RESEARCH ARTICLEEffect of surgical and natural menopause on proximal femur morphometry in obese women
Introduction
Postmenopausal osteoporosis is a significant public health problem; and there are many factors influencing the bone mineral density (BMD) (Douchi et al., 2000). BMD changes with age, menopausal status, body mass index (BMI), body composition parameters and physical activity level (Ertungealp et al., 1999; Wee et al., 2013).
When previous studies were examined, it was determined that although the effect of many parameters on BMD was investigated, there was less focus on whether or not this change in BMD affected bone morphometry (Dretakis et al., 1999; Stathopoulos et al., 2011). When previous studies that were conducted on bone structure were examined, it was determined that these studies focused on the factors affecting BMD, and as a result, bone fractures (Bergot et al., 2002).
Bone structure and its metabolism are affected by age, ethnicity, genetic variations, body composition, life style, menopausal status, sex hormones and gonadotropins status (Conradie et al., 2014; Imai, 2014; Méndez et al., 2013; Yoo et al., 2012). In previous studies conducted on the relation between obesity parameters and BMD values, it was determined that different results were reported on body composition in postmenopausal women. The body mass index is easily calculated by dividing the body weight (kg) by the square of the height (m), and in case the result is over 30 kg/m2, this is accepted as being clinical obese (Pi-Sunyer, 2009; WHO, 1995). As a positive effect of obesity, although BMD values were determined as higher at a significant level in the obese group by a researcher (Silva et al., 2007), another researcher reported no significant relation in this respect (Kocyigit et al., 2013). Menopausal status occurs in some women when ovaries are excised surgically due to various medical reasons at an early age and suddenly. Since ovaries show endocrine activities in women who have them, it is known that the positive effects of the androgen hormones continues on the muscle and skeletal system (Fogle et al., 2007; Gallagher, 2007). Although previous morphometric studies were conducted by taking the reasons of bone loss into consideration, it was determined that such studies were few in number, and the bone parameters that were associated with the menopausal status were insufficient. To obtain these data, the Cross-Sectional CT method was employed (Dretakis et al., 1999; Stathopoulos et al., 2011). However, when bone morphology was evaluated by considering the literature, although cortical thickness was evaluated with the help of CT in a cross-sectional manner, no data were obtained on whether or not the outer morphology of the bone is affected by menopause.
The purpose of the present study was to evaluate the effect of surgical and natural menopause on proximal femur morphometry in obese postmenopausal women with radiography by limiting the BMI to 30 kg/m2 and above, and to investigate the effect of the difference in sex hormone levels that stem from the formation of menopause on proximal femur morphometry.
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Materials and methods
In the present study, a total of 60 women who were diagnosed as postmenopausal were evaluated. A total of 30 women were natural and 30 were surgical menopausal. The cases were divided into two groups as surgical and natural menopause groups according to their medical histories. The women whose bilateral ovaries were excised during hysterectomy were included in the surgical menopause group.
In the present study, the patients who applied to the Physical Therapy and Rehabilitation Polyclinic of a
Results
The descriptive statistical values of the numerical variables of the obese women with surgical and natural menopause were evaluated, and no significant differences were detected between the groups (p > 0.05). This shows that the two groups are homogeneous (Table 1).
The numerical variables of the anthropometric properties, body composition parameters (Table 2) and BMD values (Table 3) of the cases were examined; and no significant differences were detected between surgical and natural
Discussion
Determining the parametric measurement values of the bones that exist in the skeleton is important for anatomy, forensic medicine, archeology and anthropology. Many comprehensive studies have been conducted on proximal femur morphology in healthy patients because femur, which is one of the important bones of the skeletal structure, joined to the structure of the art. coxae (Harma and Karakas, 2007; Mall et al., 2000; Steyn and İşcan, 1997).
Knowing all factors that influence the morphometric
Conclusions
When the morphometric measurements of the proximal femur were examined in terms of the mean values of the numerical variables, no significant differences were observed between the surgical and natural menopause groups despite the high FSH values and low BMD values in surgical menopause group. In previous studies, when the effects of surgical and natural menopause on sex hormones, BMD parameters and bone turnover parameters were investigated, the demographic characteristics of the cases such
Ethical statement
The patients who were included in the study were informed about the study, and their written approvals were received. The study protocol was approved by the Ethics Committee of Abant Izzet Baysal University (Protocol No: 2013/69).
Funding statement
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Acknowledgments
The authors would like to thank radiologist Professor Safiye GÜREL and biostatistics and medical informatics specialists Professor Handan ANKARALI. We also thank the Radiology and Physical Therapy Departments of Bolu private hospital and their specialist staff. Special thanks to Dr. Turgut MEYVACI and all volunteers who contributed to our research.
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2021, Annals of AnatomyCitation Excerpt :Estrogen receptors have been detected in major and minor salivary glands and oral buccal mucus membranes (Tsinti et al., 2009). Estrogen (E2) level has been found to significantly decrease in both surgical and natural menopause (Meyvaci et al., 2020). A correlation between xerostomia (dry mouth), a common post-menopausal consequence, and E2 deficiency has been reported (Dutt et al., 2013).