Postmenopausal Saudi Women Research Articles

Health Problems and Disabilities Among the Postmenopausal Saudi Women in Bisha City Receiving Home Care: A Descriptive Cross-Sectional Study.

Postmenopausal women experience physical and psychological changes that may affect their health status. In Saudi Arabia, where the population of postmenopausal women is increasing, there is a need to examine the health problems and disabilities experienced by this group, particularly those who receive home care. This study aims to identify the common health problems and disabilities experienced by postmenopausal Saudi women in Bisha city who receive home care services. A cross-sectional study in Bisha city, Saudi Arabia, involved 155 postmenopausal women (age 60 years and above) receiving home care services. Data were collected using structured interviews and medical records. The study found that the most common health problems among postmenopausal women receiving home care were cardiovascular diseases in 85 women (54.84%), diabetes in 85 women (54.84%), and musculoskeletal disorders in 56 women (36.13%). There was a significant association between the number of health problems and disabilities, indicating that women with more health problems were more likely to experience disabilities (p-value ≤ 0.05). The results showed that age (OR=1.56, 95% CI 1.23-1.99, p=0.001), chronic diseases (OR=2.34, 95% CI 1.43-3.84, p=0.001), and lower education level (OR=1.45, 95% CI 1.01-2.08, p=0.045) were significantly associated with the presence of health problems and disabilities among postmenopausal Saudi women receiving home care in Bisha city. However, marital status and employment status were not found to be significant predictors. Postmenopausal women in Bisha city who receive home care services experience a range of health problems and disabilities, particularly related to hypertension, diabetes, and musculoskeletal disorders. The findings of this study can help healthcare providers develop effective interventions and strategies to improve the health outcomes of this population.

The Relation Between Osteoporosis and Bone Fractures and Health-Related Quality of Life in Post-menopausal Saudi Women in the Jazan Region: A Cross-Sectional Study.

Osteoporosis is a significant health concern, often leading to fragility fractures and severely impacting the quality of life in post-menopausal women. Studies evaluating the effects of osteoporosis and resultant fractures on health-related quality of life (HRQoL) in Saudi women are lacking. This study aimed to assess the relationship between osteoporosis and fracture and physical, psychological, social, and environmental HRQoL domains in post-menopausal Saudi women. In this cross-sectional study conducted in Jazan, Saudi Arabia, 158 post-menopausal Saudi women completed HRQoL surveys using the validated Arabic WHOQOL-BREF questionnaire. Data on socioeconomics, comorbidities, and fracture history were gathered. Descriptive statistics delineated sample characteristics. Analysis of variance (ANOVA) and post-hoc tests identified differences in HRQoL across socioeconomic and clinical categories. Multivariate regression analyses determined factors independently related to HRQoL. Of 158 women surveyed, 39% had a history of osteoporotic fracture. Foot (35%), hand (31%), and vertebral (10%) fractures were the most frequent. Women over 70 had significantly lower physical HRQoL than those aged 45-55 (p<0.001). Unemployed and lower-income women showed poorer HRQoL across domains (p<0.01). Vertebral and hand fractures were negatively related to physical and psychological health (p<0.05). Chronic diseases like hypertension and rheumatoid arthritis reduced HRQoL (p<0.01). In regression analyses, older age, vertebral fracture, physical inactivity, long-term hormone therapy, and unemployment emerged as determinants of poorer HRQoL (p<0.05). Osteoporosis and resultant fragility fractures, especially in vertebral and hand bones, led to substantial impairments in physical, social, psychological, and environmental HRQoL in Saudi women. Modifiable risk factors like physical inactivity and long-term hormone use also affected HRQoL. Targeted screening and multidomain interventions for disadvantaged women with osteoporosis are warranted to improve functioning and quality of life.

Diabetes, dynapenia, and dynapenic obesity in Saudi postmenopausal women

Diabetes, dynapenia, and dynapenic obesity in Saudi postmenopausal women

The Effect of Ramadan Intermittent Fasting on Food Intake, Anthropometric Indices, and Metabolic Markers among Premenopausal and Postmenopausal Women: A Cross-Sectional Study.

