Prof. Dr. Vladyslav Povoroznyuk

Committee: International Scientific Committee of Medical and Health Sciences
University: D. F. Chebotarev State Institute of Gerontology NAMS of Ukraine
Department: Department of Clinical Physiology and Pathology of Locomotor Apparatus
Research Fields: obesity, trabecular bone score, bone mineral density, women,

Publications

7 Age, Body Composition, Body Mass Index and Chronic Venous Diseases in Postmenopausal Women

Authors: Vladyslav Povoroznyuk, Grygorii Kostromin

Abstract:

Chronic venous diseases (CVD) are one of the common, though controversial problems in medicine. It is generally accepted that this pathology predominantly occurs in women. The issue of excessive weight as a risk factor for CVD is still considered debatable. To the author's best knowledge, today in Ukraine, there are barely any studies that describe the relationship between CVD and obesity. Our study aims to determine the association between age, body composition, obesity and CVD in postmenopausal women. The study was conducted in D. F. Chebotarev Institute of Gerontology, National Academy of Medical Sciences of Ukraine. We have examined 96 postmenopausal women aged 46-85 years (mean age – 66.19 ± 0.96 years), who were divided into two groups depending on the presence of CVD. The women were examined by vascular surgeons. For the diagnosis of CVD, we used clinical, anatomic and pathophysiologic classifications. We also performed clinical, ultrasound and densitometry examinations. We found that the CVD frequency in postmenopausal women increased with age (from 72% in those aged 45-59 years to 84% in those aged 75-89 years). A significant correlation between the total fat mass and age was determined in postmenopausal women with CVD. We also observed a significant correlation between the lower extremities’ fat mass and age in both examined groups. A significant correlation between body mass index and age was determined only in postmenopausal women without CVD.

Keywords: Obesity, age, Risk Factors, postmenopausal women, chronic venous disease

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6 Vitamin D Deficiency and Insufficiency in Postmenopausal Women with Obesity

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Oksana Ivanyk, Anna Musiienko, Roksolana Povoroznyuk

Abstract:

Deficiency and insufficiency of Vitamin D is a pandemic of the 21st century. Obesity patients have a lower level of vitamin D, but the literature data are contradictory. The purpose of this study is to investigate deficiency and insufficiency vitamin D in postmenopausal women with obesity. We examined 1007 women aged 50-89 years. Mean age was 65.74±8.61 years; mean height was 1.61±0.07 m; mean weight was 70.65±13.50 kg; mean body mass index was 27.27±4.86 kg/m2, and mean 25(OH) D levels in serum was 26.00±12.00 nmol/l. The women were divided into the following six groups depending on body mass index: I group – 338 women with normal body weight, II group – 16 women with insufficient body weight, III group – 382 women with excessive body weight, IV group – 199 women with obesity of class I, V group – 60 women with obesity of class II, and VI group – 12 women with obesity of class III. Level of 25(OH)D in serum was measured by means of an electrochemiluminescent method - Elecsys 2010 analyzer (Roche Diagnostics, Germany) and cobas test-systems. 34.4% of the examined women have deficiency of vitamin D and 31.4% insufficiency. Women with obesity of class I (23.60±10.24 ng/ml) and obese of class II (22.38±10.34 ng/ml) had significantly lower levels of 25 (OH) D compared to women with normal body weight (28.24±12.99 ng/ml), p=0.00003. In women with obesity, BMI significantly influences vitamin D level, and this influence does not depend on the season.

