Postmenopozal Kad›nlarda Vücut Kitle ‹ndeksinin ... - FTR Dergisi

P-308
Diz Osteoartriti ‹le Kemik Mineral Yo¤unlu¤u Aras›ndaki ‹liflki
Hakan Nur 1, Özgür Nalbant 2, Füsun Toraman 1
1 Antalya E¤itim ve Araflt›rma Hastanesi Fiziksel T›p ve Rehabilitasyon Klini¤i, Antalya
2 Akdeniz Üniversitesi Beden E¤itimi ve Spor Yüksekokulu, Antalya
AMAÇ: Bu çal›flman›n amac› diz osteoartriti ile lomber ve femur kemik mineral yo¤unluklar›
aras›ndaki iliflkiyi incelemekti.
GEREÇ-YÖNTEM: Çal›flmaya Amerikan Romatoloji Birli¤i kriterlerine göre diz osteoartrit tan›s›
konulan 91 kad›n hasta al›nd›. Hastalar›n demografik bilgileri kaydedildi, ayakta a¤›rl›k verilerek
çekilen ön-arka diz grafileri Kellgren-Lawrence kriterlerine göre de¤erlendirilerek 0 ile
4 aras›nda evrelendirildi. Lomber omurga (L1-L4) ve femoral boyun bölgelerinden dual enerji
x-ray absorbsiyometri yöntemi ile kemik mineral yo¤unluk (KMY) ölçümleri yap›ld›. Anamnezinde,
fizik muayene ve radyolojik incelemelerinde sekonder osteoartrit ve sekonder osteoporoz
flüphesi olan hastalar çal›flma d›fl› b›rak›ld›. Radyolojik evre de¤erleri ve kemik mineral
yo¤unlu¤u de¤erleri aras›nda iliflki incelendi.
BULGULAR: Hastalar›n yafl ortalamas› 60,42±8,68 y›l, vücut kitle indeksi ortalamas› 32,1±4,4
kg/m 2 idi. Kellgren-Lawrence radyografik evreleme kriterlerine göre 7 hasta (%7,7) evre 0, 23
hasta (%25,3) evre 1, 23 hasta (%25,3) evre 2, 25 hasta (%27,5) evre 3 ve 13 hasta (%14,3)
evre 4 bulundu. Lomber omurgada KMY ortalamas› 0,887±0,124 gr/cm 2 , femoral boyun bölgesinde
KMY ortalamas› 0,777±0,146 gr/cm 2 tespit edildi. Hastalar›n diz osteoartrit evreleri
ile lomber omurga ve femoral boyun bölgesi KMY de¤erleri aras›nda anlaml› iliflki bulunmad›.
Yafl ve vücut kitle indeksi etkileri düzeltilerek yap›lan de¤erlendirmede ise radyografik evre
ile lomber omurga (r=0,284, p=0,007) ve femoral boyun bölgesi (r=0,279, p=0,008) KMY
de¤erleri aras›nda pozitif anlaml› iliflki tespit edildi.
SONUÇ: Diz osteoartrit ile lomber omurga ve femoral boyun bölgesi KMY de¤erleri aras›nda
anlaml› iliflki mevcut olup radyografik evre artt›kça KMY de¤erlerinde art›fl meydana gelmekteydi.
Bu sonuç osteoartritin kemik mineral yo¤unluk kayb›n› engelledi¤i ve yafll› popülasyonda
s›k görülen iki hastal›k olan osteoartrit ve osteoporoz aras›nda ters yönde oran oldu¤u yönündeki
görüflü desteklemektedir.
Anahtar Kelimeler: Diz osteoartriti, kemik mineral yo¤unlu¤u, osteoporoz
P-309
Postmenopozal Kad›nlarda Dengenin Yafl,
Kemik Mineral Yo¤unlu¤u ve Vücut Kitle ‹ndeksi ‹le ‹liflkisi
Hakan Nur, Tuncay Çak›r, Füsun Toraman
Antalya E¤itim ve Araflt›rma Hastanesi Fiziksel T›p ve Rehabilitasyon Klini¤i, Antalya
AMAÇ: Postmenopozal dönemde kemik mineral yo¤unlu¤unda azalma ile birlikte denge kay›plar›da
görülmektedir. Denge kay›plar› neticesi görülen düflme e¤ilimi bu dönemde kemik
gücündeki azalma ile birlikte k›r›k riskini artt›rmaktad›r. Bu çal›flman›n amac› postmenopozal
dönemde bulunan sa¤l›kl› kad›nlarda dengenin yafl, kemik mineral yo¤unlu¤u ve vücut kitle
indeksi ile iliflkisini araflt›rmakt›.
GEREÇ-YÖNTEM: Çal›flmaya 215 postmenopozal kad›n olgu dahil edildi. Denge kayb›na neden
olabilecek öyküsü olanlar çal›flmadan ç›kar›ld›. Olgular›n demografik özellikleri kaydedildi, boy
ve kilolar› ölçülerek vücut kitle indeksleri hesapland›. Dual enerji x-ray absorbsiyometri (DXA)
ile lomber (L1-L4) bölge ve femoral boyun bölgesinden kemik mineral yo¤unluk ölçümleri yap›ld›.
Denge de¤erlendirmesi için tek ayak üzerinde durma süresi (sn) ölçüldü.