Background and objectives: Ramadan intermittent fasting (RIF) is a monthlong practice in which Muslims fast during the whole day from sunrise to sunset. During this month, fasting people change their dietary behavior and alter their eating hours from day to night. The objective of the current study was to examine the effect of RIF on dietary consumption, anthropometric indices, and metabolic markers in healthy premenopausal (PRE-M) and postmenopausal (POST-M) Saudi women. Materials and Methods: The study included 62 women (31 PRE-M, 21-42 years, and 31 POST-M, 43-68 years). A structured questionnaire was used to collect socioeconomic data. Physical activity, anthropometric, dietary, and biochemical assessments were assessed before and at the end of the third week of Ramadan. Results: Socioeconomic data varied among participants. For both groups, observing RIF was associated with significantly (at either p ≤ 0.01 or p ≤ 0.05) lower intake of calories, macronutrients, minerals (excluding Na), and vitamins than before RIF. For the PRE-M group, the percentage of overweight participants decreased significantly (p ≤ 0.01) during Ramadan, while the percentage of obese participants remained unchanged. In contrast, for the POST-M group, the percentage of overweight participants increased significantly (p ≤ 0.05) during Ramadan, but dropped at the end of Ramadan. Following RIF, waist-to-hip ratio, body fat, and fat mass (FM) decreased in both groups. High-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), triglycerides (TG), and blood pressure (SBP, DBP) were generally maintained at acceptable normal levels in most participants before and at the end of RIF. However, low-density lipoprotein cholesterol (LDL-C) at the end of RIF was significantly lower than before, particularly in POST-M women. Age, occupation, and monthly income were the most important predictors for the changes in nutritional status and body fat upon RIF. Conclusions: observing RIF by PRE-M and POST-M Saudi women was associated with significant improvements in variable health indicators, with a few exceptions, and may help lower risk factors for chronic diseases, particularly among POST-M women. However, further studies with a larger sample size are required to determine and confirm the exact effect of RIF on these groups.

Use of the Osteoporosis Self-Assessment Tool as a Screening Tool for Osteoporosis in Saudi Postmenopausal Women.

Osteoporosis is commonly referred to as the "silent disease," as bone loss is gradual and asymptomatic. In older women and men, osteoporosis can lead to increased bone fragility, thus increasing the risk of fractures. These fractures are associated with healthcare costs, physical disabilities, impaired quality of life, and mortality. Therefore, the study's main objective was to assess the applicability of the osteoporosis self-assessment tool (OST) in predicting osteoporosis in Saudi postmenopausal women who are 60 years of age and older and to give a thorough understanding of how such a method can aid in the early diagnosis of osteoporosis in Saudi Arabia and give physicians enough time to treat it. Methods: This study was done at King Abdulaziz Medical City, Riyadh, Saudi Arabia, where we included postmenopausal Saudi women 60 years of age and older who took the bone mineral density (BMD) test in the family medicine department. The approximate target population in this group, between the years 2016 and 2022, was 2969 patients. All data was taken from the BestCare database at King Abdulaziz Medical City in Riyadh. Data weretyped in an Excel sheet (Redmond, USA), then transferred to the R Studio software. The data collection method was chart review, so no informed consent was needed from patients. Names and medical record numbers were not stored. Results: The study included 2969 participants. According to the bone mineral density (BMD) T score results, 490 participants (16.5%) were normal, 1746 participants (58.8%) had osteopenia, and 733 participants (24.7%) suffered from osteoporosis. BMD T scores for normal, osteopenia, and osteoporosis participants were -0.6 (-0.9, -.3), -1.8 (-2.1), and -3 (-3.5, -2.7), consecutively. Estimated OSTI scores for those patients were 2 (0, 4), 1 (-2, 3), and -1 (-4, 1), consecutively. According to the OSTI score for normal participants, 4.29% were classified as being at high risk of osteoporosis. A high risk of osteoporosis was identified in 0.74% of those with osteopenia. 27.83% of osteoporosis patients were classified as being at high risk of osteoporosis. To differentiate normal individuals from those with osteopenia, the cutoff value with optimal sensitivity was 3.5. At such a cutoff value, the test sensitivity was 81.04%. To differentiate normal participants from those with osteoporosis, the cutoff value with optimal sensitivity was 2.5. At such a cutoff value, the test sensitivity was 86.49%. To differentiate osteopenia from osteoporosis patients, the cutoff threshold with optimal sensitivity was 1.5. At such a threshold, sensitivity was 78.44%. Conclusion: OSTA is a simple and validated tool that can identify subjects at increased risk of osteoporosis. Its use could facilitate a more cost-effective use of BMD; by avoiding measurements in low-risk groups.

