رابطه ترکیب بدنی و پوکی استخوان در زنان یائسه

محورهای موضوعی : میکروبیولوژی مواد غذایی

ماندانا غلامی ¹ (استادیار دانشگاه آزاد اسلامی، واحد علوم و تحقیقات تهران، گروه تربیت بدنی و علوم ورزشی، تهران، ایران)
ندا قاسم بگلو ² (کارشناس ارشد فیزیولوژی ورزش، دانشگاه آزاد اسلامی، واحد علوم و تحقیقات تهران، ایران)
حجت الله نیک بخت ³ (دانشیار دانشگاه آزاد اسلامی، واحد علوم تحقیقات تهران، ایران)
فریبا اسلامیان ⁴ (دانشیار دانشگاه علوم پزشکی تبریز، متخصص طب فیزیکی و توانبخشی، مرکز تحقیقات طب فیزیکی و توانبخشی)

تاریخ دریافت : 1390/11/05 تاریخ پذیرش : 1391/10/10 تاریخ انتشار : 1392/07/01

کلید واژه: پوکی استخوان, تراکم استخوانی, ترکیب بدنی, زنان,

چکیده مقاله :

مقدمه: پوکی استخوان یک بیماری سیستم اسکلتی است که با کاهش تراکم توده استخوانی مشخص می شود. نتیجه عمده این بیماری شکستگی های استخوان در نواحی تحمل کننده وزن بدن مانند مهره ها، ران و حتی مفاصلی است که وزنی را تحمل نمی کنند مثل مچ دست. هدف از این مطالعه توصیف رابطه ترکیب بدنی با پوکی استخوان در زنان یائسه بود. مواد و روش‌ها: این مطالعه مقطعی شامل 50 زن یائسه مبتلا به پوکی استخوان در سنین 65-45 سال از بیمارستان سینا در تبریز انتخاب شدند. جرم بدن، جرم چربی بدن، جرم بدون چربی بدن، و تراکم استخوانی فقرات و ران اندازه گیری شد. ارزیابی ضخامت چین پوستی با استفاده از کالیپر ارزیابی شد. تراکم استخوان با استفاده از روشDEXA در ناحیه ستون مهره ها و سر استخوان ران انجام گرفت.برای بررسی رابطه بین اجزاء ترکیب بدنی با تراکم استخوانی فقرات و ران از مدل رگرسیون چندگانه استفاده شد. یافته ها: از اجزاء ترکیب بدنی فقط جرم بدون چربی با تراکم استخوانی گردن ران (0.05>P و0.271=R2) و فقرات (0.05>P و 0.088=R2) رابطه معنی دار داشت. نتیجه‌گیری: یافته‌های ما نشان می دهد که از بین عوامل ترکیب بدنی؛ جرم بدون چربی، یکی از پیش‌بینی کننده‌های قدرتمند پوکی استخوان می باشد. با استفاده از این مدل، می توان زنان در معرض خطر استئوپروز را شناسایی کرد، بنابراین اقدامات پیشگیری و درمانی هم زودتر مقدور است؛ هم چنین می توان از صرف هزینه های اضافی تشخیصی برای افرادی که در معرض خطر نیستند جلوگیری به عمل آورد.

چکیده انگلیسی:

Introduction: Osteoporosis is a skeletal system disease that is characterized by the low bone mass. The major consequence of this disease is bone fractures that occur more in weightbearing areas such as vertebrae, femur and even non weight-bearing joints such as wrist. The purpose of this study was to describe the relationship of body composition and osteoporosis in postmenopausal women.Materials and Methods: This cross-sectional study involved 50 postmenopausal women with osteoporosis, aged between 45 and 65 years who were recruited from Sina hospital in Tabriz. Body mass, fat mass, lean body mass, and bone mineral density at the spine and femoral neck were measured. Skinfold thickness was determined by caliper. Bone mineral density was measured by DEXA at the spine and femoral neck. Association between parameters of body composition and bone mineral density analyzed using a multiple regression analysis.Results: The body composition parameters indicated that only lean body mass had a significant relationship with osteoporosis in the femoral neck (R2 =0.271, P<0.05) and in the lumbar spine (R2=0.088, P<0.05).Conclusion: Our data indicated that from the body composition parameters, lean body mass is a powerful predictor of osteoporosis. Using this model, females at risk of osteoporosis can be identified; therefore early prevention and treatment are possible. This can also prevent unnecessary expenses of diagnostic procedures for people without the risks of osteoporosis.

