Faktor risiko osteoporosis pada wanita usia 40-80 tahun: status menopause dan obesitas

https://doi.org/10.22146/ijcn.24872

Fillah Fithra Dieny(1*), Deny Yudi Fitranti(2)

(1) Departemen Ilmu Gizi, Fakultas Kedokteran Universitas Diponegoro
(2) Departemen Ilmu Gizi, Fakultas Kedokteran Universitas Diponegoro
(*) Corresponding Author

Abstract


Background: Osteoporosis is a disease of the musculoskeletal system which are common in women. Menopausal status which affects the production of oestrogen and obesity status that describes mass and distribution of body fat have the potential to affect bone density, which in turn may have an impact on the incidence of osteoporosis.

Objective: To analyze the menopausal and obesity status as risk factors for osteoporosis in women aged 40-80 years.

Method: Cross-sectional study was conducted on 224 women aged 40-80 years in Ngemplak Simongan, Semarang. Status of obesity was determined by percent of body fat, body mass index (BMI), waist circumference, and waist-hip ratio (WHR). Menopausal status was determined based on the occurrence of menstruation in the past one year, and the age was calculated from the difference between date of birth and date of measurement. Bone density was assessed frombone mineral density measurement. Chi-square test and logistic regression were used to determine the relationship and the most influential factors. The risk was expressed in ratio prevalence (RP).

Results: The prevalence of low bone density and obesity in each age range, were 43.8% and 57.9% for ages 40-50 years, 67.7% and 58.6% for ages 51-60 years, 84.9% and 49.1% for ages 61-70 year, 86.7% and 66.7% for ages 71-80 years. There were significant relationships between age, menopausal status, BMI, WHR and bone density (p=0.000, p=0.032, p=0.043, p=0.017, respectively). Osteoporosis (13.3%) and osteopenia (58.7%) were most widely experienced by subjects with high WHR and menopause. Percentage of osteopenia in high WHR and non-menopause subjects (60%) was higher than normal WHR and menopause subjects (52.9%). Age 61-80 years, high WHR, and non-obese BMI were the most influenced risk factorsfor the incidence of low bone density (p=0.001, p=0.038, p=0.043). Ratio prevalence of elderly, high WHR and non-obese BMI were 1.448, 1.326, 1.208.

Conclusion: High WHR explains the role of android obesity and visceral fat as risk factors for low bone density. Premenopausal women will be more at risk of having low bone density if they have high WHR.


Keywords


BMI; bone density; menopause; obesity; WHR

Full Text:

