Menopozun Proksimal Femur Açı Parametrelerine Etkisi Üzerine Radyografik Bir Çalışma

Yıl 2021, , 259 - 264, 27.09.2021

Seda Sertel Meyvacı , Yasin Emre Kaya

https://doi.org/10.21673/anadoluklin.846959

Öz

Amaç: Bu çalışmada menopozun pelvik anteroposteriyor radyografi parametrelerinden femur inklinasyon açısı (FİA) ve femur Alsberg açısı (FAA) üzerindeki etkisini incelemek amaçlanmıştır.
Yöntem: Ekim 2019—Haziran 2020 döneminde ortopedi ve travmatoloji kliniğimize gelen ve anteroposteriyor pelvik röntgeni çekilen menopozlu (menopoz grubu) ve düzenli menstrüel sikluslu (kontrol grubu) toplam 133 kadına ait FİA ve FAA verileri retrospektif olarak incelendi.
Bulgular: Menopoz ve kontrol grupları arasında yaş (p<0,001), sağ FAA değeri (p<0,001) ve de sağ ve sol FİA değerleri (sırasıyla p<0,001 ve p=0,026) bakımından istatistiksel olarak anlamlı farklılık vardı. Sadece sol FAA değerleri iki grup arasında anlamlı farklılık göstermedi (p=0,446). Tüm parametre ölçümleri menopoz grubunda daha yüksekti.
Sonuç: Menopozlu kadınlarda FİA ve FAA değerlerinin daha yüksek olması menopozun ileriki yaşlarda ortaya çıkmasına ve yaşam tarzında değişikliklere neden olmasına bağlanabilir. Kemik morfometrisine dair çalışmalarda kemik yapı ve metabolizmasını çeşitli şekillerde etkileyebilecek olan menopoz varlığının da dikkate alınmasını tavsiye etmekteyiz.

Anahtar Kelimeler

Alsberg açısı, inklinasyon açısı, menopoz durumu, proksimal femur, radyografi

A Radiographic Study on the Effect of Menopause on Proximal Femoral Angle Parameters

Öz

Aim: In this study we aimed to investigate the effects of menopause on the femoral inclination angle (FIA) and femoral Alsberg angle (FAA) parameters in pelvic anteroposterior radiography.
Methods: The FIA and FAA data were retrospectively reviewed in a total of 133 female subjects with natural menopause (the menopause group) and regular menstrual cycles (the control group) who were admitted to our orthopedics and traumatology clinic and underwent anteroposterior pelvic X-ray examination between October 2019 and June 2020.
Results: There was a statistically significant difference between the menopause and control groups in terms of age (p<0.001), right-side FAA values (p<0.001), and right- and left-side FIA values (p<0.001 and p=0.026, respectively). Only the left-side FAA values did not differ significantly between the groups (p=0.446). All parameter measurements were higher in the menopause group.
Conclusion: The finding that the FIA and FAA values were higher in the menopause group could be attributed to the fact that menopause occurs in the later decades of life and brings along changes in lifestyle. We recommend that the presence of menopause as a factor that can affect bone structure and metabolism in various ways should also be considered in studies on bone morphometry.

