacol Ther. 2002; 93: 37-49.
11. Köseoğlu Seçgin C, Gülşahı A. Kemik kalite değerlendirmesi(osteoporoz). Türkiye Klinikleri J Oral Maxillofac Radiol-Special Topics. 2017;3(2):122-126.
12. Kanis JA, Borgstrom F, Johnell O, Jonsson B. Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporosis International. 2004;15:862-871.
13. 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: 2359-2381.
14. International Osteoporosis Foundation. Facts and statistics. [Erişim:24 Kasım 2021]. 2021. https://www.osteoporosis.foundation/facts-statistics.
15. Tüzün Ş. "Epidemiyoloji Türkiye Çalışması Fracturk." In Osteoporozda Tanı ve Tedavi, Peker Ö, Meray J editors. İstanbul: Galenos Yayınevi, 2012;s. 22-34.
16. MacLennan AH, Henderson VW, Paine BJ, et al. Hormone therapy, timing of initiation, and cognition in women older than 60 years: the REMEMBER pilot study. Menopause. 2006;13(1):28-26.
17. Svejme OH, Ahlborg HG, Nilsson JA, Karlsson MK. Early menopause and risk of osteoporosis, fracture and mortality: a 34 year prospective observational study in 390 women. BJOG. 2012;119: 810-816.
18. Ho SC, Chen YM, Woo JL. Educational level and osteoporosis risk in postmenopausal Chinese women. Am J Epidemiol. 2005; 161: 680-690.
19. Demir B, Haberal A, Geyik P, et al. Identification of the risk factors for osteoporosis among postmenopausal women. Maturitas. 2008;60: 253–256.
20. Kaya N, Bölükbaş N, Atıcı İ, Demetgül M. Kadınların yaşam tarzı değişkenleri ile osteoporoz arasındaki ilişki. Aile ve Toplum. 2003;6(6).
21.Turan V. Grand-grand multiparity (more than 10 deliveries) does not convey a risk for osteoporosis. Acta Obstet Gynecol Scand. 2011;90: 1440-1442.
22. Streeten EA, Ryan KA, McBride DJ, Pollini TI, Shuldiner AR, Mitchell BD. The relationship between parity and bone mineral density in women characterized by a homogeneous lifestyle and high parity. J Clin Endocrinol Metab. 2005;90: 4536-4541.
23. Nieves J. Calcium and vitamin D. In In Managing Osteoporosis, edited by T O’Neill, R Morris, D Skeleton and A Sutcliffe SA Lanham-New. Oxford: Clinical Publishing, 2007;21-33.
24. Eskiyurt N. Osteoporozda Beslenme.Osteoporoz, Modern Tıp Serileri Vol 19, 2001; 224-233.
25. Fidan F, Alkan BM, Tosun A. Çağın Pandemisi: D vitamini eksikliği ve yetersizliği. Türk Osteoporoz Dergisi. 2014;20:71-74.
26. Korugan Ü. Menopozda Beslenme. In Menopoz ve Osteoporoz. Seyisoğlu H, Ertüngealp E Editörler. İstanbul, 2000; 343-345.
27. Lanham-New SA. Importance of calcium, vitamin D and vitamin K for osteoporosis prevention and treatment. Proc Nutr Soc. 2008;67:163-176.
28. DRI. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Consensus study report, Institue of Medicine, Washington DC, 1997.
29. Bailey RL, Dodd KW, Goldman JA, Gahche JJ, Dwyer JT, Moshfegh AJ, et al. Estimation of total usual calcium and vitamin D intakes in the United States. J. Nutr. 2010;140(4):817-822.
30. Lorentzon M, Mellstrom D & Ohlsson C. Age of attainment of peak bone mass is site specific in Swedish men – The GOOD study. Bone Miner Res. 2005;20: 1223–1227.
31. FDA(Food and Drug Administration). Title 21: Food and Drugs Part 101 Food Labeling. Specific Requirements for Healthy Claims: Calcium and Osteoporosis. 2008. [Erişim 25 Kasım 2021]. https://www.ecfr.gov/current/title-21/chapter-I/subchapter-B/part-101.
32. Hirani V, et al. Low Levels of 25-hydroxy Vitamin D Independently Associated with Type 2 Diabetes Mellitus in Older Australian Men: The Concord Health and Ageing in Men Project. J Am Geriatr Soc. 2014;62: 417.
33. McCarty CA. Sunlight exposure assessment:can we accurately assess vitamin D exposure from sunlight questionnaires? Am J Clin Nutr. 2008;87: 1097-1101.
34. Boonen S, Rizzoli R, Meunier PJ, Stone M, Nuki G, Syversen U, et al. The need for clinical guidance in the use of calcium and vitamin D in the management of osteoporosis: a consensus report. Osteoporos Int. 2004;15: 511-519.
35. Khan A, Fortier M, Reid R, Abramson BL, Blake J, Desindes S, Wolfman W, et al. Osteoporosis in menopause. Journal of Obstetrics and Gynaecology Canada. 2014;36(9): 839-840.
36. Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster JY, Borgstrom F, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2008;19:399-428.
37. Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK, et al. Pharmacologic treatment of low bone density or osteoporosis to prevent fractures: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008;149: 404-415.
38. Avenell A, Gillespie WJ, Gillespie LD, O’Connell DL. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database Syst Reviews. 2005;3.
39. Meunier P. Prevention of hip fractures by correct- ing calcium and vitamin D insufficiencies in elderly people. Scand J Rheumatol Suppl. 1996;103: 75-78.
40. Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, et al, and Women’s Health Initiative Investigators. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006;354: 669–683.
41. Chapuy MC, Arlot ME, Duboeuf F, Meunier PJ. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med. 1992;327:1637-1642.
42. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, et al. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ. 2009;339.
43. Ireland P, Fordtran JS. Effect of dietary calcium and age on jejunal calcium absorption in humans studied by intestinal perfusion. J Clin Invest. 1973;52:2672-2682.
44. Rizzoli R, Boonen S, Brandi ML, et al. The role of calcium and vitamin D in the management of osteoporosis. Bone. 2008;42:246-249.
45. Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Report Brief, Washington DC, 2010.
46. Brown JP, Josse RG. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ. 2002;167:1-34.