منابع و مأخذ:

گائینی، ع. ع. و دبیدی روشن، و. (1385). اصول بنیادی فیزیولوژی ورزشی. انتشارات سمت.
شجاعی، ف. (1376). بررسی تراکم مواد معدنی استخوان زنان ورزشکار تیم ملی و مقایسه با استاندارد غیر ورزشکاران ایران و جهان، رساله دکتری تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی، واحد تحصیلات تکمیلی و تحقیقات عالی.
Hossein-Nezhad, A., Mojtahedi, A., Pazhohi, M., Bastanhagh, M. H., Soltani, A., mirfeizi, S. Z. & Dashti, R. )2005(. Normative date of bone Mineral Density in healthy population of Tehran, Iran: cross sectional study.BMC Musculoskeletal Disorder.
Barret, C. E. )1993.( Epideiology and the menopause: A global over view. Int J Fertil., 38:6-14.
Bedayat, B. )2005(. Osteoarthritis and osteoporosis. Tehran: Tabib. p 12-13
Bedogny, G., Mussi, C., Malavolti, M., Borghi, A., Poli, M., Battistini, N. & Salvioli, G. (2002). Relationship between body composition and bone mineral content in young and elderly women. Ann Hum Biol 29:599-565.
Blum, M., Harris, S. S. & Must, A. (2003). Leptin, body composition and bone mineral density in premenopausal women. Calcif Tissue Int., 73:27–32.
Capozza, R. F., Cointry, G. R., Cure-Ramirez, P., Ferretti, J. L. & Cure-Cure, C. (2004). A DXA study of muscle-bone relationships in the whole body and limbs of 2512 normal men and pre- and post-menopausal women. Bone. 35:283–95.
Compston, J. E., McConachie, C., Stott, C., Hannon, R. A., Kaptoge, S., Debiram, I., Love, S. & Jaffa, A. )2006). Changes in bone mineral density, body composition and biochemical markers of bone turnover during weight gain in adolescents with severe anorexia nervosa: a 1-year prospective study. 17(1):77-84.
Consensus development conference. )1993(. diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med., 94:646–50.
Cornish, J. & Reid, I. R. (2001). Effects of amylin and adrenomedullinon the skeleton. J Musculoskelet Neuronal Interact, 2:15–24
Cui, L. H., Shin, M. H., Kweon, S. S., Park, K. S., Lee, Y. H., Chung, E. K., Nam, H. S. & Choi, J. S. (2007). Relative contribution of body composition to bone mineral density at different sites in men and women of South Korea. 25(3):165-71.
Di Monaco, M., Vallero, F., Di Monaco, R., Tappero, R. & Cavanna, A. (2007). Skeletal muscle mass, fat mass, and hip bone mineral density in elderly women with hip fracture. 25(4):237-42.
Edelstein, S. L. & Barrett-Connor, E. (1993). Relation between body size and bone mineral density in elderly men and women. Am J Epidemiol., 138:160–9.
Elefteriou, F., Takeda, S., Ebihara, K., Magre, J., Patano, N., Kim, C. A., Ogawa, Y., Liu, X., Ware, S. M., Craigen, W. J., Robert, J. J., Vinson, C., Nakao, K., Capeau, J. & Karsenty, G. (2004). Serum leptin level is a regulator of bone mass. PNAS 101(9):3258–3263.
Ellis, K. J., Abrams, S. A. & Wong, W. W. (1997). Body composition of a young, multiethnic female population. Am J Clin Nutr 65;724-731.
Frost, H. M. (1997). On our age-related bone loss: insights from a new paradigm. J Bone Miner Res 12:1539–1546.
Gilsanz, V., Chalfant, J., Mo, A. O., Lee, D. C., Dorey, F. J. & Mittelman, S. D. (2009). Reciprocal relations of subcutaneous and visceral fat to bone structure and strength. J Clin Endocrinol Metab 94:3387–3393.