Associations of Bone Mineral Density with RANKL and Osteoprotegerin in Arab Postmenopausal Women: A Cross-Sectional Study.

Background and objective: There is limited information as to the association of several key bone markers with bone mineral density (BMD) in understudied ethnic groups. This study investigated the relationship between circulating levels of osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-Β ligand (RANKL) with BMD in Arab postmenopausal women. Materials and methods: In this cross-sectional study, a total of 617 Saudi postmenopausal women from the Osteoporosis Registry of the Chair for Biomarkers of Chronic Diseases were included. Anthropometric data, BMD, and biochemical data were retrieved from the registry. Participants were stratified into three groups based on T-score; n = 169 with osteoporosis, n = 282 with osteopenia, and n = 166 normal. Analysis of bone markers including RANKL, OPG, osteocalcin, and N-terminal telopeptide (NTx) was completed using commercially available bioassays. Results: The results suggested that OPG was significantly and positively correlated with age in the osteoporosis group (r = 0.29, p < 0.05), while it was inversely correlated with BMD femoral neck left (r = −0.56, p < 0.001) and BMD femoral neck right (r = −0.37, p < 0.05) in the same group. Moreover, RANKL showed a significant inverse correlation with NTx in the osteopenia group (r = −0.37, p < 0.05). Furthermore, the RANKL/OPG ratio had a positive and significant correlation with BMI (r = 0.34, p < 0.05), BMD femoral neck left (r = 0.36, p < 0.05) and BMD femoral neck right (r = 0.35, p < 0.05) in the osteopenia group. By contrast, it showed a significant inverse correlation with waist to hip ratio in the osteoporosis group (r = −0.38, p < 0.05). Multiple regression analysis showed that OPG contributes to BMD variations in the osteopenia group (p = 0.03). Conclusions: In conclusion, changes in circulating levels of RANKL and OPG might be a protective mechanism contrary to the increased bone loss in postmenopausal women.

The Association of Menopausal Symptoms and Social Support Among Saudi Women at Primary Health Care Centers in Taif, Saudi Arabia.

BackgroundMenopause is a challenging period for all women. The severity of menopausal symptoms hurts their quality of life and daily activity. The aim of this study was to investigate whether the severity of menopausal symptoms are associated with social support and lifestyle factors among Saudi women to help policymakers develop the appropriate intervention health program.MethodsA cross-sectional study of 361 middle-aged Saudi women was conducted through interviews using a valid and reliable questionnaire. The menopause rating scale (MRS) was used to determine the severity of menopausal symptoms and the multidimensional scale of perceived social support (MSPSS) was used to assess perceived social support among females. Linear regression was conducted to assess the association between MRS scores and MSPSS scores after adjustment of covariates.ResultsThe mean total menopause rating scale was 13.7 ± 8.3. Physical and mental exhaustion (80.3%), joint and muscular discomfort (79.2%), and irritability (75.9%) were the most prevalent menopausal symptoms for all women. The mean MSPSS was calculated as 4.3 ±1.8. Perceived social support and lifestyle factors were significant predictors of menopausal symptoms.ConclusionsPostmenopausal Saudi women complain of a variety of physical and psychological symptoms. The current study shows that social support, quitting smoking, losing weight, and increasing physical exercise can help to alleviate or reduce many of the unpleasant symptoms of menopause. This evidence will help policymakers design health intervention for this age group.

Health Promoting Lifestyle Behaviors and Sleep Quality Among Saudi Postmenopausal Women.

BackgroundOne of the most effective measures regarding improving women's health is to promote healthy lifestyle behaviors. This study aimed to investigate the relationship between health-promoting behaviors and sleep quality among a sample of Saudi menopausal women.MethodsA descriptive cross-sectional study was used to collect data from 410 Saudi postmenopausal women visiting primary healthcare care centers located in Sakaka, Jouf, Saudi Arabia, using the Menopause Rating Scale (MRS), Health-Promoting Lifestyle Profile II (HPLPII) and Pittsburgh Sleep Quality Index (PSQI).ResultsThe mean age of the study participants was 52.60 ± 4.65 years, the study findings highlighted that among all the HPLP domains, the highest mean score was observed for spiritual growth (24.00 ± 6.60) whereas the lowest score was observed for physical activity (16.18 ± 1.8). Statistically significant negative relations between the total score of HPLP and sleep quality score and menopausal symptoms (p < 0.001, p < 0.005), respectively. Total scores of lifestyle, health responsibility, and stress management were significant differences between participants with good and poor sleep quality. Being overweight/obese, physically inactive, having a chronic illness and poor sleep quality were predictors influencing health-promoting behavior.ConclusionHealth-Promoting Lifestyle Profile II was more obvious in the good sleeper in form of health responsibility and stress management. Being overweight and or obese, having a chronic illness, and having poor sleep quality were the significant factors influencing health-promoting behaviors. Designing and performing educational interventional plans are crucial to create motivation toward a healthy lifestyle and improve the quality of their sleep.

