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BMC Women's Health
Published in: BMC Women's Health 1/2015

Open Access 01-12-2015 | Research article

Relationships between vertebral fractures, sex hormones and vitamin D in Moroccan postmenopausal women: a cross sectional study

Authors: Aissam El maataoui, Abdellah El Maghraoui, Asmae Biaz, Samira Idrissi Elmachtani, Abdellah Dami, Sanae Bouhsain, Aziza Mounach, Layachi Chabraoui, Zohra Ouzzif

Published in: BMC Women's Health | Issue 1/2015

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.
Literature
1.
Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359(9319):1761–7.CrossRefPubMed
2.
Delmas PD, van de Langerijt L, Watts NB, Eastell R, Genant H, Grauer A, et al. Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res. 2005;20(4):557–63.CrossRefPubMed
3.
Pasco JA, Henry MJ, Korn S, Nicholson GC, Kotowicz MA. Morphometric vertebral fractures of the lower thoracic and lumbar spine, physical function and quality of life in men. Osteoporos Int. 2009;20(5):787–92.CrossRefPubMed
4.
Delmas PD, Genant HK, Crans GG, Stock JL, Wong M, Siris E, et al. Severity of prevalent vertebral fractures and the risk of subsequent vertebral and nonvertebral fractures: results from the MORE trial. Bone. 2003;33(4):522–32.CrossRefPubMed
5.
Ettinger B, Pressman A, Sklarin P, Bauer DC, Cauley JA, Cummings SR. Associations between low levels of serum estradiol, bone density, and fractures among elderly women: the study of osteoporotic fractures. J Clin Endocrinol Metab. 1998;83(7):2239–43.PubMed
6.
Nevitt MC, Ettinger B, Black DM, Stone K, Jamal SA, Ensrud K, et al. The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med. 1998;128(10):793–800.CrossRefPubMed
7.
Ensrud KE, Thompson DE, Cauley JA, Nevitt MC, Kado DM, Hochberg MC, et al. Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass. Fracture Intervention Trial Research Group. J Am Geriatr Soc. 2000;48(3):241–9.CrossRefPubMed
8.
Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR. Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med. 1999;159(11):1215–20.CrossRefPubMed
9.
Emaus N, Berntsen GK, Joakimsen R, Fonnebo V. Longitudinal changes in forearm bone mineral density in women and men aged 45–84 years: the Tromso Study, a population-based study. Am J Epidemiol. 2006;163(5):441–9.CrossRefPubMed
10.
Riggs BL, Khosla S, Melton 3rd LJ. A unitary model for involutional osteoporosis: estrogen deficiency causes both type I and type II osteoporosis in postmenopausal women and contributes to bone loss in aging men. J Bone Miner Res. 1998;13(5):763–73.CrossRefPubMed
11.
Slemenda C, Longcope C, Peacock M, Hui S, Johnston CC. Sex steroids, bone mass, and bone loss. A prospective study of pre-, peri-, and postmenopausal women. J Clin Investig. 1996;97(1):14.CrossRefPubMedPubMedCentral
12.
Lee JS, LaCroix AZ, Wu L, Cauley JA, Jackson RD, Kooperberg C, et al. Associations of serum sex hormone-binding globulin and sex hormone concentrations with hip fracture risk in postmenopausal women. J Clin Endocrinol Metab. 2008;93(5):1796–803.CrossRefPubMedPubMedCentral
13.
Bjornerem A, Ahmed LA, Joakimsen RM, Berntsen GK, Fonnebo V, Jorgensen L, et al. A prospective study of sex steroids, sex hormone-binding globulin, and non-vertebral fractures in women and men: the Tromso Study. Eur J Endocrinol. 2007;157(1):119–25.CrossRefPubMed
14.
Ghebre MA, Hart DJ, Hakim AJ, Kato BS, Thompson V, Arden NK, et al. Association between DHEAS and bone loss in postmenopausal women: a 15-year longitudinal population-based study. Calcif Tissue Int. 2011;89(4):295–302.CrossRefPubMedPubMedCentral
15.
Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005;16 Suppl 2:S3–7.CrossRefPubMed
16.
Ballane G, Cauley JA, Arabi A, El-Hajj Fuleihan G. Chapter 27 - Geographic Variability in Hip and Vertebral Fractures. In: Cauley RMFWDLA, editor. Osteoporosis. 4th ed. San Diego: Academic; 2013. p. 623–44.CrossRef
17.
El Maghraoui A, Morjane F, Nouijai A, Achemlal L, Bezza A, Ghozlani I. Vertebral fracture assessment in Moroccan women: prevalence and risk factors. Maturitas. 2009;62(2):171–5.CrossRefPubMed
18.
