The effect of serum vitamin D level and bone mineral density on balance and the risk of falling in postmenopausal women

Yıl 2013, Cilt: 40 Sayı: 3, 391 - 395, 01.09.2013

Ayşegül Küçükali Türkyılmaz Emine Eda Kurt Gül Devrimsel

https://doi.org/10.5798/diclemedj.0921.2013.03.0295

Cited By: 2

Öz

Objective: The aim of this study was to investigate the effect of bone mineral density and vitamin D level on the risk of falling and balance in postmenopausal women. Methods: The age ranged from 44 to 67 (57.25±7.27) years, 133 postmenopausal women were enrolled. Age, height, weight, socio-demographic information, history of falling and fracture in last year, risk factors for osteoporosis, and menopause duration were recorded. Serum 25OHD3 level and bone mineral density (BMD) of participants were measured. Postural balance function and the risk of falling were evaluated by time-up and go test (TUG), and Berg balance scale (BBS). Patients were divided into 4 groups; group 1: low vitamin D and osteoporosis, group 2: only low vitamin D, group 3: only osteoporotic, group 4: normal. Results: There was significant difference between the groups according to TUG (p

Anahtar Kelimeler

Vitamin D, bone mineral density, balance, risk of falling

Postmenopozal kadınlarda serum vitamin D düzeyi ve kemik mineral yoğunluğunun denge ve düşme riski üzerine etkisi

Öz

Amaç: Bu çalışmanın amacı postmenopozal kadınlarda kemik mineral yoğunluğu ve vitamin D düzeyinin birlikte ve ayrı ayrı denge ve düşme riski üzerine etkisini araştırmaktır. Yöntemler: Çalışmaya yaşları 44 ile 67 (57,25 ± 7,27) yıl arasında değişen 133 postmenopozal kadın alındı. Olguların yaş, boy uzunluğu, vücut ağırlığı, sosyodemografik bilgileri, son bir yıldaki düşme ve kırık öyküleri, osteoporoz risk faktörleri, menopoz süresi sorgulandı. Olguların serum 25OHD3 düzeyi ve kemik mineral yoğunluğu (KMY) ölçüldü. Hastaların postural denge fonksiyonu zamanlı ayağa kalk ve yürü testi (ZAYT) ile, düşme riski ise Berg denge skalası (BDS) ile değerlendirildi. Olgular 4 gruba ayrıldı; grup 1: vitamin D düzeyi düşük ve osteoporotik, grup 2: yalnızca vitamin D düzeyi düşük, grup 3: yalnızca osteoporotik, grup 4: normal. Bulgular: ZAYT\'e göre gruplar arasında anlamlı farklılık saptandı (p

