Evaluation Of Gynecological Risk Factors In Osteoporosis

Yıl 2014, Cilt: 47 Sayı: 1, 11 - 15, 21.08.2014

Öznur Uzun Kurtuluş Köklü Sumru Özel Alize Yılmaz Şahin Sibel Ünsal Delialioğlu Fazıl Kulaklı

https://doi.org/10.5505/aot.2014.43153

Öz

OBJECTIVE: To evaluate gynecological risk factors in patients with and without osteoporosis who are older than 50 years of age.
METHODS: One hundred and twenty seven patients with postmenopausal-senile osteoporosis and 53 non-osteoporotic volunteers were included. The subjects were examined in terms of age, body mass index (BMI), risk factors like age at menarche, age at menopause, number of births, numbers of miscarriage and curettage, and history of breast-feeding,
RESULTS: The mean age was statistically higher and the mean BMI level was statistically lower in patients (p<0,05). The mean menopause age was significantly lower, and the breast-feeding period equal or more than 12 months was significantly higher in patients (p<0,05). The mean age at menopause in the patient group was significantly lower (p<0,05). However, there was no difference between the patient and the control groups in terms of age at menarche, number of births, numbers of miscarriage and curettage (p>0,05). Hundred out of 117 patients (85.5%) breastfed equal or more than 12 months; 34 out of 51 volunteers (66.7%) breastfed equal or more than 12 months. This difference was found to be significant (p<0.05).
CONCLUSION: Finding the gynecological risk factors leading to osteoporosis, taking necessary precautions, and increasing the consciousness can decrease the morbidity and mortality ratios of fractures.

Anahtar Kelimeler

Osteoporosis, Menopause; Menarche

Osteoporozda Jinekolojik Risk Faktörlerinin Değerlendirilmesi

Öz

AMAÇ: Bu çalışmada 50 yaş üzeri osteoporozu olan ve olmayan olgularda osteoporoz için jinekolojik risk faktörlerini değerlendirmek amaçlanmıştır.
YÖNTEMLER: Çalışmaya postmenopozal-senil osteoporoz tanısı alan 127 hasta ve 53 osteoporozu olmayan gönüllü alındı. Katılımcılar yaş, vücut kitle indeksi (VKİ), menarş yaşı, menopoz yaşı, doğum sayısı, düşük-küretaj sayısı, emzirme hikayesi gibi jinekolojik risk faktörleri açısından sorgulandı.
BULGULAR: Hastaların yaş ortalaması kontrollere göre daha yüksek, VKİ değerleri daha düşüktü (p<0,05). Menopoza girme yaşı hastalarda daha düşük, 12 ay ve üzeri emzirme oranı ise daha yüksekti (p<0,05). Hasta grubunun menapoz yaş ortalaması kontrol grubundan anlamlı olarak düşük bulundu (p<0,05). Bununla birlikte hasta ve kontrol grupları arasında menarş yaşı, doğum sayısı, düşük-küretaj sayıları açısından anlamlı bir fark saptanmadı (p>0,05). Hasta grubunda emziren 117 katılımcının 100’ü (%85.5), kontrol grubunda emziren 51 katılımcının ise 34’ü (%66.7) 12 ay ve üzeri sürede emzirmişti, istatistiksel olarak bu fark anlamlı bulundu (p<0,05).
SONUÇ: Osteoporoz için jinekolojik risk faktörlerinin belirlenmesi, gerekli önlemlerin alınması ve bu konudaki bilincin artırılması ile osteoporoz nedeniyle oluşabilecek kırıklardan doğan mortalite ve morbidite oranları azaltılabilir.

