El Maataoui Aissam, El Maghraoui Abdellah, Biaz Asmae, Elmachtani Samira Idrissi, Dami Abdellah, Bouhsain Sanae, Mounach Aziza, Chabraoui Layachi, Ouzzif Zohra
University Mohamed V Souissi, Faculty of Medicine and Pharmacy, Av. Mohamed Belarbi El Alaoui Rabat Institut, University Mohamed V Souissi, BP 6203, Rabat, Morocco.
Biochemsitry Department, Military Hospital, Rabat, Morocco.
BMC Womens Health. 2015 May 13;15:41. doi: 10.1186/s12905-015-0199-9.
Vertebral Fractures (VFs) are associated with bone loss that occurs before menopause but is accelerated at menopause as a result of sex hormone deficiency. To determine the association of sex hormones, bone remodeling markers and vitamin D levels with bone mineral density (BMD) and asymptomatic VFs prevalence using vertebral fracture assessment (VFA) in a cohort of Moroccan menopausal women.
This was a cross-sectional study conducted from October 2012 to April 2013 with menopausal women aged 50 years old and over. A total of 207 women who had no previous diagnosis of osteoporosis were enrolled in this cross-sectional study. Women were recruited prospectively from our laboratory department. VFA images and scans of the lumbar spine and proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative approach and morphometry. Serum levels of estradiol, dehydroepiandrosterone sulfate, Sex hormone binding globulin, vitamin D, Osteocalcin, Crosslaps, intact parathormone were measured by Electrochemiluminescent immunoassay technique.
Among the 207 women, 18.3 % (n = 38) had densitometric osteoporosis. On VFA, VFs were detected in 134 (62.3 %), including 96 (44.6 %) grade 1 and 38 (17.6 %) grade 2/3. There was no difference in the plasma levels of sex steroids, bone remodeling markers and vitamin D in the group of women with VFs (grade 1 and grade 2/3) and without VFs. The combination of variables that best predicted grade 2/3 VFs included the number of years since menopause and the lumbar spine T-score.
These data confirm the importance of postmenopausal estrogen and SHBG concentrations in the bone loss and the pathogenesis of osteoporosis in elderly women, but not in the occurrence of the VFs.
椎体骨折（VFs）与绝经前发生的骨质流失有关，但在绝经后由于性激素缺乏而加速。目的是在一组摩洛哥绝经后妇女中，使用椎体骨折评估（VFA）来确定性激素、骨重塑标志物和维生素D水平与骨矿物质密度（BMD）及无症状椎体骨折患病率之间的关联。
这是一项于2012年10月至2013年4月对50岁及以上绝经后妇女进行的横断面研究。共有207名既往未诊断为骨质疏松症的妇女纳入该横断面研究。这些妇女是从我们实验室前瞻性招募的。使用GE医疗Lunar Prodigy骨密度仪获取腰椎和股骨近端的VFA图像及扫描结果。椎体骨折采用Genant半定量方法和形态测量学相结合的方式进行定义。通过电化学发光免疫分析技术测定血清雌二醇、硫酸脱氢表雄酮、性激素结合球蛋白、维生素D、骨钙素、交联C端肽、完整甲状旁腺激素水平。
在207名妇女中，18.3%（n = 38）患有密度测定型骨质疏松症。在VFA检查中，134名（62.3%）检测到椎体骨折，其中96名（44.6%）为1级，38名（17.6%）为2/3级。有椎体骨折（1级和2/3级）和无椎体骨折的女性组在血浆性激素、骨重塑标志物和维生素D水平上没有差异。最能预测2/3级椎体骨折的变量组合包括绝经后的年限和腰椎T值。
这些数据证实了绝经后雌激素和性激素结合球蛋白浓度在老年女性骨质流失和骨质疏松发病机制中的重要性，但在椎体骨折的发生中并非如此。
