Menopoz Sonrası Kadınlarda Osteoporoz Riskini Değerlendirmede Antropometrik Ölçümlerin Etkisi

Yıl 2024, Cilt: 6 Sayı: 3, 93 - 99, 26.09.2024

Büşra Körpe , Caner Kose , Samet Kutluay Ergörün , Sümeyye Mermi , Hüseyin Levent Keskin

https://doi.org/10.46969/EZH.1522869

Öz

Amaç: Bu çalışma, Vücut Kitle İndeksi (VKİ), Bel-Kalça Oranı (WHR), Bel-Yükseklik Oranı (WHtR), Konisite İndeksi (CI) ve Visceral Adipozite İndeksi (VAI) gibi çeşitli antropometrik ölçümlerin postmenopozal kadınlarda osteoporoz ile ilişkisini değerlendirmektedir.
Gereç ve Yöntem: Bu kesitsel çalışmaya, 45-75 yaş arası 304 postmenopozal kadın katılmıştır. Kemik Mineral Yoğunluğu (KMD), İkili Enerji X-Işını Absorpsiyometrisi (DEXA) kullanılarak değerlendirilmiştir. Antropometrik ölçümler (ağırlık, boy, bel çevresi, kalça çevresi) kaydedilmiş ve indeksler (VKI, WHR, WHtR, CI, VAI) hesaplanmıştır. Demografik ve tıbbi veriler toplanmıştır.
Bulgular: VKİ, lomber omurga (β = 0.503, p = 0.001) ve femoral boyun T-skorları (β = 0.413, p = 0.004) ile pozitif ilişki göstermiştir. WHR (β = 0.256, p = 0.002) KMD ile pozitif ilişkilidir, CI (β = -0.455, p = 0.001) ise femoral boyun T-skorları ile negatif korelasyona sahiptir. ROC eğrisi analizleri, düşük VKİ ve WHtR değerlerinin osteoporozu öngördüğünü, VKİ’nin en güçlü öngörücü olduğunu göstermiştir. VAI, osteoporoz risk kategorilerini anlamlı şekilde ayırt edememiştir (p > 0.05).
Sonuç: CI, WHR ve WHtR gibi antropometrik indeksler, VKİ ile birlikte kullanıldığında postmenopozal kadınlarda osteoporoz riskinin değerlendirilmesini artırmaktadır. Bu ölçümlerin klinik pratiğe entegrasyonu, osteoporoz tarama ve yönetimini özellikle çeşitli vücut kompozisyonlarına sahip popülasyonlarda iyileştirebilir.

Anahtar Kelimeler

Osteoporoz, postmenopoz, vücut yağ dağılımı, antropometrik ölçümler, vücut kitle indeksi

Etik Beyan

Ethics committee approval: The study design was approved by the instutional research ethics committee (AEŞH-BADEK-2024-020).

Destekleyen Kurum

None

Teşekkür

None

Assessing the Impact of Anthropometric Measurements on Osteoporosis Risk in Postmenopausal Women

Öz

Aim: This study evaluates various anthropometric measurements, including BMI, Waist-to-Hip Ratio (WHR), Waist-to-Height Ratio (WHtR), Conicity Index (C-index), and Visceral Adiposity Index (VAI), to determine their association with osteoporosis in postmenopausal women.
Material and Method: In this cross-sectional study, 304 postmenopausal women aged 45-75 years from a gynecology and menopause clinic participated. Dual-Energy X-ray Absorptiometry (DEXA) was used to assess Bone Mineral Density (BMD). Anthropometric measurements (waist circumference, hip circumference) were recorded, and indices (BMI, WHR, WHtR, C-index, VAI) were calculated. Demographic and medical histories were collected through questionnaires.
Results: BMI showed a positive association with lumbar spine (β = 0.503, p = 0.001) and femoral neck T-scores (β = 0.413, p = 0.004). WHR (β = 0.256, p = 0.002) was positively associated with BMD, while C-index (β = -0.455, p = 0.001) was negatively correlated with femoral neck T-scores. Lower BMI and WHtR values were found predictive for osteoporosis according to the ROC curve analysis. While BMI was found as the strongest predictor, VAI did not significantly differentiate between groups (p > 0.05).
Conclusion: For assessment of osteoporosis risk in postmenopausal women; anthropometric indices like CI, WHR, and WHtR may be combined with BMI. In populations with different body compositions, these measures in clinical practice can improve osteoporosis screening and management.