Simpson ER, Bulun SE, Nichols JE, Zhao Y. Estrogen biosynthesis in adipose tissue: regulation by paracrine and autocrine mechanisms. J Endocrinol. 1996;150(Suppl):S51–7.PubMed
19.
Garnero P, Sornay-Rendu E, Claustrat B, Delmas PD. Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study. J Bone Miner Res. 2000;15(8):1526–36.CrossRefPubMed
20.
Stone K, Bauer DC, Black DM, Sklarin P, Ensrud KE, Cummings SR. Hormonal predictors of bone loss in elderly women: a prospective study. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res. 1998;13(7):1167–74.CrossRefPubMed
21.
Chapurlat RD, Garnero P, Breart G, Meunier PJ, Delmas PD. Serum estradiol and sex hormone-binding globulin and the risk of hip fracture in elderly women: the EPIDOS study. J Bone Miner Res. 2000;15(9):1835–41.CrossRefPubMed
22.
van Hemert AM, Birkenhager JC, De Jong FH, Vandenbroucke JP, Valkenburg HA. Sex hormone binding globulin in postmenopausal women: a predictor of osteoporosis superior to endogenous oestrogens. Clin Endocrinol (Oxf). 1989;31(4):499–509.CrossRef
23.
Tromp AM, Ooms ME, Popp-Snijders C, Roos JC, Lips P. Predictors of fractures in elderly women. Osteoporos Int. 2000;11(2):134–40.CrossRefPubMed
24.
Goderie-Plomp HW, van der Klift M, de Ronde W, Hofman A, de Jong FH, Pols HA. Endogenous sex hormones, sex hormone-binding globulin, and the risk of incident vertebral fractures in elderly men and women: the Rotterdam Study. J Clin Endocrinol Metab. 2004;89(7):3261–9.CrossRefPubMed
25.
Hoppé E, Bouvard B, Legrand E, Levasseur R, Masson C, Audran M: Serum Sex Hormone-Binding Globulin Level to Predict Osteoporosis Severity. In: Journal of Bone and Mineral Research 2008: Amer Soc Bone & Mineral Res, Washington, DC 20036-3309 USA; 2008: S447-S447.
26.
Hoppe E, Bouvard B, Royer M, Audran M, Legrand E. Sex hormone-binding globulin in osteoporosis. Joint Bone Spine. 2010;77(4):306–12.CrossRefPubMed
27.
Devine A, Dick IM, Dhaliwal SS, Naheed R, Beilby J, Prince RL. Prediction of incident osteoporotic fractures in elderly women using the free estradiol index. Osteoporos Int. 2005;16(2):216–21.CrossRefPubMed
28.
29.
Dong SS, Liu XG, Chen Y, Guo Y, Wang L, Zhao J, et al. Association analyses of RANKL/RANK/OPG gene polymorphisms with femoral neck compression strength index variation in Caucasians. Calcif Tissue Int. 2009;85(2):104–12.CrossRefPubMedPubMedCentral
30.
Batra GS, Hainey L, Freemont AJ, Andrew G, Saunders PT, Hoyland JA, et al. Evidence for cell-specific changes with age in expression of oestrogen receptor (ER) alpha and beta in bone fractures from men and women. J Pathol. 2003;200(1):65–73.CrossRefPubMed
31.
Nilsson S, Gustafsson JA. Estrogen receptors: therapies targeted to receptor subtypes. Clin Pharmacol Ther. 2011;89(1):44–55.CrossRefPubMed
32.
Allali F, El Aichaoui S, Khazani H, Benyahia B, Saoud B, El Kabbaj S, et al. High prevalence of hypovitaminosis D in Morocco: relationship to lifestyle, physical performance, bone markers, and bone mineral density. Semin Arthritis Rheum. 2009;38(6):444–51.CrossRefPubMed
33.
Lopes JB, Danilevicius CF, Takayama L, Caparbo VF, Scazufca M, Bonfá E, et al. Vitamin D insufficiency: a risk factor to vertebral fractures in community-dwelling elderly women. Maturitas. 2009;64(4):218–22.CrossRefPubMed
34.
El Maghraoui A, Ouzzif Z, Mounach A, Rezqi A, Achemlal L, Bezza A, et al. Hypovitaminosis D and prevalent asymptomatic vertebral fractures in Moroccan postmenopausal women. BMC Womens Health. 2012;12(1):11.CrossRefPubMedPubMedCentral
35.
Cummings SR, Browner WS, Bauer D, Stone K, Ensrud K, Jamal S, et al. Endogenous hormones and the risk of hip and vertebral fractures among older women. N Engl J Med. 1998;339(11):733–8.CrossRefPubMed
36.
Metadata
Title
Relationships between vertebral fractures, sex hormones and vitamin D in Moroccan postmenopausal women: a cross sectional study
Authors
Aissam El maataoui
Abdellah El Maghraoui
Asmae Biaz
Samira Idrissi Elmachtani
Abdellah Dami
Sanae Bouhsain
Aziza Mounach
Layachi Chabraoui
Zohra Ouzzif
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2015
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-015-0199-9

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