Anahtar Kelimeler

Alsberg angle, inclination angle, menopause status, proximal femur, radiography

Kaynakça

• Nusrat N, Nishat Z, Gulfareen H, Aftab M, Asia N. Knowledge, attitude and experience of menopause. J Ayub Med Coll Abbottabad. 2008;20(1):56–9.
• Ko SH, Kim HS. Menopause-associated lipid metabolic disorders and foods beneficial for postmenopausal women. Nutrients. 2020;12(1):202.
• Marchand GB, Carreau AM, Weisnagel SJ, Bergeron J, Labrie F, Lemieux S, et al. Increased body fat mass explains the positive association between circulating estradiol and insulin resistance in postmenopausal women. Am J Physiol Endocrinol Metab. 2018;314(5):E448–56.
• Wildman RP, Tepper PG, Crawford S, Finkelstein JS, Sutton-Tyrrell K, Thurston RC, et al. Do changes in sex steroid hormones precede or follow increases in body weight during the menopause transition? Results from the study of women’s health across the nation. J Clin Endocrinol Metab. 2012;97(9):E1695–704.
• Liedtke S, Schmidt ME, Vrieling A, Lukanova A, Becker S, Kaaks R, et al. Postmenopausal sex hormones in relation to body fat distribution. Obesity. 2012;20(5):1088–95.
• Stefanska A, Bergmann K, Sypniewska G. Metabolic syndrome and menopause: pathophysiology, clinical and diagnostic significance. Adv Clin Chem. 2015;72:1–75.
• Lazzer S, Bedogni G, Lafortuna CL, Marazzi N, Busti C, Galli R, et al. Relationship between basal metabolic rate, gender, age, and body composition in 8,780 white obese subjects. Obesity. 2010;18(1):71–8.
• Dubé MC, Lemieux S, Piché ME, Corneau L, Bergeron J, Riou ME, et al. The contribution of visceral adiposity and mid-thigh fat-rich muscle to the metabolic profile in postmenopausal women. Obesity. 2011;19(5):953–9.
• Wee J, Sng BYJ, Shen L, Lim CT, Singh G, De SD. The relationship between body mass index and physical activity levels in relation to bone mineral density in premenopausal and postmenopausal women. Arch Osteoporos. 2013;8(1):1–8.
• Sipilä S, Törmäkangas T, Sillanpää E, Aukee P, Kujala UM, Kovanen V, et al. Muscle and bone mass in middle-aged women: role of menopausal status and physical activity. J Cachexia Sarcopenia Muscle. 2020;11(3):698–709.
• Barron RL, Oster G, Grauer A, Crittenden DB, Weycker D. Determinants of imminent fracture risk in postmenopausal women with osteoporosis. Osteoporos Int. 2020;31(11):2103–11.
• Zhuang HF, Wang PW, Li YZ, Lin JK, Yao XD, Xu H. Analysis of related factors of brittle hip fracture in postmenopausal women with osteoporosis. Orthop Surg. 2020;12(1):194–8.
• Sertel Meyvaci S, Bamaç B, Duran B, Çolak T, Memişoğlu K. Effect of surgical and natural menopause on proximal femur morphometry in obese women. Ann Anat. 2020;227:151416.
• Lee DH, Jung KY, Hong AR, Kim JH, Kim KM, Shin CS, et al. Femoral geometry, bone mineral density, and the risk of hip fracture in premenopausal women: a case control study. BMC Musculoskelet Disord. 2016;17(1):1–6.
• Gnudi S, Sitta E, Fiumi N. Bone density and geometry in assessing hip fracture risk in postmenopausal women. Br J Radiol. 2007;80:893–7.
• Heep H, Xu J, Löchteken C, Wedemeyer C. A simple and convenient method guide to determine the magnification of digital X-rays for preoperative planning in total hip arthroplasty. Orthop Rev. 2012;4(1):e12.
• Cervellati C, Bergamini CM. Oxidative damage and the pathogenesis of menopause related disturbances and diseases. Clin Chem Lab Med. 2016;54(5):739–53.
• Kisakol G, Kaya A, Gonen S, Tunc R. Bone and calcium metabolism in subclinical autoimmune hyperthyroidism and hypothyroidism. Endocr J. 2003;50(6):657–61.
• Kim KM, Brown JK, Kim KJ, Choi HS, Kim HN, Rhee Y, et al. Differences in femoral neck geometry associated with age and ethnicity. Osteoporos Int. 2011;22:2165–74.
• Dinçel VE, Şengelen M, Sepici V, Çavuşoǧlu T, Sepici B. The association of proximal femur geometry with hip fracture risk. Clin Anat. 2008;21:575–80.
• Shieh A, Ishii S, Greendale GA, Cauley JA, Karvonen-Gutierrez C, Karlamangla AS. A bone resorption marker as predictor of rate of change in femoral neck size and strength during the menopause transition. Osteoporos Int. 2019;30(12):2449–57.
• Gnudi S, Sitta E, Pignotti E. Prediction of incident hip fracture by femoral neck bone mineral density and neck-shaft angle: a 5-year longitudinal study in post-menopausal females. Br J Radiol. 2012;85:467–73.
• Farinelli L, Baldini M, Bucci A, Ulisse S, Carle F, Gigante A. Axial and rotational alignment of lower limb in a Caucasian aged non-arthritic cohort. Eur J Orthop Surg Traumatol. 2021;31(2):221–8.
• Costa SMB, Feltran GS, Namba V, Silva TM, Hallur RLS, Saraiva PP, et al. Infraphysiological 17β-estradiol (E2) concentration compromises osteoblast differentiation through Src stimulation of cell proliferation and ECM remodeling stimulus. Mol Cell Endocrinol. 2020;518:111027.
• Nicks KM, Perrien DS, Akel NS, Suva LJ, Gaddy D. Regulation of osteoblastogenesis and osteoclastogenesis by the other reproductive hormones, activin and inhibin. Mol Cell Endocrinol. 2009;310(1–2):11–20.
• Weitzmann MN, Pacifici R. Estrogen deficiency and bone loss: an inflammatory tale. J Clin Invest. 2006;116(5):1186–94.