Osteoporosis, vertebral fractures and metabolic syndrome in postmenopausal women

Abstract

BackgroundThe combined effect of the metabolic syndrome (MS) risk factors on bone health has led to controversial results and it is still not clear whether this effect is protective or detrimental. The study aimed to examine the association between MS and bone mineral density (BMD), osteoporosis, and vertebral fractures (VFs) among ambulatory older postmenopausal women.Methods270 post-menopausal women with a mean age of 61.0 years ± 7.8 (50 to 90) with no prior known diagnosis of osteoporosis were recruited. BMD and Lateral vertebral fracture assessment (VFA) images were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative approach and morphometry.ResultsThe MS as defined by the NCEP-ATP III was present in 62 women (23.0%). According to the WHO classification, 82 had osteoporosis at any site (30.4%). VFs were identified in 116 (43.0%): 80 (29.6%) had grade 1 and 36 (13.3%) had grade 2 or 3. Women with MS had a significantly higher BMD and lower prevalence of osteoporosis (17.7% vs. 34.1%) than those without MS. No significant statistical difference was noted in prevalence of VFs (14.5 vs. 13.0%). There were significantly less women with MS among the group of osteoporotic women (13% vs. 27%; p = 0.018). Conditional regression binary analysis assessing the presence of osteoporosis as the dependent variable showed that women with a MS had a significant 71% decrease in the odds of being osteoporotic by BMD compared with women who had not MS accounting for age, BMI, number of parities and years since menopause.ConclusionWomen with MS had higher BMD at the hip and spine, suggesting a protective effect of MS on bone. However, the prevalence of VFs was similar between women with or without MS.

Metabolic Syndrome and Osteoporosis in Relation to Muscle Mass

“…Because waist circumference, a main factor for the development of MetS, is highly correlated with body mass index and weight, the adjustment of body mass index or weight may over-adjust the association between MetS and bone mineral density and consequently distort the clinical significance of this association [20]. Therefore, in the analyses that did not account for body mass index, weight, and height, MetS was inversely associated with lower bone mineral density in the US populations [8] and osteoporosis in Caucasian postmenopausal women [7].…”

“…Some studies have shown that MetS or its components are a detrimental factor [3][4][5]. In other studies, MetS was a beneficial factor before adjusting for weight and height or for body mass index [6][7][8][9] and was not a risk factor by gender [10]. In addition, a meta-analysis suggested a negative effect of MetS on bone mineral density in men but not in women [2].…”

MANAGEMENT OF ENDOCRINE DISEASE: Diabetes and osteoporosis: cause for concern?

“…This may perhaps also explain why patients with metabolic syndrome have lower bone mineral density (BMD) than expected after adjustment for confounders (26) and a slightly increased risk of fractures (27). Unadjusted, the higher body mass index (BMI) that occurs in metabolic syndrome is associated with higher BMD (28).…”

DHEA promotes osteoblast differentiation by regulating the expression of osteoblast-related genes and Foxp3⁺ regulatory T cells

“…Treatment of postmenopausal osteoporosis is mainly hormone replacement therapy, but this therapy is often accompanied by adverse reactions, limiting its use (2,3). The pressing task is to identify a new way to treat PMO that can prevent osteoporosis without causing adverse reactions.…”