Safinaz Ataoglu

Influence of number of pregnancies on bone mineral density in postmenopausal women of different age groups.

Abstract As data on the relationship between parity and bone mineral density often seem to be controversial, ultimately, a comprehensive research study was thought to be necessary. This study focused on examining the influence of the number of pregnancies on bone mineral density and investigating the relationship between pregnancy and bone mineral density at four sites in postmenopausal women of different age groups. A total of 509 postmenopausal women, varying from 45 to 86 years of age (mean age of 60.85 ± 7.53 years) were considered for the study. A standardized interview was employed to obtain information on demographics, lifestyle, and, reproductive and menstrual histories. Patients were separated into four groups according to the number of pregnancies, i.e., nulliparae (52 patients), one to two parity (66 patients), three to five parity (178 patients), and more than five parity (213 patients). The patients were further classified into two age groups, 40–59 years (233 patients) and 60–80 years (276 patients), respectively. The number of pregnancies was found to range from 0 to 17 (with an overall mean of 5.42 ± 3.68), with 4.29 ± 2.74 (range, 0–16) accounting for live births, while 1.02 ± 1.53 (range, 0–14) were abortions. There were no significant differences among the groups with respect to parameters such as, age, body mass index (BMI), age at menarche, age at menopause, and years since menopause (P > 0.05) in all of the 509 women and in the 40- to 59- and 60- to 80-year groups. When all the patients were considered, the bone mineral density (BMD) values of the spine and the trochanter for the more-than-five-parity group, were found to be significantly lower than those of the other groups (P < 0.05), while the BMD values of the spine and the femur (neck, trochanter) appeared to decrease with increasing parity. In the 40- to 59-year group, the BMD of the spine in both the nulliparae and one-to-two-parity groups was significantly higher than that of the more-than-five-parity group (P < 0.05). No significant differences were found among the groups with respect to the BMD values at any femur sites. The nulliparae patients in the 60- to 80-year group exhibited significantly higher trochanter and Wards BMD values than those of the more-than-five-parity group (P < 0.05), whereas in the one-to-two-parity group, spine BMD values appeared to be significantly higher than those of the more-than-five-parity group (p < 0.05). Significant correlations were found between the number of pregnancies and BMD values for the spine (r = −0.23; P < 0.01), trochanter (r = −0.16; P < 0.01), and Wards triangle (r = −0.14; P < 0.05), with no significant correlation for femur neck BMD (r = −0.08; P > 0.05) values. In conclusion, the present study suggests that the number of pregnancies has an effect on the BMD values and that this situation shows a variation in different age groups. In addition, our study indicates that there is a significant correlation between the number of pregnancies and the spine, trochanter, and Wards triangle BMD, but there is no correlation for the femur neck BMD.

The effect of breast-feeding duration on bone mineral density in postmenopausal Turkish women: a population-based study.

Introduction In the present study, we investigated the effects of breast-feeding time on bone mineral density (BMD) later in life. Material and methods The current study was based on a retrospective analysis of 586 postmenopausal women with a mean age of 60.8 years, who were screened for osteoporosis by dual energy X-ray absorptiometry (DXA).They were classified into 4 groups with respect to the duration of their breast-feeding as never (group 1), 1-24 months (group 2), 25-60 months (group 3), or > 60 months (group 4). Bone mineral density results for the femur neck and lumbar spine were classified into 3 groups according to WHO criteria as normal (T score > –1.0 SD), osteopenia (T score –1.0 to –2.5 SD), and osteoporosis (T score < –2.5 SD). Patients with osteopenia or osteoporosis (T score < –1.0 SD) were considered as having low bone mass (LBM). Results We found a correlation between duration of lactation and femur BMD or spine BMD in the study population (r = 0.116, p < 0.005; r = –0.151, p = 0.001, respectively). Significant differences were found between femur BMD and spine BMD of groups in one-way ANOVA analysis (p = 0.025, p = 0.005, respectively). Additionally, when compared with the other three groups, group 4 was older and had longer duration of menopause (p < 0.01). In logistic regression analysis, age and body mass index were found as independent risk factors of LBM [odds ratio: 1.084 (95% CI 1.031-1.141); odds ratio: 0.896 (95% CI 0.859-0.935)], while duration of lactation was not found as an independent predictor of LBM. Conclusions In this study, we have found that changes of bone metabolism during lactation had no effect on postmenopausal BMD measured by DXA. Consequently, it can be suggested that long breast-feeding duration is not a risk factor for low bone mass later in life.

Relationship between blood pressure levels and bone mineral density in postmenopausal Turkish women.

Introduction We investigated the association between bone mineral density (BMD) detected by dual-energy X-ray absorptiometric (DXA) method and blood pressure (BP) in a large sample of postmenopausal women. Material and methods The current study was based on a retrospective analysis of 586 postmenopausal women with a mean age of 60.8 ±8.8 years, who were screened for osteopenia or osteoporosis by DXA. Patients with hypertension (HT, n= 306) were compared with normotensive (NT, n = 290) individuals. Bone mineral density results for the femur neck and spine were classified into 3 groups according to World Health Organization criteria: normal (T score > –1.0 SD), osteopenia (T score –1.0 to –2.5 SD) and osteoporosis (T score < –2.5 SD). Patients with osteopenia or osteoporosis (T score < –1.0 SD) were grouped as having low bone mass (LBM). Results There were no significant differences in femur T score, femur BMD, femur Z score, spinal T score, spinal BMD and spinal Z score between hypertensive and normotensive groups. The group of patients with low bone mass calculated from femur T scores had higher age, systolic BP, duration of hypertension and duration of menopause, but lower BMI. Similarly, patients with low spine BMD had higher age and duration of menopause, but lower BMI. Linear regression analysis showed a significant correlation between systolic BP and femur BMD and T score values. Furthermore, logistic regression analysis revealed that hypertension is an independent predictor of spinal osteopenia and osteoporosis. Conclusions The presence of hypertension is an independent predictor of spinal low bone density in Turkish women after menopause.