Year 2022, Volume: 3 Issue: 1, 46 - 55, 02.02.2022

Ayşenur Özünal Nural Erzurum Alim

Abstract

References

1. Qiu C, Chen H, Wen J, Zhu P, Lin F, Huang B et al. Associations Between Age at Menarche and Menopause With Cardiovascular Disease, Diabetes, and Osteoporosis in Chinese Women. J Clin Endocrinol Metabolis. 2013;98(4):1612–1621.
2. WHO(World Health Organization). Research on the menopause in the 1990s. Report of a WHO Scientific Group, 1996.
3. Caufriez A. Hormonal replacement therapy (HRT) inpostmenopause: a reappraisal. Annales d'Endocrinologie. 2007;68:241-250.
4. Görgel EB, Çakıroğlu FP. Menopoz Döneminde Kadın. Ankara: Ankara Üniversitesi Basımevi, 2007.
5. Bacon JL. The menopausal transition. Obstet Gynecol Clin. 2017;44(2):285-296.
6. Kaplan S. "Postmenopozal osteoporozda risk faktörleri ve korunma yolları." Fırat Sağlık Hizmetleri Dergisi. 2007;2:23-31.
7. Seçginli S. "Kadınların osteoporoza ilişkin bilgi, inanç ve risk faktörlerinin incelenmesi." Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2007;10:77-88.
8. Akbulut A. Krause's Food & The Nutrition Care Process.14. baskı. Ankara Nobel Tıp Kitabevi, 2019.
9. Riggs BL, Parfitt AM. Drugs used to treat osteoporosis: the critical need for a uniform nomenclature based on their action on bone remodeling. J Bone Miner Res. 2005;20:177-184.
10. Rodríguez-Martínez MA. García-Cohen EC. Role of Ca(2+) and vitamin D in the prevention and treatment of osteoporosis. Pharmacol Ther. 2002; 93: 37-49.
11. Köseoğlu Seçgin C, Gülşahı A. Kemik kalite değerlendirmesi(osteoporoz). Türkiye Klinikleri J Oral Maxillofac Radiol-Special Topics. 2017;3(2):122-126.
12. Kanis JA, Borgstrom F, Johnell O, Jonsson B. Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporosis International. 2004;15:862-871.
13. 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: 2359-2381.
14. International Osteoporosis Foundation. Facts and statistics. [Erişim:24 Kasım 2021]. 2021. https://www.osteoporosis.foundation/facts-statistics.
15. Tüzün Ş. "Epidemiyoloji Türkiye Çalışması Fracturk." In Osteoporozda Tanı ve Tedavi, Peker Ö, Meray J editors. İstanbul: Galenos Yayınevi, 2012;s. 22-34.
16. MacLennan AH, Henderson VW, Paine BJ, et al. Hormone therapy, timing of initiation, and cognition in women older than 60 years: the REMEMBER pilot study. Menopause. 2006;13(1):28-26.
17. Svejme OH, Ahlborg HG, Nilsson JA, Karlsson MK. Early menopause and risk of osteoporosis, fracture and mortality: a 34 year prospective observational study in 390 women. BJOG. 2012;119: 810-816.
18. Ho SC, Chen YM, Woo JL. Educational level and osteoporosis risk in postmenopausal Chinese women. Am J Epidemiol. 2005; 161: 680-690.
19. Demir B, Haberal A, Geyik P, et al. Identification of the risk factors for osteoporosis among postmenopausal women. Maturitas. 2008;60: 253–256.
20. Kaya N, Bölükbaş N, Atıcı İ, Demetgül M. Kadınların yaşam tarzı değişkenleri ile osteoporoz arasındaki ilişki. Aile ve Toplum. 2003;6(6).
21.Turan V. Grand-grand multiparity (more than 10 deliveries) does not convey a risk for osteoporosis. Acta Obstet Gynecol Scand. 2011;90: 1440-1442.
22. Streeten EA, Ryan KA, McBride DJ, Pollini TI, Shuldiner AR, Mitchell BD. The relationship between parity and bone mineral density in women characterized by a homogeneous lifestyle and high parity. J Clin Endocrinol Metab. 2005;90: 4536-4541.
23. Nieves J. Calcium and vitamin D. In In Managing Osteoporosis, edited by T O’Neill, R Morris, D Skeleton and A Sutcliffe SA Lanham-New. Oxford: Clinical Publishing, 2007;21-33.
24. Eskiyurt N. Osteoporozda Beslenme.Osteoporoz, Modern Tıp Serileri Vol 19, 2001; 224-233.
25. Fidan F, Alkan BM, Tosun A. Çağın Pandemisi: D vitamini eksikliği ve yetersizliği. Türk Osteoporoz Dergisi. 2014;20:71-74.
26. Korugan Ü. Menopozda Beslenme. In Menopoz ve Osteoporoz. Seyisoğlu H, Ertüngealp E Editörler. İstanbul, 2000; 343-345.
