Bone Mineral Density and Frequency of Low-Trauma Fractures in Ukrainian Women with Metabolic Syndrome

Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

Abstract:

Osteoporosis is one of the important problems in postmenopausal women due to an increased risk of sudden and unexpected fractures. This study is aimed to determine the connection between bone mineral density (BMD) and trabecular bone score (TBS) in Ukrainian women suffering from metabolic syndrome. Participating in the study, 566 menopausal women aged 50-79 year-old were examined and divided into two groups: Group A included 336 women with no obesity (BMI ≤ 29.9 kg/m²), and Group B – 230 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). Dual-energy X-ray absorptiometry was used for measuring of lumbar spine (L1-L4), femoral neck, total body and forearm BMD and bone quality indexes (last according to Med-Imaps installation). Data were analyzed using Statistical Package 6.0. A significant increase of lumbar spine (L1-L4), femoral neck, total body and ultradistal radius BMD was found in women with metabolic syndrome compared to those without obesity (p < 0.001) both in their totality and in groups of 50-59 years, 60-69 years, and 70-79 years. TBS was significantly higher in non-obese women compared to metabolic syndrome patients of 50-59 years and in the general sample (p < 0.05). Analysis showed significant positive correlation between body mass index (BMI) and BMD at all levels. Significant negative correlation between BMI and TBS (L1-L4) was established. Despite the fact that BMD indexes were significantly higher in women with metabolic syndrome, the frequency of vertebral and non-vertebral fractures did not differ significantly in the groups of patients.

Keywords: Bone mineral density, trabecular bone score, metabolic syndrome, fracture.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1130149

References:

[1] Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. ‘Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women’, JAMA, 301:513–521, 2009; doi: 10.1001/jama.2009.50.
[2] Didier Hans, Andrew L Goertzen, Marc-Antoine Krieg, William D Leslie. “Bone Microarchitecture Assessed by TBS Predicts Osteoporotic Fractures Independent of Bone Density: The Manitoba Study”, Journal of Bone and Mineral Research, Vol. 26, No. 11, November 2011, pp 2762–2769/ DOI: 10.1002/jbmr.499.
[3] Gonelli S., Caffarelli C., Nuti R. “Obesity and fracture risk” Clin. Cases Miner. Bone Metab., Jan; 11 (1): 9-14, 2014.
[4] N.C. Harvey, C.C. Glüer, N. Binkley, et al. “Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice”, Bone. Sep; 78: 216–224, 2015; doi: 10.1016/j.bone.2015.05.016.
[5] International Diabetes Federation. Worldwide definition of the metabolic syndrome. Available at: http: //www.idf.org/web-data/docs/IDF Metasyndrome definition.pdf Accessed on August 24, 2005.
[6] Kan Sun; Jianmin Liu; Nan Lu; Hanxiao Sun; Guang Ning “Association between metabolic syndrome and bone fractures: a meta-analysis of observational studies,” BMC Endocr Disord.; 14(13), 2014, Published online 2014 Feb 9. doi 10.1186/1472-6823-14-13.
[7] El Maghraoui A1, Rezqi A, El Mrahi S, Sadni S, Ghozlani I, Mounach A. “Osteoporosis, vertebral fractures and metabolic syndrome in postmenopausal women n” BMC Endocr Disord., Dec 10;14:93, 2014; doi: 10.1186/1472-6823-14-93.
[8] Poiana C, Carsote M, Radoi V, Mihai A, Capatina C. “Prevalent osteoporotic fractures in 622 obese and non- obese menopausal women”, J Med Life, Oct-Dec; 8(4): 462–466, 2015.
[9] Povoroznyuk, N. Dzerovych, L. Martynyuk, T. Kovtun “Bone Mineral Density and Trabecular Bone Score in Ukrainian Women with Obesity”, International Journal of Medical, Health, Biomedical, Bioengineering and Pharmaceutical Engineering, Vol:9, No:5, 2015.
[10] Sun K, Liu J, Lu N, Sun H, Ning G. Association between metabolic syndrome and bone fractures: a meta-analysis of observational studies. BMC Endocr Disord. 2014 Feb 9; 14:13. doi: 10.1186/1472-6823-14-13.
[11] Susan M. Ott. “Bone strength: more just density”, Kidney International, 89; p.16-19, 2016.
[12] Yang L, Lv X, Wei D, Yue F, Guo J, Zhang T. “Metabolic syndrome and the risk of bone fractures: A Meta-analysis of prospective cohort studies”, Bone, Mar; 84:52-6, 2016; doi: 10.1016/j.bone.2015.12.008. Epub 2015 Dec 18.