Παναγόπουλος Περικλής, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Παπαντωνίου Νικόλαος, Καθηγητής, Ιατρική, ΕΚΠΑ
Χρέλιας Χαράλαμπος, Αναπληρωτής Καθηγητής, ΕΚΠΑ
Καλανταρίδου Σοφία, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Σαλάκος Νικόλαος, Καθηγητής, Ιατρική, ΕΚΠΑ
Πέππα Μελπομένη, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Μπουτάτη Ελένη , Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Introduction: The relationship between metabolic syndrome and bone density disorders has been studied in recent years. The investigation of the possible correlation of the two pathophysiological conditions is particularly important for perimenopausal and postmenopausal women.
Objective: The present study aims to evaluate the social, educational and occupational characteristics of perimenopausal women from Western Attica and to study this association with the clinical and laboratory characteristics of these women and in particular the metabolic parameters related to the metabolic syndrome (triglyceride levels, HDL cholesterol, fasting blood sugar, arterial hypertension, central type obesity) and osteoporosis (T-SCORE and Z-SCORE from bone density measurement).
Methods: The study sample consisted of 311 perimenopausal women from the outpatient menopausal clinic of the 3rd Clinic of Obstetrics and Gynecology, "ATTIKON" Hospital. The study included the patient history, as well as the social and the family history. Patients were examined and their somatometric characteristics were recorded. Finally, they were subjected to venous blood analysis, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone, dehydroepiandrosterone sulfate (DHEA-S), alkaline phosphatase (ALP), osteocalcin, hydroxyproline, glucose, insulin, complete blood count, cholesterol levels, triglycerides, HDL-C, LDL-C, CRP, TSH, FT3, FT4, T3, T4, lipoprotein (a), apolipoprotein A1, apolipoprotein B, parathyroid hormone (PTH), calcium and phosphate serum and urine , T-score and Z-score from bone density measurement. The SPSS 22.0 statistical software was used.
Results: The 32.5% of women were overweight (25 ≤ BMI <30) and 29% obese (BMI ≥ 30). 19.3% of the study participants met the criteria for the metabolic syndrome. The frequency of metabolic syndrome did not differ significantly among women depending on whether they were in perimenopause, postmenopause or menopause after surgery. Subjects with metabolic syndrome had significantly higher glucose (p <0.001), significantly higher cholesterol (p = 0.002), triglyceride (p<0.001) and significantly lower HDL-C values (p <0.001) compared to those without metabolic syndrome. Both bone density markers had higher values in subjects with metabolic syndrome to a significant extent (p <0.001 for T-score and p = 0.003 for Z-score). Participants with normal BMI had significantly lower T-score values compared to overweight and obese (p = 0.013 and p = 0.001 respectively). Similarly, patients with normal BMI had significantly lower Z-score values compared to obese (p = 0.004). Married patients also had significantly lower T-score and Z-score compared to unmarried (p = 0.025 and p = 0.005 respectively). Those with a family history of osteoporosis had statistically significantly lower T-score scores compared to those who did not have a family history of osteoporosis (p = 0.004). Significantly higher T-score values from bone density measurements were observed in perimenopausal women compared to postmenopausal (p <0.001) or those with menopause after surgery (p = 0.038). Higher values in FSH, LH, hematocrit and HDL were associated with lower T-score and Z-score. In contrast, higher values in E2, CRP and triglycerides were associated with higher T-score and Z-score. The presence of metabolic syndrome in women is associated with a higher T-score of 1.09 units and a higher Z-score of 0.88 units compared to women who did not meet the criteria.
Conclusion: Perimenopausal women from Western Attica seem to have a BMI over the normal range. However, high BMI and the presence of metabolic syndrome are associated with higher values of bone density markers.
Perimenopausal women, Metabolic syndrome, Osteoporosis, T-Score, BMD