BULGULAR: Denge süresi ile yafl ve vücut kitle indeksi aras›nda negatif korelasyon saptand›
( s›ras›yla r=-0,376, p=0,001, r=-0,200, p=0,003). Denge süresi ile lomber ve femur boynu kemik
mineral yo¤unluk de¤erleri aras›nda ise anlaml› iliflki tespit edilmedi (p>0,05).Yafl, vücut
kitle indeksi ve lomber ile femoral boyun kemik mineral yo¤unluklar›n›n denge süresi üzerine
etkinli¤ini incelemek için yap›lan çoklu regresyon analizi sonucunda da denge süresine en
önemli etkiyi yafl ve vücut kitle indeksi gösterirken (p0,05).
SONUÇ: Bu çal›flma sonucunda postmenopozal dönemde yafl ve vücut kitle indeksinin denge
üzerine etkin faktörler oldu¤u, yafl ve vücut kitle indeksindeki art›fl›n denge süresinde azalmaya
neden oldu¤u tespit edildi. Denge ile kemik mineral yo¤unlu¤u aras›nda ise anlaml› iliflki yoktu.
Anahtar Kelimeler: Denge, kemik mineral yo¤unlu¤u, vücut kitle indeksi, yafl
306
23. Ulusal Fiziksel T›p ve Rehabilitasyon Kongresi / 23 rd National Physical Medicine & Rehabilitation Congress
Türk Fiz Rehab Derg 2011:57Özel Say›; 1-334 /Turk J Phys Med Rehab 2011:57Suppl; 1-334
P-308
The Relationship Between Knee Osteoarthritis and Bone Mineral Density
Hakan Nur 1, Özgür Nalbant 2, Füsun Toraman 1
1 Antalya Education and Research Hospital Department of
Physical Medicine and Rehabilitation, Antalya
2 Akdeniz University School of Physical Education and Sports, Antalya
OBJECTIVE: The purpose of this study was to investigate the relationship between knee osteoarthritis
and bone mineral density of lumbar spine and femur.
MATERIALS - METHODS: 91 female patients diagnosed as knee osteoarthritis according to
the American Collage of Rheumatology criteria were included in the study. Demographic
characteristics of the patients were recorded. Weight bearing anterior-posterior knee
radiographs were evaluated according to Kellgren-Lawrence criteria and staged from 0 to 4.
Bone mineral density (BMD) of lumbar spine (L1-L4) and femoral neck was measured using
dual X-ray absorptiometry (DXA). The patients suspected of having secondary osteoarthritis
and secondary osteoporosis according to their medical history, physical and radiological
examinations were excluded from the study. The relationship between radiologic stage and
bone mineral densities was examined.
RESULTS: The mean age of the patients was 60.42±8.68, while the mean body mass index
was 32.1±4.4 kg/m 2 . According to Kellgren-Lawrence radiologic staging criteria, 7 (7.7%), 23
(25.3%), 23 (25.3%), 25 (27.5%) and 13 (14.3%) patients were found to be in stages 1,2,3 and
4, respectively. The mean BMD of lumbar spine (L1-L4) was 0.887±0.124 gr/cm 2 , while it was
0.777±0.146 gr/cm 2 in the femoral neck. There was no significant relationship between
knee osteoarthritis and bone mineral density of lumbar spine and femoral neck. After the
adjustment for age and body mass index, on the other side, a positive, significant relationship
was observed between radiologic stage and lumbar spine (r=0.284, p=0.007) and femoral
neck (r=0.279, p=0.008) BMD.
CONCLUS‹ON: There was a significant relationship between knee osteoarthritis and bone
mineral density of lumbar spine and femoral neck, and BMD values showed an increase as
the radiologic stage increased. This result supports the suggestion that osteoarthritis
prevents loss of bone mineral density and there is an inverse relationship between
osteoarthritis and osteoporosis, two commonly encountered diseases in the elderly population.
Keywords: Knee osteoarthritis, bone mineral density, osteoporosis
P-309
The Relationship of Balance with Age, Bone Mineral Density and Body
Mass Index in Postmenopausal Women
Hakan Nur, Tuncay Çak›r, Füsun Toraman
Antalya Education and Research Hospital Department of Physical
Medicine and Rehabilitation, Antalya
OBJECTIVE: Loss of balance can be seen in the postmenopausal period in addition to the
decrease of bone mineral density. The increase of the predisposition to fall due to loss of
balance along with the decrease of the strength of bones, increases the risk of fracture. The
purpose of this study was to investigate the relationship of the balance with age, bone
mineral density and body mass index.
MATERIALS -METHODS: 215 postmenopausal women were included in the study. Those with
any possible history that could explain the loss of balance were excluded from the study.
Demographic characteristics of the cases were recorded. The heights and body weights
were measured and body mass indexes were calculated. Bone mineral density of lumbar
spine (L1-L4) and femoral neck was measured using dual X-ray absorptiometry (DXA). In
order to evaluate the balance, single-leg standing time (in seconds) was measured.
RESULTS: Negative correlation was detected between balance duration, age and body mass
index(r=-0.376, p=0.001, r=-0.200, p=0.003, respectively). No significant relationship was
detected between the balance duration and bone mineral density of lumbar spine and
femoral neck (p>0.05). The results obtained from multiple regression analysis to investigate
the effects of the age, body mass index and bone mineral density of lumbar spine and
femoral neck on the balance duration, showed that the most important effect on balance
duration came from age and body mass index (p0.05).
CONCLUSION: This study showed that the age and the body mass index had significant
effects on balance; and an increase in age and body mass index caused a decrease in
balance duration. There was no significant relationship between balance and bone mineral
density.
Keywords: Balance, bone mineral density, body mass index, age