Keywords: Obesity, age, body mass index, postmenopausal women, vitamin D deficiency/insufficiency

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5 Associations between Metabolic Syndrome and Bone Mineral Density and Trabecular Bone Score in Postmenopausal Women with Non-Vertebral Fractures

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

Abstract:

Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m2), B – 442 females with obesity (BMI >29.9 kg/m2)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

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

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4 Bone Mineral Density and Quality, Body Composition of Women in the Postmenopausal Period

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Oksana Ivanyk

Abstract:

In the diagnostics of osteoporosis, the gold standard is considered to be bone mineral density; however, X-ray densitometry is not an accurate indicator of osteoporotic fracture risk under all circumstances. In this regard, the search for new methods that could determine the indicators not only of the mineral density, but of the bone tissue quality, is a logical step for diagnostic optimization. One of these methods is the evaluation of trabecular bone quality. The aim of this study was to examine the quality and mineral density of spine bone tissue, femoral neck, and body composition of women depending on the duration of the postmenopausal period, to determine the correlation of body fat with indicators of bone mineral density and quality. The study examined 179 women in premenopausal and postmenopausal periods. The patients were divided into the following groups: Women in the premenopausal period and women in the postmenopausal period at various stages (early, middle, late postmenopause). A general examination and study of the above parameters were conducted with General Electric X-ray densitometer. The results show that bone quality and mineral density probably deteriorate with advancing of postmenopausal period. Total fat and lean mass ratio is not likely to change with age. In the middle and late postmenopausal periods, the bone tissue mineral density of the spine and femoral neck increases along with total fat mass.

Keywords: Osteoporosis, lean mass, fat mass, bone tissue mineral density, bone quality, postmenopausal osteoporosis

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3 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: metabolic syndrome, fracture, bone mineral density, trabecular bone score

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2 Bone Mineral Density and Trabecular Bone Score in Ukrainian Men with Obesity

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Anna Musiienko, Roksolana Povoroznyuk

Abstract:

Osteoporosis and obesity are widespread diseases in people over 50 years associated with changes in structure and body composition. Нigher body mass index (BMI) values are associated with greater bone mineral density (BMD). However, trabecular bone score (TBS) indirectly explores bone quality, independently of BMD. The aim of our study was to evaluate the relationship between the BMD and TBS parameters in Ukrainian men suffering from obesity. We examined 396 men aged 40-89 years. Depending on their BMI all the subjects were divided into two groups: Group I – patients with obesity whose BMI was ≥ 30 kg/m2 (n=129) and Group II – patients without obesity and BMI of < 30 kg/m2 (n=267). The BMD of total body, lumbar spine L1-L4, femoral neck and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1- L4 was assessed by means of TBS iNsight® software installed on DXA machine (product of Med-Imaps, Pessac, France). In general, obese men had a significantly higher BMD of lumbar spine L1-L4, femoral neck, total body and ultradistal forearm (p < 0.001) in comparison with men without obesity. The TBS of L1-L4 was significantly lower in obese men compared to non-obese ones (p < 0.001). BMD of lumbar spine L1-L4, femoral neck and total body significantly differ in men aged 40-49, 50-59, 60-69, and 80-89 years (p < 0.05). At the same time, in men aged 70-79 years, BMD of lumbar spine L1-L4 (p=0.46), femoral neck (p=0.18), total body (p=0.21), ultra-distal forearm (p=0.13), and TBS (p=0.07) did not significantly differ. A significant positive correlation between the fat mass and the BMD at different sites was observed. However, the correlation between the fat mass and TBS of L1-L4 was also significant, though negative.

Keywords: Obesity, bone mineral density, men, trabecular bone score

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1 Bone Mineral Density and Trabecular Bone Score in Ukrainian Women with Obesity

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Larysa Martynyuk, Tetiana Kovtun

Abstract:

Obesity and osteoporosis are the two diseases whose increasing prevalence and high impact on the global morbidity and mortality, during the two recent decades, have gained a status of major health threats worldwide. Obesity purports to affect the bone metabolism through complex mechanisms. Debated data on the connection between the bone mineral density and fracture prevalence in the obese patients are widely presented in literature. There is evidence that the correlation of weight and fracture risk is sitespecific. This study is aimed at determining the connection between the bone mineral density (BMD) and trabecular bone score (TBS) parameters in Ukrainian women suffering from obesity. We examined 1025 40-89-year-old women, divided them into the groups according to their body mass index: Group A included 360 women with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women with no obesity and BMI of <30 kg/m2. The BMD of total body, lumbar spine at the site L1-L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1- L4 was assessed by means of TBS iNsight® software installed on our DXA machine (product of Med-Imaps, Pessac, France). In general, obese women had a significantly higher BMD of lumbar spine, femoral neck, proximal femur, total body and ultradistal forearm (p<0.001) in comparison with women without obesity. The TBS of L1-L4 was significantly lower in obese women compared to nonobese women (p<0.001). The BMD of lumbar spine, femoral neck and total body differed to a significant extent in women of 40-49, 50- 59, 60-69 and 70-79 years (p<0.05). At same time, in women aged 80-89 years the BMD of lumbar spine (p=0.09), femoral neck (p=0.22) and total body (p=0.06) barely differed. The BMD of ultradistal forearm was significantly higher in women of all age groups (p<0.05). The TBS of L1-L4 in all the age groups tended to reveal the lower parameters in obese women compared with the nonobese; however, those data were not statistically significant. By contrast, a significant positive correlation was observed between the fat mass and the BMD at different sites. The correlation between the fat mass and TBS of L1-L4 was also significant, although negative. Women with vertebral fractures had a significantly lower body weight, body mass index and total body fat mass in comparison with women without vertebral fractures in their anamnesis. In obese women the frequency of vertebral fractures was 27%, while in women without obesity – 57%.

Keywords: Obesity, Women, bone mineral density, trabecular bone score

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Abstracts

10 Age, Body Composition, Body Mass Index and Chronic Venous Diseases in Postmenopausal Women

Authors: Vladyslav Povoroznyuk, Grygorii Kostromin

Abstract:

Chronic venous diseases (CVD) are one of the common, though controversial problems in medicine. It is generally accepted that this pathology predominantly occurs in women. The issue of excessive weight as a risk factor for CVD is still considered debatable. To the author's best knowledge, today in Ukraine, there are barely any studies that describe the relationship between CVD and obesity. Our study aims to determine the association between age, body composition, obesity and CVD in postmenopausal women. The study was conducted in D. F. Chebotarev Institute of Gerontology, National Academy of Medical Sciences of Ukraine. We have examined 96 postmenopausal women aged 46-85 years (mean age – 66.19 ± 0.96 years), who were divided into two groups depending on the presence of CVD. The women were examined by vascular surgeons. For the diagnosis of CVD, we used clinical, anatomic and pathophysiologic classifications. We also performed clinical, ultrasound and densitometry examinations. We found that the CVD frequency in postmenopausal women increased with age (from 72% in those aged 45-59 years to 84% in those aged 75-89 years). A significant correlation between the total fat mass and age was determined in postmenopausal women with CVD. We also observed a significant correlation between the lower extremities’ fat mass and age in both examined groups. A significant correlation between body mass index and age was determined only in postmenopausal women without CVD.

Keywords: Obesity, age, Risk Factors, postmenopausal women, chronic venous disease

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9 Obesity and Bone Mineral Density in Patients with Large Joint Osteoarthritis

Authors: Vladyslav Povoroznyuk, Anna Musiienko, Roksolana Povoroznyuk, Nataliia Zaverukha

Abstract:

Along with the global aging of the population, the number of people with somatic diseases is increasing, including such interrelated pathologies as obesity, osteoarthritis (OA), and osteoporosis (OP). The objective of the study is to examine the connection between body mass index (BMI), OA, and body mass density (BMD) of the lumbar spine, femoral neck, and TBS in postmenopausal women with OA. We have observed 359 postmenopausal women (50-89 years old) and divided them into four groups by age decades: 50-59 yrs, 60-69 yrs, 70-79 yrs, and over 80 years old. In addition, according to the ACR clinical classification criteria for knee and hip OA, we divided them into group I –117 females with symptomatic osteoarthritis (including 89 patients with knee OA, 28 patients with hip OA) and group II –242 women with normal functional activity of large joints. Analysis of data was performed, taking into account their BMI, classified by the World Health Organization (WHO). The diagnosis of obesity was established when BMI was above 30 kg/m². In a woman with obesity, a symptomatic OA was detected in 44 postmenopausal women (41.1%), a normal functional activity of large joints -in 63 women (58.9%). However, in women with normal BMI –73 women, who account for 29.0% of cases, a symptomatic OA was detected. According to a chi-squared (χ²) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ²=5.05, p=0.02). Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of large joints. No significant differences of BMD of femoral necks or TBS were detected in either the group with OA or with the normal functional activity of large joints.

