The role of aging, body mass index and estrogen on symptomatic lumbar osteoarthritis in post-menopausal women

Abstract

Background: Low back pain is a common complaint which is always found in old age due to degeneration process. Degeneration process of spine, especially in the lumbar region is called lumbar osteoarthritis (OA). Various factors are thought to be the cause of lumbar OA, including primarily due to hormonal changes of estrogen and increase of age and body mass index in postmenopausal women. Methods: The purpose of this study is to determine the role of hormonal changes pathogenesis in lumbar osteoarthritis in postmenopausal women and its correlation with age and body mass index. Cross sectional analytic method had been conducted to determine the role of age, body mass index and estrogen for lumbar OA in postmenopausal women. The study was conducted in Sanglah General Hospital from October 2015 until March 2016 by anthropometric measures and blood samples. Results: From 196 samples showed that the estrogen deficiency in postmenopausal women have a correlation with the symptomatic lumbar OA (r=0.252, p = 0.000). While age and the body mass index in postmenopausal women has a correlation with symptomatic lumbar OA (r = 0.150 and 0.198, p = 0.000 and 0.013). Conclusions:The aging process, body mass index and estrogen deficiency correlated with the symptomatic OA lumbar in post-menopausal women. Suyasa IK et al. Int J Res Med Sci. 2016 May;4(5):1325-1328 International 4-6 These three components are familiar with the three joint complex interplay in lumbar osteoarthritis. There are 3 clinical signs and stages of the degeneration of spinal biomechanics i.e. disc dysfunctions, instability and stability. Keywords7 Spinal degeneration include disc degeneration (DD), facet joint osteoarthritis (OA Facet joint), changes in components of muscle and ligament degeneration. [5][6][7] Hormonal changes that occur during menopause will affect the occurrence of osteoarthritis. In postmenopausal women, the use of HRT (Hormone Replacement Therapy) lowered radiological progression. Estrogen stimulates proteoglycan changes in cartilage, either directly or indirectly through cytokines. 8,9 Estrogen directly affects the tissue by estrogen receptors on human articular chondrocytes and indirectly by secondary messenger.10 Estrogen affects the levels of cytokines in vitro and in vivo. Identification over two estrogen receptors ERα and ERβ on chondrocyte prove that cartilage is sensitive to estrogen.11 Several in vivo and in vitro studies also showed that chondrocytes respond to estrogen and affect its metabolism. 11,12 METHODSThe study was conducted from October 2015 until March 2016 at the Sanglah General Hospital Denpasar Bali. The aim of this study is to prove the correlation of age, body mass index and hormonal changes with symptomatic lumbar osteoarthritis in postmenopausal women.This study is a cross sectional analytic design with the sample are post-menopausal women population with consecutive sampling method.One hundred and ninety six post-menopausal women from the population were taken the anthropometry measure i.e. body weight...

Elevated High-Sensitivity C-Reactive Protein And Interleukin-6 Plasma As Risk Factors For Symptomatic Lumbar Osteoarthritis In Postmenopausal Women

“…In this study, IL-6 was found to be statistically significant with (OR = 2.7; p = 0.033). Both Weber et al, and Valdes also reported that IL-6 was higher in LBP patients [ 11 ], [ 12 ]. Both IL-1 and IL-10 were also reported to correlate with the risk of osteoarthritis [ 11 ], [ 12 ].…”

Interleukin-6 and ratio of plasma interleukin-6/interleukin-10 as risk factors of symptomatic lumbar osteoarthritis

“…According to Richette et al[ 1 ] (2003), there is a relationship between estrogen decline and progression of OA, and it was found that its prevalence increases over age 50 years. Suyasa IK and Setiawan IGNY (2016) also found relationship of aging, BMI and estrogen deficiency with symptomatic lumbar OA[ 13 ]. The lumbar OA defined as a degeneration of cartilage which involves three joint complexes which characterized by narrowing of lumbar intervertebral disc, vertebral osteophytes formation and occurrence of OA in facet joints.…”

Correlation between Sex Hormone Deficiency and Osteoarthritis

“…It is known that estrogen plays a pivotal role in bone maintenance and can directly interact with osteocytes, and, additionally, it has also been discovered that estrogen deficiency alone interferes with the anabolic effect of mechanical stress [15]. Some studies even show that this hormone stimulates proteoglycan changes in cartilage, either directly or indirectly through cytokines and, identification of estrogen receptors ERα and ERβ on human articular chondrocytes confirm that cartilage is sensitive to estrogen [17]. Scarcity of this steroid hormone leads to increased osteoclast recruitment and, therefore, enhanced bone resorption as well as impaired mechanosensitivity and mechanotransduction, compromising the optimal level of osteoblast activity in bone deposition.…”