Knowledge and behavior of postmenopausal women regarding osteoporosis and its screening in Al-Baha region, Saudi Arabia

Background: The risk of osteoporosis and functional deterioration is challenging for Saudi women with increased disease cases. However, recent analysis has shown that Saudi women were unaware of the risk of osteoporosis, so their knowledge and attitudes toward osteoporosis risk and prevention are necessary. We aimed to assess the knowledge and attitudes of Saudi women regarding osteoporosis and its screening in Al-Baha region, Saudi Arabia. Methods: About 464 participants (post-menopausal women) in Al-Baha region were recruited for the study to participate in the online survey. A modified osteoporosis knowledge assessment tool questionnaire was distributed online to collect data on participants’ responses regarding knowledge, attitudes, and practices (KAP) of osteoporosis. Then data was transferred to apply descriptive statistics to measure the frequency and percentage of KAP factors. Results: Most participants had good knowledge of osteoporosis and were 40-50 years old. White women are at higher risk of osteoporosis, but responses were quite uncertain. In addition, the frequency of knowledge of risk and symptoms was 89.7% and 76.3%, respectively. The percentage of knowledge and attitudes was higher for some aspects of risk and symptoms. The perceived knowledge about osteoporosis screening was positive, but actual knowledge remained uncertain. In addition, although knowledge and attitude gave significant results for some aspects of KAP factors, most participants’ overall knowledge was poor. Conclusion: The study concluded that the overall knowledge and attitudes of Saudi post-menopausal women in Al-Baha region regarding osteoporosis was poor, and therefore standard interventions must be recommended to enhance knowledge and practices. Keywords: postmenopausal, osteoporosis, knowledge, Al-Baha, Saudi Arabia

Vitamin D Receptor Gene Variants Susceptible to Osteoporosis in Arab Post-Menopausal Women.

Post-menopausal osteoporosis (PMO) is a multifactorial bone disorder in elderly women. Various vitamin D receptor (VDR) gene variants have been studied and associated with osteoporosis in other populations, but not in a homogenous Arab ethnic group. Herein, the current study explores the association between VDR polymorphisms and susceptibility to osteoporosis in Saudi postmenopausal women. In total, 600 Saudi postmenopausal women (N = 300 osteoporosis; N = 300 control) were genotyped for VDR gene variants (rs7975232, rs1544410, rs731236) using TaqMan® SNP genotyping assays. Bone mineral density (BMD) for the lumbar spine and femur was assessed using dual-energy X-ray absorptiometry (DEXA). The heterozygous frequency distributions AC of rs7975232, CT of rs1544410, and AG of rs731236 were significantly higher in the osteoporosis group than controls (p < 0.05). Heterozygous AC of rs7975232 (1.6; 95% CI 1.1–2.3; p < 0.023), CT of rs1544410 (1.6; 95% CI 1.1–2.4; p < 0.022), and AG of rs731236 (1.6; 95% CI 1.1–2.4; p < 0.024) were significantly associated with increased risk of osteoporosis, independent of age and BMI. In conclusion, VDR gene variants rs7975232, rs1544410, rs731236 had a significant effect on BMD and were associated with osteoporosis risk in Saudi postmenopausal women.

Is there an association of bone mineral density and risk of breast cancer in postmenopausal Saudi women?