Keywords: Obesity, Osteoarthritis, Overweight, body mass index, bone mineral density, postmenopausal women

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8 Associations between Metabolic Syndrome and Bone Mineral Density and Trabecular Bone Score in Postmenopausal Women with Non-Vertebral Fractures

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

Abstract:

Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m2), B – 442 females with obesity (BMI >29.9 kg/m2)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

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

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7 Vitamin D Deficiency and Insufficiency in Postmenopausal Women with Obesity

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Oksana Ivanyk, Anna Musiienko, Roksolana Povoroznyuk

Abstract:

Deficiency and insufficiency of Vitamin D is a pandemic of the 21st century. Obesity patients have a lower level of vitamin D, but the literature data are contradictory. The purpose of this study is to investigate deficiency and insufficiency vitamin D in postmenopausal women with obesity. We examined 1007 women aged 50-89 years. Mean age was 65.74±8.61 years; mean height was 1.61±0.07 m; mean weight was 70.65±13.50 kg; mean body mass index was 27.27±4.86 kg/m2, and mean 25(OH) D levels in serum was 26.00±12.00 nmol/l. The women were divided into the following six groups depending on body mass index: I group – 338 women with normal body weight, II group – 16 women with insufficient body weight, III group – 382 women with excessive body weight, IV group – 199 women with obesity of class I, V group – 60 women with obesity of class II, and VI group – 12 women with obesity of class III. Level of 25(OH)D in serum was measured by means of an electrochemiluminescent method - Elecsys 2010 analyzer (Roche Diagnostics, Germany) and cobas test-systems. 34.4% of the examined women have deficiency of vitamin D and 31.4% insufficiency. Women with obesity of class I (23.60±10.24 ng/ml) and obese of class II (22.38±10.34 ng/ml) had significantly lower levels of 25 (OH) D compared to women with normal body weight (28.24±12.99 ng/ml), p=0.00003. In women with obesity, BMI significantly influences vitamin D level, and this influence does not depend on the season.

Keywords: Obesity, age, body mass index, postmenopausal women, vitamin D deficiency, vitamin D insufficiency

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6 Vitamin D Status in Relation to Body Mass Index: Population of Carpathian Region

Authors: Vladyslav Povoroznyuk, Ivan Pankiv

Abstract:

The present research has attempted to link a higher body weight with a lower vitamin D status. Objective: Vitamin D status of Carpathian region population in Ukraine was studied to examine whether serum levels of 25-hydroxyvitamin D [25(OH)D] are associated with body mass index (BMI). Methods: Data collected from 302 adults (18–84 years) were analyzed. Variables measured included serum 25(OH)D, weight and height used to determine BMI status. Results: Mean 25(OH)D level was 23.2 ± 8.1 ng/mL for the group; 26.3 ± 8.4 ng/mL and 22.8 ± 9.1 ng/mL for males and females, respectively. Based on BMI, 3.6% were underweight, 21.2% had a normal weight, 46.4% were overweight and 28.8% obese. Only in 28 cases (9.3%), content of 25(ОН)D in the serum of blood was within the normal limits, and there were vitamin D deficiency and insufficiency observed in other cases (90.7%). Thus, severe vitamin D deficiency was revealed in 1.7% of the inspected. A significant interrelation between levels of 25(OH)D in blood and BMI was found among persons with BMI 25-29.9 kg/m2. Mean value of 25(OH)D levels among persons with obesity did not differ to a significant extent from indexes in persons with normal body weight. Conclusion: Status of vitamin D among the population of Carpathian region remains far from optimal and requires urgent measures in correction and prevention. Results confirmed a poor inverse relationship between vitamin D status and BMI. Intercommunication between maintenance of vitamin D and BMI requires further investigations.