27. Lanham-New SA. Importance of calcium, vitamin D and vitamin K for osteoporosis prevention and treatment. Proc Nutr Soc. 2008;67:163-176.
28. DRI. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Consensus study report, Institue of Medicine, Washington DC, 1997.
29. Bailey RL, Dodd KW, Goldman JA, Gahche JJ, Dwyer JT, Moshfegh AJ, et al. Estimation of total usual calcium and vitamin D intakes in the United States. J. Nutr. 2010;140(4):817-822.
30. Lorentzon M, Mellstrom D & Ohlsson C. Age of attainment of peak bone mass is site specific in Swedish men – The GOOD study. Bone Miner Res. 2005;20: 1223–1227.
31. FDA(Food and Drug Administration). Title 21: Food and Drugs Part 101 Food Labeling. Specific Requirements for Healthy Claims: Calcium and Osteoporosis. 2008. [Erişim 25 Kasım 2021]. https://www.ecfr.gov/current/title-21/chapter-I/subchapter-B/part-101.
32. Hirani V, et al. Low Levels of 25-hydroxy Vitamin D Independently Associated with Type 2 Diabetes Mellitus in Older Australian Men: The Concord Health and Ageing in Men Project. J Am Geriatr Soc. 2014;62: 417.
33. McCarty CA. Sunlight exposure assessment:can we accurately assess vitamin D exposure from sunlight questionnaires? Am J Clin Nutr. 2008;87: 1097-1101.
34. Boonen S, Rizzoli R, Meunier PJ, Stone M, Nuki G, Syversen U, et al. The need for clinical guidance in the use of calcium and vitamin D in the management of osteoporosis: a consensus report. Osteoporos Int. 2004;15: 511-519.
35. Khan A, Fortier M, Reid R, Abramson BL, Blake J, Desindes S, Wolfman W, et al. Osteoporosis in menopause. Journal of Obstetrics and Gynaecology Canada. 2014;36(9): 839-840.
36. Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster JY, Borgstrom F, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2008;19:399-428.
37. Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK, et al. Pharmacologic treatment of low bone density or osteoporosis to prevent fractures: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008;149: 404-415.
38. Avenell A, Gillespie WJ, Gillespie LD, O’Connell DL. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database Syst Reviews. 2005;3.
39. Meunier P. Prevention of hip fractures by correct- ing calcium and vitamin D insufficiencies in elderly people. Scand J Rheumatol Suppl. 1996;103: 75-78.
40. Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, et al, and Women’s Health Initiative Investigators. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006;354: 669–683.
41. Chapuy MC, Arlot ME, Duboeuf F, Meunier PJ. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med. 1992;327:1637-1642.
42. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, et al. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ. 2009;339.
43. Ireland P, Fordtran JS. Effect of dietary calcium and age on jejunal calcium absorption in humans studied by intestinal perfusion. J Clin Invest. 1973;52:2672-2682.
44. Rizzoli R, Boonen S, Brandi ML, et al. The role of calcium and vitamin D in the management of osteoporosis. Bone. 2008;42:246-249.
45. Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Report Brief, Washington DC, 2010.
46. Brown JP, Josse RG. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ. 2002;167:1-34.

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Details

Primary Language	Turkish
Subjects	Health Care Administration
Journal Section	Review
Authors	Ayşenur Özünal 0000-0001-6122-7119 Nural Erzurum Alim 0000-0001-9931-0639
Publication Date	February 2, 2022
Submission Date	November 26, 2021
Published in Issue	Year 2022 Volume: 3 Issue: 1

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Vancouver	Özünal A, Erzurum Alim N. Menopozal Dönemde Görülen Osteoporozda Kalsiyum ve D Vitaminin Rolü. TJHR. 2022;3(1):46-55.

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