Several studies revealed an association between high bone mineral density (BMD) and the increased risk for developing breast cancer (BC). Aim: Explore if there is an association between BMD and BC risk in postmenopausal Saudi (PMS) women. Material and Method: In a retrospective cohort study of 1145 PMS women age range from 46 – 85 year (mean = 55 year). The average time period of menopause 4 years.We reviewed BMD of all patients performed between October 2012 and November 2018. All patients had BMD measurements of lumbar spine L2-L4 and right femoral neck in gm/cm². Results: The T-score was used for analysis of the results. Among the total patient studied 195 (17%) were found to have BC group 1 (G1) while 950 (93%) without BC group 2(G2). Analysis of lumbar spine T-score in G1 showed that: 29 % had osteoporosis, 37% osteopenia and 34% had normal BMD and in G2 40% had osteoporosis, 31% osteopenia and 29 had normal values. Results showed prevalence of osteoporosis in G1 was significantly lower than in G2 (p =0.002) while there was no significant difference between the two groups with osteopenia and normal BMD results (p = 0.06 and 0.205 respectively). Conclusion: PMS women with BC had higher BMD at time of diagnosis compared to their counterpart without BC.

Vitamin D Metabolites and Sex Steroid Indices in Postmenopausal Women with and without Low Bone Mass.

While the independent roles of vitamin D and sex hormones in skeletal health are well established, the associations of vitamin D and its metabolites to sex hormones and their indices are less investigated. In this observational study, clinical information of 189 Saudi postmenopausal women aged ≥50 years old [N = 80 with normal bone mineral density (BMD), aged 53.3 ± 7.7 years with body mass index (BMI)= 34.1kg/m2 ± 5.8, and N = 109 with low BMD (T-score −1.0 to −2.5), aged 57.0 ± 8.2 years, BMI = 32.4kg/m2 ± 6.2] was extracted from an existing capital-wide osteoporosis registry in Riyadh, Saudi Arabia. Data included were BMD scores, serum total 25(OH)D, sex hormones, and bone turnover markers which were measured using commercially available assays. Age- and BMI-adjusted comparisons revealed significantly higher parathyroid hormone (PTH) levels as well as significantly lower testosterone and bioavailable testosterone in the low BMD group than the normal BMD group (p-values 0.04, 0.02, and 0.03, respectively). Stepwise linear regression showed that circulating testosterone levels accounted for 9.7% and 8.9% of the variances perceived in bioavailable 25(OH)D and free 25(OH)D, respectively (p < 0.01), independent of other sex hormones, sex hormone indices, and bone turnover markers. Our study suggests that androgens are significantly associated with non-conventional vitamin D metabolites and these associations may have clinical relevance in assessing risk for low BMD and osteoporosis in Arab postmenopausal women.

Association of Polymorphisms in RANK and RANKL Genes with Osteopenia in Arab Postmenopausal Women.

The RANKL/RANK/OPG pathway regulates bone remodelling and turnover. However, the genetic background of bone mineral density (BMD) and osteopenia in Saudi postmenopausal women is yet to be studied. We studied the genetic polymorphism of RANKL/RANK/OPG with BMD and other associated factors in Saudi postmenopausal osteopenic women. A total of 439 (223 osteopenia and 216 control) postmenopausal women were recruited from the orthopaedic department of the King Khalid University Hospital, Riyadh, KSA. Genetic variants of RANK (rs1805034 and rs35211496), RANKL (rs2277438 and rs9533156), and OPG (rs2073618 and rs3102735) were genotyped using RT-PCR. Anthropometrics, bone mineral density, and other bone markers were measured. The levels of bone turnover markers, PTH, and RANKL were found to be significantly different between control and the osteopenia group. The odds ratio of 2.37 (1.00–5.69) for RANK SNP (rs1805034) indicates that subjects with CC genotype are more vulnerable to developing osteopenia as compared to subjects with TT genotype. Similarly, for RANKL SNP (rs2277438), the significant odds ratio of 20.56 (9.82–43.06) indicates that the subjects with GG genotype are at significantly higher risk of having osteopenia compared with the AA genotype subjects. In addition, G allele in rs2277438 also found to be a risk factor for osteopenia 4.54 (3.18–6.49) compared with A allele. However, none of the OPG genotypes shows association with osteopenia. The association of RANK polymorphisms with osteopenia shows its clinical importance in the diagnosis and prognosis of the bone diseases; here, we suggest that the subjects with RANK and RANKL polymorphisms may develop osteoporosis.