PDF


References

  1. Anderson JJB. Nutrition and Bone Health in Krause’s Food and Nutrition Therapy.12th Edition. USA: Saunders Elsevier; 2009.
  2. Setiyohadi B. Osteoporosis dalam buku ajar Ilmu Penyakit Dalam Jilid II. Edisi IV. Jakarta: Pusat Penerbitan Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia; 2006.
  3. International Osteoporosis Foundation (IOF). What is osteoporosis?. [series online] 2014 [cited 4 Maret 2015]. Available from: URL: http://www.iofbonehealth.org/what-is-osteoporosis.html
  4. Pettifor JM, Prentice A, Ward K, Cleaton-Jones P. The skeletal system in nutrition and metabolism 2nd edition. United States of America: Wiley Blackwel; 2011.
  5. Lee RD. Disease of the musculoskeletal system in nutrition theraphy and pathophysiology. 2nd Edition. Unitated States of America. Wadsworth Cengange Learning. 2010; 771-787
  6. Martono H. Penyakit tulang dan patah tulang. Dalam: Buku ajar Boedhi Darmojo geriatri (ilmu kesehatan usia lanjut). Jakarta: Balai Penerbit FK UI; 2009.
  7. Mithal A, Bansal B, Kyer CS, Ebeling P. The Asia-Pacific regional audit-epidemiology, costs, and burden of osteoporosis in India 2013: a report of International Osteoporosis Foundation. Indian J Endocr Metab [serial online] 2014 [cited 2017 Sep 26];18:449-54. Available from: URL: http://www.ijem.in/temp/IndianJEndocrMetab184449-2539946_070319.pdf
  8. Setiyohadi B. Osteoporosis. Dalam: Buku ajar ilmu penyakit dalam jilid II edisi IV. Jakarta: Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia; 2007.
  9. Tirtarahardja G, Setyohadi B, Weynand LS, Zhou Q. Bone mineral density reference values for indonesian men and women. In: The Asia-Pacific Regional Audit; Epidemiology, Costs and Burden of Osteoporosis in 2013. International Osteoporosis Foundation. [serial online] 2013 [cited 2017 Sep 26]. Available from: URL: https://www.iofbonehealth.org/sites/default/files/media/PDFs/Regional%20Audits/2013-Asia_Pacific_Audit-Indonesia_0_0.pdf
  10. Dinas Kesehatan Kota Semarang. Profil kesehatan Kota Semarang tahun 2012. Semarang: Dinkes Kota Semarang; 2013.
  11. Harvey N, Cooper C. Pencegahan penyakit: osteoporosis dan fraktur panggul. Dalam: Gizi kesehatan masyarakat. Jakarta: Penerbit Buku Kedokteran EGC; 2009.
  12. Kanis JA, Mc Closkey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. International Osteoporosis Foundation 2013;24(1):23-57.
  13. Martono H. Aspek fisiologik dan patologik akibat proses menua. Dalam: Buku ajar Boedhi Darmojo geriatri (ilmu kesehatan usia lanjut). Jakarta: Balai Penerbit FK UI; 2009.
  14. Lestari P. Studi literatur: berbagai faktor yang berpengaruh terhadap kejadian patah tulang pada usia lanjut. Eksplanasi 2011;6(2).
  15. Hsu YH, Venners SA, Terwedow HA, Feng Y, Niu T, Li Z, et al. Relation of body composition, fat mass, and serum lipids to osteoporotic fractures in bone mineral density in Chinese Men and Women. Am J Clin Nutr 2006;83:146-54.
  16. Bhupathiraju SN, Hughes BD, Hannan MT, Lichtenstein AH, Tucker KL. Centrally located body fat is associated with lower bone mineral density in older Puerto Rican adults. Am J Clin Nutr 20011;94:1063-70.
  17. WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO study group. Geneva: World Health Organization; 1994.
  18. World Health Organization. Prevention and Management of Osteoporosis. Geneva: WHO; 2003.
  19. Kim JH, Choi HJ, Ku EJ, Hong AR, Kim KM, Kim SW, et al. Regional body fat depots differently affect bone microarchitecture in postmenopausal Korean women. Osteoporosis Int 2006;27:1161-1168.
  20. Kawai M, de Paula FJA, Rosen CJ. New insight into osteoporosis: the bone-fat connection. J Intern Med 2012;272(4):317-329.
  21. Rosen CJ, Klibanski A. Bone, fat, and body composition: evolving concepts in the pathogenesis of osteoporosis. Am J Med 2009;122(5):409-14.
  22. Prihatini S, Mahirawati VK, Jahari AB, Sudiman H. Faktor determinan risiko osteoporosis di tiga provinsi di Indonesia. Media Litbang Kesehatan 2010;Vol.XX No.2.
  23. Widyaningsih V. Obesity: protective or risk factor of osteoporosis?. Jurnal Ilmu Berbagi: Seri Ilmu Kesehatan dan Lingkungan 2014;2:11-23.
  24. Skrzek A, Koziel S, Ignasiak Z. The optimal value of BMI for the lowest risk of osteoporosis in postmenopausal women aged 40-88 years. HOMO – Journal of Comparative Human Biology 2014;65:232-239.
  25. Lloyd JT, Alley DE, Hawkes WG, Hochberg MC, Waldstein SR, Orwig DL. Body mass index is positively associated with bone mineral density in US older adults. Arch Osteoporos 2014;9:175.
  26. Maimoun L, Mura T, Leprieur E, Avignon A, Mariano-Goulart D, Sultan A. Impact of obesity on bone mass throughout adult life: influence of gender and severity of obesity. Bone 2016;90:23-30.
  27. Ho-Pham LT, Nguyen UDT, Nguyen TV. Association between lean mass, fat mass, and bone mineral density: a meta-analysis. J Clin Endocrinol Metab 2014;99(1):30-38.
  28. Bredella MA. Perspective: the bone-fat connection. Skeletal Radiol 2010;39:729-731.
  29. Blaauw R, Albertse EC, Hough S. Body fat distribution as a risk factor for osteoporosis. S Afr Med J 1996;86(9):1081-4.
  30. Shi XM, Chutkan N, Hamrick MW, Isales CM. Mechanism of glucocorticoid-induced osteoporosis: an update. InTech 2012:41-60.
  31. Neustadt J, Pieczen S. Osteoporosis: beyond bone mineral density. A special report on the state of osteoporosis research for NBI. [serial online] 2012 [cited 2017 Sep 26]. Available from: URL: http://www.nbihealth.com/supporting/osteoporosisreport.pdf



DOI: https://doi.org/10.22146/ijcn.24872

Article Metrics

Abstract views : 14150 | views : 10313

Refbacks

  • There are currently no refbacks.


Bookmark and Share


Copyright (c) 2017 Jurnal Gizi Klinik Indonesia

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Jurnal Gizi Klinik Indonesia (JGKI) Indexed by:
 
  

  free web stats View My Stats