Fibromyalgia Syndrome in Patients with Nasal Septum Deviation

Abstract Objectives: Some studies conducted with patients with obstructive sleep apnea syndrome [OSAS] have suggested an association between sleep-disordered breathing [SDB] and fibromyalgia syndrome [FMS]. Nasal septum deviation [NSD] is a common physical disorder of the nose and it manifests itself with similar complaints, like respiratory distress and headache, as in patients with OSAS. The aim of this study was to determine the frequency of FMS in patients with NSD. Methods: Consecutive patients, 18 to 60 years old, evaluated in an academic otorhinolaryngology outpatient clinic were prospectively recruited for this study. Patients with nasal septal deviation were included in the nasal septum deviation group. Patients without nasal symptom deviation were recruited to serve as controls. All recruited cases were assessed by a single physiatrist for FMS. The FMS diagnosis was made on the basis of the 1990 American College of Rheumatology Research Classification Criteria. Results: One hundred ninety-nine consecutive patients, 18 to 60 years old, were enrolled in the study. Patients were divided into two groups as those with nasal symptom deviation [n = 115] and those without nasal symptom deviation [control group, n = 84]. Fibromyalgia syndrome was diagnosed in six NSD patients [5.2%] and in four [4.8%] control patients. No differences were noted in the prevalence of FMS between the two groups [p = 0.578]. Conclusion: In this study, we demonstrated a normal prevalence of FMS among patients with NSD. Although some studies suggest a relation between sleep disordered breathing and FMS, we could not find any relationship between NSD and FMS. This result may be associated with the fact that patients with OSAS and morbid obesity were excluded from our study. Future studies are warranted to clarify the association between obstructive sleep-disordered breathing and FMS.

The importance of torg ratio in patients with ankylosing spondylitis

Aim: Ankylosing spondylitis is a disease of unknown etiology. It is an inflammatory, rheumatic disease basically influencing peripheral articulations and extra-articular structures. It is chronic and it leads to deformities in vertebra. Deformities in vertebras may lead to cervical spinal stenosis in long term that may result in cervical myelopathy which is a serious health disorder. One of the methods to evaluate the diameter of cervical canal is Torg ratio. Materail and Methods: In this study, patients with ankylosing spondylitis for more than 10 years have been examined through lateral cervical radiograms. The patients were both male and female whose ages range from 40-50 to 50-60. Morphometric measurements of cervical vertebras were made digitally and the differences between groups were revealed. Results: Considering the percentages of the narrowest cervical spinal canal diameter (CSCD) from anterior to posterior, it was seen that females have the highest vertebra levels in C4 and C6 whereas males have the highest vertebra levels in C3 and C7. The difference between males and females was found statistically significant (P=0.021). Minimum Torg ratio vertebra levels for females was in C6 for the age group 40-50 while it was C7 for the age group 50-60. As for the males, both age groups’ Torg ratio vertebra levels was minimum in C7. Conclusions: In this sense, it was concluded that patients with ankylosing spondylitis for more than 10 years should be monitored more carefully for neurological deficits that stem from cervical myelopathy.

Fibromiyalji Hastalarının Yaşam Kalitesini Değerlendirmede Kullanılan Ölçeklerin Karşılaştırılması

Amac: Kompleks ve cok boyutlu bir klinik sendrom olan Fibromiyalji sendromu (FMS), bircok somatik ve psikolojik yakinmalara neden oldugu icin yasam kalitesini bozmaktadir. Calismanin amaci, FMS tanisi almis kisilerin, yasam kalitesini en kisa surede ve en verimli sekilde olcen olcegi belirlemektir. Ayrica SF12, SF8 ve SF6D formlarinin guvenilirligi ve gecerliligi de incelenmis olacaktir. Gerec ve Yontemler: Duzce Universitesi Tip Fakultesi Fiziksel Tip ve Rehabilitasyon AD’ da tanisi konulan, calismaya katilmayi kabul eden ve sorulari tam dolduran 59 FMS hastasi degerlendirildi. SF36, WHOQoLBreef, QuickDush, SF12, SF8 ve SF6D olcekleri ile FMS hastalarinin yasam kalitesi sorgulandi. Bulgular : Elde edilen veriler dogrultusunda olceklerin ic tutarliligi ve olcek puanlarinin tekrarlama derecesi yuksek bulundu. SF36 olcek puanlari ile SF olceklerinin diger 3 kisa formundan elde edilen puanlar arasindaki iliskiler incelendiginde, SF12 ve SF6D olceklerinin gecerliligi SF8’ den daha iyi bulundu. Tartisma ve Sonuc : Gecerlilik icin yapilan butun hesaplamalar degerlendirildiginde, FMS’de SF12 ve SF6D olcekleri yasam kalitesini olcmede SF36 yerine kullanabilir. SF8’in ise butun alt boyutlarda SF12 ve SF6D kadar etkili olmamasi ve mental saglik alt boyutunun bulunmamasi nedenleriyle FMS’de yasam kalitesini olcmek amaciyla kullanimi onerilmemektedir.