Keywords: Obesity, body mass index, vitamin D, Carpathian region

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5 Bone Mineral Density and Trabecular Bone Score in Ukrainian Men with Obesity

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Anna Musiienko, Roksolana Povoroznyuk

Abstract:

Osteoporosis and obesity are widespread diseases in people over 50 years associated with changes in structure and body composition. Нigher body mass index (BMI) values are associated with greater bone mineral density (BMD). However, trabecular bone score (TBS) indirectly explores bone quality, independently of BMD. The aim of our study was to evaluate the relationship between the BMD and TBS parameters in Ukrainian men suffering from obesity. We examined 396 men aged 40-89 years. Depending on their BMI all the subjects were divided into two groups: Group I – patients with obesity whose BMI was ≥ 30 kg/m2 (n=129) and Group II – patients without obesity and BMI of < 30 kg/m2 (n=267). The BMD of total body, lumbar spine L1-L4, femoral neck and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1- L4 was assessed by means of TBS iNsight® software installed on DXA machine (product of Med-Imaps, Pessac, France). In general, obese men had a significantly higher BMD of lumbar spine L1-L4, femoral neck, total body and ultradistal forearm (p < 0.001) in comparison with men without obesity. The TBS of L1-L4 was significantly lower in obese men compared to non-obese ones (p < 0.001). BMD of lumbar spine L1-L4, femoral neck and total body significantly differ in men aged 40-49, 50-59, 60-69, and 80-89 years (p < 0.05). At the same time, in men aged 70-79 years, BMD of lumbar spine L1-L4 (p=0.46), femoral neck (p=0.18), total body (p=0.21), ultra-distal forearm (p=0.13), and TBS (p=0.07) did not significantly differ. A significant positive correlation between the fat mass and the BMD at different sites was observed. However, the correlation between the fat mass and TBS of L1-L4 was also significant, though negative.

Keywords: Obesity, bone mineral density, men, trabecular bone score

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4 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: metabolic syndrome, fracture, bone mineral density, trabecular bone score

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3 Bone Mineral Density and Quality, Body Composition of Women in the Postmenopausal Period

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Oksana Ivanyk

Abstract:

In the diagnostics of osteoporosis, the gold standard is considered to be bone mineral density; however, X-ray densitometry is not an accurate indicator of osteoporotic fracture risk under all circumstances. In this regard, the search for new methods that could determine the indicators not only of the mineral density, but of the bone tissue quality, is a logical step for diagnostic optimization. One of these methods is the evaluation of trabecular bone quality. The aim of this study was to examine the quality and mineral density of spine bone tissue, femoral neck, and body composition of women depending on the duration of the postmenopausal period, to determine the correlation of body fat with indicators of bone mineral density and quality. The study examined 179 women in premenopausal and postmenopausal periods. The patients were divided into the following groups: Women in the premenopausal period and women in the postmenopausal period at various stages (early, middle, late postmenopause). A general examination and study of the above parameters were conducted with General Electric X-ray densitometer. The results show that bone quality and mineral density probably deteriorate with advancing of postmenopausal period. Total fat and lean mass ratio is not likely to change with age. In the middle and late postmenopausal periods, the bone tissue mineral density of the spine and femoral neck increases along with total fat mass.