Anahtar Kelimeler

Osteoporosis, Postmenopausal Women, Body Fat Distribution, Anthropometric Indices, Body Mass Index (BMI)

Kaynakça

• Kose C, Korpe B, Ibanoglu M, Sahin B, Engin Ustun Y. Controlling Nutritional Status score and postmenopausal osteoporosis. Menopause. 2023;30(5):539-544. https://doi.org/10.1097/GME.0000000000002175
• Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res. 1994;9(8):1137-41. https://doi.org/10.1002/jbmr.5650090802
• Chen R, Armamento-Villareal R. Obesity and Skeletal Fragility. J Clin Endocrinol Metab. 2024;109(2):e466-e477. https://doi.org/10.1210/clinem/dgad415
• Jensen VFH, Mølck AM, Dalgaard M, McGuigan FE, Akesson KE. Changes in bone mass associated with obesity and weight loss in humans: Applicability of animal models. Bone. 2021;145:115781. https://doi.org/10.1016/j.bone.2020.115781
• Palermo A, Tuccinardi D, Defeudis G, et al. BMI and BMD: The Potential Interplay between Obesity and Bone Fragility. Int J Environ Res Public Health. 2016;13(6):544. https://doi.org/10.3390/ijerph13060544
• National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board; Roundtable on Obesity Solutions, Callahan EA, editors. Translating Knowledge of Foundational Drivers of Obesity into Practice: Proceedings of a Workshop Series. Washington (DC): National Academies Press (US); July 31, 2023.
• Zierle-Ghosh A, Jan A. Physiology, Body Mass Index. In: StatPearls. Treasure Island (FL): StatPearls Publishing; November 5, 2023.
• Kawai M, de Paula FJ, Rosen CJ. New insights into osteoporosis: the bone-fat connection. J Intern Med. 2012;272(4):317-29. https://doi.org/10.1111/j.1365-2796.2012.02564.x
• Piqueras P, Ballester A, Durá-Gil JV, Martinez-Hervas S, Redón J, Real JT. Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review. Front Psychol. 2021;12:631179. https://doi.org/10.3389/fpsyg.2021.631179
• Akpinar E, Bashan I, Bozdemir N, Saatci E. Which is the best anthropometric technique to identify obesity: body mass index, waist circumference or waist-hip ratio? Coll Antropol. 2007;31(2):387-93.
• Hewage N, Wijesekara U, Perera R. Determining the best method for evaluating obesity and the risk for non-communicable diseases in women of childbearing age by measuring the body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio, A Body Shape Index, and hip index. Nutrition. 2023;114:112135. https://doi.org/10.1016/j.nut.2023.112135
• Valdez R. A simple model-based index of abdominal adiposity. J Clin Epidemiol. 1991;44(9):955-6. https://doi.org/10.1016/0895-4356(91)90059-i
• Amato MC, Giordano C, Galia M, et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33(4):920-2. https://doi.org/10.2337/dc09-1825
• Fan J, Jiang Y, Qiang J, Han B, Zhang Q. Associations of Fat Mass and Fat Distribution With Bone Mineral Density in Non-Obese Postmenopausal Chinese Women Over 60 Years Old. Front Endocrinol (Lausanne). 2022;13:829867. https://doi.org/10.3389/fendo.2022.829867
• Yaman A, Özdemir O, Gök Ş, Karahan S, Kutsal YG. Evaluation of the Relationships Between Bone Mineral Density and Anthropometric Measurements in Women with Postmenopausal Osteoporosis. Turk J Osteoporos. 2024;30(1):16-21. https://doi.org/10.4274/tod.galenos.2023.54036
• Murat S, Dogruoz Karatekin B, Demirdag F, Kolbasi EN. Anthropometric and Body Composition Measurements Related to Osteoporosis in Geriatric Population. Medeni Med J. 2021;36(4):294-301. https://doi.org/10.4274/MMJ.galenos.2021.32396
• Wang L, Ran L, Zha X, et al. Adjustment of DXA BMD measurements for anthropometric factors and its impact on the diagnosis of osteoporosis. Arch Osteoporos. 2020;15(1):155. https://doi.org/10.1007/s11657-020-00833-1
• Li L, Zhong H, Shao Y, Zhou X, Hua Y, Chen M. Association between lean body mass to visceral fat mass ratio and bone mineral density in United States population: a cross-sectional study. Arch Public Health. 2023;81(1):180. https://doi.org/10.1186/s13690-023-01190-4
• Sun A, Hu J, Wang S, Yin F, Liu Z. Association of the visceral adiposity index with femur bone mineral density and osteoporosis among the U.S. older adults from NHANES 2005-2020: a cross-sectional study. Front Endocrinol (Lausanne). 2023;14:1231527. https://doi.org/10.3389/fendo.2023.1231527