Panahi Nekoo, Ostovar Afshin, Fahimfar Noushin, Gharibzadeh Safoora, Shafiee Gita, Heshmat Ramin, Raeisi Alireza, Nabipour Iraj, Larijani Bagher, Ghasem-Zadeh Ali
Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Bone Rep. 2021 Apr 22;14:101071. doi: 10.1016/j.bonr.2021.101071. eCollection 2021 Jun.
Pregnancy is associated with changes in bone remodeling and calcium metabolism, which may increase the risk of fragility fracture after menopause. We hypothesized that in postmenopausal women, with history of grand multiparity, the magnitude of trabecular bone deterioration is associated with number of deliveries.
1217 women aged 69.2 ± 6.4 years, from the Bushehr Elderly Health (BEH) program were recruited. The areal bone mineral density (aBMD) of the lumbar spine and femoral neck and trabecular bone score (TBS) of 916 postmenopausal women, with grand multiparity defined as more than 4 deliveries, were compared with those of 301 postmenopausal women with 4 or fewer deliveries. The association of multiparity with aBMDs and TBS were evaluated after adjustment for possible confounders including age, years since menopause, body mass index, and other relevant parameters.
The aBMD of femoral neck (0.583 ± 0.110 vs. 0.603 ± 0.113 g/cm), lumbar spine (0.805 ± 0.144 vs. 0.829 ± 0.140 g/cm) and TBS (1.234 ± 0.086 vs. 1.260 ± 0.089) were significantly lower in women with history of grand multiparity than others. In the multiple regression analysis, after adjusting for confounders, the negative association did persist for lumbar spine aBMD (beta = -0.02, value = 0.01), and the TBS (beta = -0.01, p value = 0.03), not for femoral neck aBMD.
We infer that grand multiparity have deleterious effects on the aBMD and the trabecular pattern of the lumbar spine.
怀孕与骨重塑和钙代谢变化有关，这可能会增加绝经后脆性骨折的风险。我们假设，在有多次生育史的绝经后女性中，小梁骨退化的程度与分娩次数有关。
招募了1217名年龄在69.2±6.4岁之间、来自布什尔老年人健康（BEH）项目的女性。将916名有多次生育史（定义为分娩次数超过4次）的绝经后女性的腰椎和股骨颈的面积骨密度（aBMD）以及小梁骨评分（TBS）与301名分娩次数为4次或更少的绝经后女性进行比较。在对包括年龄、绝经后年限、体重指数和其他相关参数在内的可能混杂因素进行调整后，评估多产与aBMD和TBS之间的关联。
有多次生育史的女性的股骨颈aBMD（0.583±0.110 vs. 0.603±0.113 g/cm）、腰椎aBMD（0.805±0.144 vs. 0.829±0.140 g/cm）和TBS（1.234±0.086 vs. 1.260±0.089）显著低于其他女性。在多元回归分析中，调整混杂因素后，腰椎aBMD（β=-0.02，p值=0.01）和TBS（β=-0.01，p值=0.03）的负相关仍然存在，而股骨颈aBMD则不存在。
我们推断多次生育对腰椎的aBMD和小梁模式有有害影响。