Gnudi, S., Sitta, E. & Fiumi, N. (2007). Relationship between body composition and bone mineral density in women with and without osteoporosis: relative contribution of lean and fat mass. 25(5):326-32.
Gudmundsdottir, S. L., Oskarsdottir, D., Indridason, O. S., Franzson, L. & Sigurdsson, G. (2010). Risk factors for bone loss in the hip of 75-year-old women: a 4-year follow-up study. 67(3):256-61.
Holbrook, T. L. & Barret-Connor, E. (1993). the association of lifetime weight and weight control patterns with bone mineral density in an adult community. Bone miner 20:141-142.
Hsu, Y. H., Venners, S. A., Terwedow, H. A., Feng, Y., Niu, T., Li, Z., Laird, N., Brain, J. D., Cummings, S. R., Bouxsein, M. L., Rosen, C. J. & Xu, X. (2006). Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women. 83(1):146-54.
Hu, F. B. )2003.( Overweight and obesity in women: health risks and consequences. J Women Health (Larchmt;(12(2):163–172.
Jürimäe, T., Sööt, T. & Jürimäe, J. )2005(. Relationships of anthropometrical parameters and body composition with bone mineral content or density in young women  with different levels of physical activity. 24(6):579-87.
Kirchengast, S., Peterson, B., Hauser, G. & Knogler, W. (2001). Body composition characteristics are associated with the bone density of the proximal femur end in middle- and old-aged women and men. Maturitas 39:133–145
Kontogianni, M. D., Dafni, U. G., Routsias, J. G. & Skopouli, F. N. (2004). Blood leptin and adiponectin as possible mediators of the relation between fat mass and BMD in perimenopausal women. J Bone Miner Res. 19:546–51.
Kyong-Chol, K., Dong-Hyuk, S., Sei-Young, L., Jee-Aee, I. & Duk-Chul, L. (2010). Relation between Obesity and Bone Mineral Density and Vertebral Fractures in Korean Postmenopausal Women. Yonsei Med J. 1; 51(6): 857–863.
Lanyon, L. E. (1992). Control of bone architecture by functional load bearing.j Bone Miner Res 7 (suppl):5369-5375.
Lazcano-ponce, E., Tamayo, J., Cruz-Valdez, A., Diaz, R., Hernandez, B., Del Cueto, R. & Hernandez-Avila, M. (2003). Peak bone mineral area density and determinants among females aged 9 to 24 years in mexico. Osteoporosis Int  14:539-547.
Lekamwasam, S., Weerarathna, T., Rodrigo, M., Arachchi, W. K. & Munidasa, D. (2009). Association between bone mineral density, lean mass, and fat mass among healthy middle-aged premenopausal women: a cross-sectional study in southern Sri Lanka. J Bone Miner Metab. 27:83–88.
Leslie, W. D., Miller, N., Rogala, L. & Bernstein, C. N. (2009). Body mass and composition affect bone density in recently diagnosed inflammatory bowel disease: the Manitoba IBD Cohort Study. Inflamm Bowel Dis. 15:39–46.
Lindsay, R., Cosman, F., Herrington, B. D. & Himmulstein, S. (1992). Bone mass and body composition in normal women. J Bone Miner Res 7: 55–63.
Liu, J. M., Zhao, H. Y., Ning, G., Zhao, Y. J., Zhang, L. Z., Sun, L. H., Xu, M. Y. & Chen, J. L. ( 2004). Relationship between body composition and bone mineral density in healthy young and premenopausal Chinese women. 15(3):238-42. Epub Jan 16.