Keywords: Osteoporosis, lean mass, fat mass, bone tissue mineral density, bone quality, postmenopausal osteoporosis

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2 Bone Mineral Density and Trabecular Bone Score in Ukrainian Women with Obesity

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Larysa Martynyuk, Tetiana Kovtun

Abstract:

Obesity and osteoporosis are the two diseases whose increasing prevalence and high impact on the global morbidity and mortality, during the two recent decades, have gained a status of major health threats worldwide. Obesity purports to affect the bone metabolism through complex mechanisms. Debated data on the connection between the bone mineral density and fracture prevalence in the obese patients are widely presented in literature. There is evidence that the correlation of weight and fracture risk is site-specific. The aim of this study was to evaluate the Bone Mineral Density (BMD) and Trabecular Bone Score (TBS) in the obese Ukrainian women. We examined 1025 40-89-year-old women, divided them into the groups according to their body mass index: Group a included 360 women with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women with no obesity and BMI of < 30 kg/m2. The BMD of total body, lumbar spine at the site L1-L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1-L4 was assessed by means of TBS iNsight® software installed on our DXA machine (product of Med-Imaps, Pessac, France). In general, obese women had a significantly higher BMD of lumbar spine, femoral neck, proximal femur, total body, and ultradistal forearm (p<0.001) in comparison with women without obesity. The TBS of L1-L4 was significantly lower in obese women compared to non-obese women (p<0.001). The BMD of lumbar spine, femoral neck and total body differed to a significant extent in women of 40-49, 50-59, 60-69, and 70-79 years (p<0.05). At same time, in women aged 80-89 years the BMD of lumbar spine (p=0.09), femoral neck (p=0.22) and total body (p=0.06) barely differed. The BMD of ultradistal forearm was significantly higher in women of all age groups (p<0.05). The TBS of L1-L4 in all the age groups tended to reveal the lower parameters in obese women compared with the non-obese; however, those data were not statistically significant. By contrast, a significant positive correlation was observed between the fat mass and the BMD at different sites. The correlation between the fat mass and TBS of L1-L4 was also significant, although negative. Women with vertebral fractures had a significantly lower body weight, body mass index and total body fat mass in comparison with women without vertebral fractures in their anamnesis. In obese women the frequency of vertebral fractures was 27%, while in women without obesity – 57%.

Keywords: Obesity, Women, bone mineral density, trabecular bone score

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1 Vertebral Pain Features in Women of Different Age Depending on Body Mass Index

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Tetiana Orlуk

Abstract:

Introduction: Back pain is an extremely common health care problem worldwide. Many studies show a link between an obesity and risk of lower back pain. The aim is to study correlation and peculiarities of vertebral pain in women of different age depending on their anthropometric indicators. Materials: 1886 women aged 25-89 years were examined. The patients were divided into groups according to age (25-44, 45-59, 60-74, 75-89 years old) and body mass index (BMI: to 18.4 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal), 25-30 kg/m2 (overweight) and more than 30.1 kg/m2 (obese). Methods: The presence and intensity of pain was evaluated in the thoracic and lumbar spine using a visual analogue scale (VAS). BMI is calculated by the standard formula based on body weight and height measurements. Statistical analysis was performed using parametric and nonparametric methods. Significant changes were considered as p <0.05. Results: The intensity of pain in the thoracic spine was significantly higher in the underweight women in the age groups of 25-44 years (p = 0.04) and 60-74 years (p=0.005). The intensity of pain in the lumbar spine was significantly higher in the women of 45-59 years (p = 0.001) and 60-74 years (p = 0.0003) with obesity. In the women of 45-74 years BMI was significantly positively correlated with the level of pain in the lumbar spine. Obesity significantly increases the relative risk of pain in the lumbar region (RR=0.07 (95% CI: 1.03-1.12; p=0.002)), while underweight significantly increases the risk of pain in the thoracic region (RR=1.21 (95% CI: 1.00-1.46; p=0.05)). Conclusion: In women, vertebral pain syndrome may be related to the anthropometric characteristics (e.g., BMI). Underweight may indirectly influence the development of pain in the thoracic spine and increase the risk of pain in this part by 1.21 times. Obesity influences the development of pain in the lumbar spine increasing the risk by 1.07 times.

Keywords: Women, age, body mass index, pain in thoracic and lumbar spine

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