The Triangle That Can Improve Postmenopausal Women's Quality of Life: Insulin, Bone Mineral Density and Fracture Risk

Abstract

Introduction: Women spend most of their life in the postmenopausal period. This period brings along many metabolic problems with the decrease in estrogen production. Our aim was to evaluate the effectiveness of bone mineral density (BMD) on fracture risk assessment tool (FRAX) between groups with and without insulin resistance and also to investigate the importance of new risk factors in FRAX identification and to facilitate early prevention, diagnosis, and treatment of women with fractures risk. Methods: Sixty-eight patients who were admitted to our clinic with diagnosis of impaired glucose tolerance during postmenopausal period were included in this study retrospectively. Those who had their routine biochemical parameters, insulin, and BMD measured were included in the study. Fracture risk analyses were performed with the FRAX score. Body mass index and homeostasis model assessment-insulin resistance of the patients were calculated. Results: In the group with insulin resistance, high-density lipoprotein cholesterol value was low (p=0.014), and triglyceride level was high (p<0.0001). When 25(OH)Vit-D3 values were examined between the groups, the mean values were 22.8±13.6 and 15.7±11.8 ng/ml, respectively (p=0.026). When femoral and lumbar T-score BMD values between the groups were examined, the bone density of the patients with insulin resistance was significantly higher than the other group (p=0.039). Discussion and Conclusion: To summarize, we believe that low bone quality is caused by slowing bone cycle due to longterm impaired glucose levels and long-term estrogen hormone deficiency caused by menopause. This suggests that BMD value is not specific enough for determining bone fractures. The conclusion to be drawn here is to accurately establish the relation between DM or impaired glucose tolerance and osteoporosis; to constitute a guide for further prospective and large-scale studies that use different diagnostic and follow-up parameters; and to investigate the significance of new risk factors in FRAX identification for early prevention, diagnosis, and treatment of women who are at a risk of fractures.