Nichol, D. L., Sanborn, C. F., Bonnick, S. L., Gengh, B. & Diomarco, N. (1995). Relationship of regional body composition to bone mineral density in collage females.Med Sci Sports Exerc 27:178-182.
Pasco, J. A., Henry, M. J., Kotowicz, M. A., Collier, G. R., Ball, M. J., Ugoni, A. M. & Nicholson, G. C. (2001). Serum leptin levels are associated withbone mass in non-obese women. J Clin Endocrinol Metab., 86(5):1884–1887
Rayalam, S., Della-Fera, M. A. & Baile, C. A. (2011). Synergism between resveratrol and other phytochemicals: implications for obesity and osteoporosis. 55(8):1177-85
Reid, I. R., Plank, L. D. & Evans, M. C. (1992). Fat mass is an important determinant of whole body bone density in premenopausal womenbut not in men. J Clin Endocrinol Metab 75:779–782.
Rico, H., Revilla, M., Villa, L. F., Alvarez del Buergo, M. & Ruiz-Contreras, D. (1994). Determinants of total body and regional bone mineral content and density in postpubertal normal women. Metabolism 43:263-266.
Russell, M., Mendes, N., Miller, K. K., Rosen, C. J., Lee, H., Klibanski, A. & Misra, M. (2010). Visceral Fat Is a Negative Predictor of Bone Density Measures in Obese Adolescent Girls. by The Endocrine Society.
Sheng, Z., Xu, K., Ou, Y., Dai, R., Luo, X., Liu, S., Su, X., Wu, X., Xie, H., Yuan, L. & Liao, E. (2011). Relationship of body composition with prevalence of osteoporosis in central south Chinese postmenopausal women. 74(3):319-24.
Sherk, V. D., Palmer, I. J., Bemben, M. G. & Bemben, D. A. (2009). Relationships between body composition, muscular strength, and bone mineral density in estrogen-deficient postmenopausal women. Jul-Sep.12(3):292-298.
Siiteri, P. K. (1987). Adipose tissue as a source of hormones. Am J Clin Nutr 45:277–282.
Slemenda, C. W., Hui, S. L., Williams, C. J., Christian, J. C., Meaney, F. J. & Johnston, C. C. )1990.( Bone mass and anthropometric measurements in adult females. Bone Miner., 11:101-109.
Weiler, H. A., Janzen, L., Green, K., Grabowski, J., Seshia, M. M. & Yuen, K. C. (2000). Percent body fat and bone mass in healthy Canadian female 10 to 19 years of age. Bone 27:203-207.
Wu, F., Ames, R., Clearwater, J., Evans, M. C., Gamble, G. & Reid, I. R. (2002). Prospective 10-year study of the determinants of bone density and bone loss in normal postmenopausal women, including the effect of hormone replacement therapy. Clin Endocrinol. 56:703–11.
Yamauchi, M., Sugimoto, T. & Yamaguchi, T. (2001). Plasma leptin concentrations are associated with bone mineral density and the presence of vertebral fractures in postmenopausal women. Clin Endocrinol. 55:341–7.
Yi-Hsiang, H., Scott, A. V., Henry, A. T., Yan, F., Tianhua, N., Zhiping, L., Nan, L., Joseph, D. B., Steve, R. C., Mary, L. B., Cliff, J. R. & Xiping, X. (2006). Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women. 83(1): 146-154.
Yoo, H. J., Park, M. S., Yang, S. J., Kim, T. N., Lim, K. I., Kang, H. J., Song, W., Baik, S. H., Choi, D. S. & Choi, K. M. (2011). The differential relationship between fat mass and bone mineral density by gender and menopausal status. 7.
Zhao, L. J., Jun, Y. & Yuhan, P. (2007). Relationship of obesity with osteoporosis. J Clin Endocrin Metabolism. 92(5):1640-6.