Anahtar Kelimeler

Osteoporoz, Menopoz; Menarş

Kaynakça

• Sarıdoğan ME. Metabolik Kemik Hastalıkları. In: Oğuz H, Dursun, E., Dursun, N., ed. Tıbbi Rehabilitasyon; 2004:1199-220.
• Bailey K, Combs MC, Rogers LJ, Stanley KL. Measuring up. Could this simple nursing intervention help prevent osteoporosis? AWHONN Lifelines 2000;4:41-4.
• Sedlak CA, Doheny MO, Jones SL. Osteoporosis education programs: changing knowledge and behaviors. Public Health Nurs 2000;17:398-402.
• Reeder S, Martin, LL. Maternity Nursing, Family Newborn and Women's Health Care. In: Philedelphia JB, ed. Promoting Gynecological Health; 1987:1137-9.
• Eroğlu K, Karaöz, S, Akkuzu G. Osteoporoz için risk faktörleri ve önlenmesi. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 1997;4:23-7.
• Hammond C. Klimakterik Dönem. In: Scott J, Disata PJ, Hammond CB ed. Danfort Obstetrik ve Jinekoloji Çeviri Ed: S Erez. 7. baskı; 1994.
• Kutsal Y. In: Arasıl T, ed. Fiziksel Tıp ve Rehabilitasyonda Yeni Ufuklar Osteoporoz; 2010.
• Shoback D. Osteoporoz ve Glukokortikoidlerin Yol Açtığı Osteoporoz. In: Imboden J, Hellman D, Stone J, eds. Current Romatoloji Tanı ve Tedavi (1 Baskı): İstanbul Güneş Kitabevi; 2006:401-15.
• 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.
• Kanis JA, Pitt FA. Epidemiology of osteoporosis. Bone 1992;13 Suppl 1:S7-15.
• El Maghraoui A, Guerboub AA, Mounach A, Ghozlani I, Nouijai A, Ghazi M, et al. Body mass index and gynecological factors as determinants of bone mass in healthy Moroccan women. Maturitas 2007;56:375-82.
• Yazici S, Korkmaz U, Erkan M, Korkmaz N, Erdem Baki A, Alçelik A, et al. The effect of breast-feeding duration on bone mineral density in postmenopausal Turkish women: a population-based study. Arch Med Sci 2011;7:486-92.
• Ozdemir F, Demirbag D, Rodoplu M. Reproductive factors affecting the bone mineral density in postmenopausal women. Tohoku J Exp Med 2005;205:277-85.
• Li S, He H, Ding M, He C. The correlation of osteoporosis to clinical features: a study of 4382 female cases of a hospital cohort with musculoskeletal symptoms in southwest China. BMC Musculoskelet Disord 2010;11:183.
• Cunha-Henriques S, Costa-Paiva L, Pinto-Neto AM, Fonsechi-Carvesan G, Nanni L, Morais SS. Postmenopausal women with osteoporosis and musculoskeletal status: a comparative crosssectional study. J Clin Med Res 2011;3:168-76.
• Hassa H, Tanir HM, Senses T, Oge T, Sahin-Mutlu F. Related factors in bone mineral density of lumbal and femur in natural postmenopausal women. Arch Gynecol Obstet 2005;273:86-9.
• Baczyk G, Opala T, Kleka P, Chuchracki M. Multifactorial analysis of risk factors for reduced bone mineral density among postmenopausal women. Arch Med Sci 2012;8:332-41.
• Sioka C, Fotopoulos A, Georgiou A, Xourgia X, Papadopoulos A, Kalef-Ezra JA. Age at menarche, age at menopause and duration of fertility as risk factors for osteoporosis. Climacteric 2010;13:63-71.
• Kritz-Silverstein D, Barrett-Connor E. Early menopause, number of reproductive years, and bone mineral density in postmenopausal women. Am J Public Health 1993;83:983-8.
• Ho AY, Kung AW. Determinants of peak bone mineral density and bone area in young women. J Bone Miner Metab 2005;23:470-5.
• Paton LM, Alexander JL, Nowson CA, Margerison C, Frame MG, Kaymakci B, et al. Pregnancy and lactation have no long-term deleterious effect on measures of bone mineral in healthy women: a twin study. Am J Clin Nutr 2003;77:707-14.
• Khoo CC, Woo J, Leung PC, Kwok A, Kwok T. Determinants of bone mineral density in older postmenopausal Chinese women. Climacteric 2011;14:378-83.
• 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.