Anahtar Kelimeler

Vitamin D, kemik mineral yoğunluğu, denge, düşme riski

Kaynakça

• Hirani V, Primatesta P. Vitamin D. concentrations among people aged 65 years and over living in private households and institutions in England: population survey. Age Ageing 2005;34:485-491.
• Holick MF. Environmental factors that influence the cutane- ous production of vitamin D. Am J Clin Nutr 1995;61:638- 645.
• Kellog International Work Group on the prevention of falls by elderly: The prevention of falls in later life. Dan Med Bull 1987;34:1-24.
• Skelton DA, Kennedy J, Rutherford OM. Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65. Age Ageing 2002;31:119- 125.
• Günendi Z, Demirsoy N. Postmenopozal osteoporozlu kadınlarda postural stabilitenin klinik ve bilgisayarlı stabi- lometrik değerlendirilmesi. Türk Fiz Tıp Rehabil Derg 2007;53:130-133.
• Cooper C, Barker DJP, Wickham C. Physical activity, muscle strength, and calcium intake in fracture of the proximal fe- mur in Britain. Br Med J 1988;297:1443-1446.
• Sinaki M, Offord KP. Physical activity in postmenopausal women:effect on back muscle strength and bone mineral density of the spine. Arch Phys Med Rehabil 1988;69:277- 280.
• Nguyen T, Sambrook P, Kelly P, et al. Prediction of osteopo- rotic fractures by postural instability and bone density. BMJ 1993;307:1111-1115.
• Shepherd JE. Effects of estrogen on cognition, mood, and de- generative brain disease. J Am Pharm Assoc 2001;41:221- 228.
• Lord SR, McLean D, Stathers G. Physiological factors as- sociated with injurious falls in older people living in the community. Gerontology 1992;38:338-346.
• Pfeifer M, Begerow B, Minne HW, et al. Vitamin D sta- tus, trunk muscle strength, body sway, falls, and fractures among 237 postmenopausal women with osteoporosis. Exp Clin Endocrinol Diabetes 2001;109:87-92.
• Allali F, Aichaoui S, Khazani H, et al. High prevalence of hypovitaminosis D in Morocco: Relationship to lifestyle, physical performance, bone markers, and bone mineral density. Semin Arthritis Rheum 2009;38:444-451.
• Dhesi JK, Bearne L, Moniz C, et al. Neuromuscular and psychomotor function in elderly people who fall and the relationship with vitamin D status. J Bone Mineral Res 2002;17:891-897.
• Lindsay R, James EL, Kippen S. The Timed Up and Go Test: unable to predict falls on the acute medical ward. Aust J Physiother 2004;50:249-251.
• Yelnik A, Bonan I. Clinical tools for assessing balance dis- orders. Neurophysiol Clin 2008;38:439-445.
• Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dau- phinee SL. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil 1992;73:1073-1080.
• Asikainen TM, Kukkonen-Herjula K, Miilunpala S. Ex- ercise for health for early postmenopausal women: a sys- tematic review of randomised controlled trials. Sports Med 2004;34:753-778.
• Peacock M. Effects of calcium and vitamin D insufficiency on the skeleton. Osteoporos Int 1998;8(suppl 2):45-51.
• Bischoff HA, Stahelin HB, Urscheler N, et al. Muscle strength in the elderly: its relation to vitamin D metabolites. Arch Phys Med Rehab 1999;80:54-58.
• Gunendi Z, Ozyemisci Taskiran Ö, Demirsoy N. The effect of 4-week aerobic exercise program on postural balance in postmenopausal women with osteoporosis. Rheumatol Int 2008;28:1217-1222.
• Dhesi JK, Jackson SH, Bearne LM, et al. Vitamin D supple- mentation improves neuromuscular function in older peo- ple who fall. Age Ageing 2004;33:589-595.
• Zamboni M, Zoico E, Tosoni P, et al. Relation between vita- min D, physical performance, and disability in elderly per- sons. J Gerontol A Biol Sci Med Sci 2002;57:7-11.
• Visser M, Deeg DJ, Lips P. Low vitamin D and high para- thyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): The Longitudi- nal Aging Study Amsterdam. J Clin Endocrinol Metab 2003;88:5766-5772.
• Laksmi PW, Setiati S, Oemardi M, et al. Correlation Be- tween Vitamin D Concentration and Basic Functional Mo- bility in Elderly Women. Acta Med Indones 2007;39:112- 118.
• Abreu DC. Trevisan DC, Costa GC, et al. The association between osteoporosis and static balance in elderly women. Osteoporos Int 2010; 21:1487–1491.
• Graafmans WC, Ooms ME, Hofstee HM, et al. Falls in the elderly. A prospective study of risk factors and risk profiles. Am J Epidemiol 1996;143:1129-1136.
• Corless D, Dawson E, Fraser F, et al. Do vitamin D supple- ments improve the physical capabilities of elderly hospital patients? Age Ageing 1985;14:76-84.
• Faulkner KA, Cauley JA, Zmuda JM, et al. Higher 1,25-di- hydroxyvitamin D3 concentrations associated with lower fall rates in older community dwelling women. Osteoporos Int 2006;17:1318-1328.
• Guler H, Turhanoğlu A, Ozer C. the effect of vitamin d sup- plementation on balance and quality of life in older women. Turkish Journal of Geriatrics 2008;11:57-61.
• Mowe M, Haug E, Bohmer T. Low serum calcidiol con- centration in older adults with reduced muscular function. J Am Geriatr Soc 1999;47:220-226.
• Shahar D, Levi M, Kurtz I, et al. Nutritional status in re- lation to balance and falls in the elderly. Ann Nutr Metab 2009;54:59-66.
• Latham NK, Anderson CS, Reid IR. Effects of vitamin D supplementation on strength, physical performance, and falls in older persons: a systematic review. J Am Geriatr Soc 2003;51:1219-1226.
• Latham NK, Anderson CS, Lee A, et al. A randomized con- trolled trial of resistance exercises and vitamin D in hospi- talized frail elderly: The Frailty Interventions Trial in El- derly Subjects (FITNESS). J Am Geriatr Soc 2003;51:291- 299.
• Lynn SG, Sinaki M, Westerlind KC. Balance characteris- tics of persons with osteoporosis. Arch Phys Med Rehabil 1997;78:273-277.
• SinakiM, Brey RHHughes CA, Larson DR, Kaufman KR. Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporos Int 2005;16:1004-1010.