Serum iron deficiency and 25-hydroxyvitamin D deficiency as an independent risk factor for osteoporosis in postmenopausal Arab women

BackgroundIron deficiency and 25-hydroxyvitamin D (25(OH)D) deficiency are among the most common nutrient deficiencies in the world. Osteoporosis, a major bone disorder, is prevalent globally as well as in Saudi Arabia. The relationship between these micronutrient deficiencies with osteoporosis is less investigated. Hence, the current study aimed to determine the relationship between iron and 25(OH)D deficiencies among postmenopausal Saudi women with osteoporosis and their associations with bone biomarkers. MethodologyA total of 184 postmenopausal Saudi women ≥ 45 years old [N = 75 osteoporosis group; N = 109 without osteoporosis or control group] were enrolled in this cross-sectional study. Anthropometrics and bone mineral density were measured. Serum iron indices, 25(OH)D and bone biomarkers [β-carboxyterminal telopeptide of type 1 collagen (β-crosslap), osteocalcin (OC), osteoprotegerin (OPG), osteopontin (OPN) and bone-specific alkaline phosphatase (BsALP) were determined. ResultsIn all subjects, significant associations were observed between serum iron and OC (r = 0.19; p = 0.02) as well as OPN (r = 0.17; p = 0.05). Also, serum 25(OH)D was inversely associated with BsALP (r = −0.25; p = 0.02), and positively with β-crosslap (r = 0.38; p = 0.01). An inverse significant association was observed between 25(OH)D and OPG (r = −0.25; p = 0.01) in the control group and BsALP (r = −0.31; p = 0.02) in the osteoporosis group. ConclusionSignificant associations between circulating iron and 25(OH)D with select bone biomarkers were observed in postmenopausal Arab women with osteoporosis, suggesting that these micronutrients may affect bone metabolism.

Anthropometry, bone mineral density and risk of breast cancer in premenopausal and postmenopausal Saudi women.

Anthropometry and bone mineral density are linked to hormonal imbalance, which plays a possible role in breast carcinogenesis. The current study was designed to explore the relationship between selected anthropometric and bone mineral density parameters and the risk of breast cancer in premenopausal and postmenopausal Saudi women. A cross-sectional study was carried out among premenopausal (n = 308) and postmenopausal (n = 148) women at two Medical Cities in Riyadh, Saudi Arabia from May 2015 to June 2016. Selected anthropometric measurements were obtained from 456 women; 213 of them had breast cancer. Bone mineral density was also measured using dual-energy X-ray absorptiometry. Greater waist circumference was significantly correlated with a higher breast cancer risk in premenopausal women (OR = 1.02, p = 0.03) but not in postmenopausal women. Greater triceps skinfold thickness had been found to be significantly correlated with a higher risk of breast cancer in premenopausal (OR = 1.06, p = 0.001) and postmenopausal (OR = 1.06, p = 0.001) women. However, bone mineral density was not significantly associated with breast cancer risk in either group of participants. Breast cancer risk was significantly associated with waist circumference and triceps skinfold thickness in premenopausal women and with only triceps skinfold thickness in postmenopausal women.

Serum minerals (Ca, P, Co, Mn, Ni, Cd) and growth hormone (IGF-1 and IGF-2) levels in postmenopausal Saudi women with osteoporosis.

Osteoporosis is reported to be common among Saudi women. Several minerals appear to be important determinants of insulin-like growth factor (IGF), the bioactivity of which regulates bone and mineral metabolism. Here we proposed that mineral status may alter the IGF system among individuals with osteoporosis. This study aims to evaluate the relationships between essential elements and IGF levels among postmenopausal Saudi women with osteoporosis. A total of 128 postmenopausal Saudi women aged ≥50 years old were recruited in this study. Diagnosis of osteoporosis was done by using dual-energy x-ray absorptiometry to determine the bone minerals density (BMD). Serum calcium and phosphate were determined using routine chemical analyzer. Serum Co, Mn, Ni, Cd were measured using inductively coupled plasma mass spectrometry. Serum IGF-1 and IGF-2 were determined using Luminex xMAP. Using stepwise linear regression analysis, only Cd was identified to be significantly associated with IGF1 in osteoporosis, explaining 3% (confidence interval 0.01–0.05; P = 0001) of the variance perceived. Our results suggest that Cd exposure indirectly affects BMD which may increase the risk of osteoporosis in postmenopausal women. Further longitudinal study using a larger sample size is recommended to determine causality of Cd levels and IGF-1.

Adrenocorticotropic Hormone Modulates Bone Mineral Density among Postmenopausal Saudi Women with Type 2 Diabetes Mellitus Irrespective of Osteoporosis Status

BackgroundThe pituitary gland secretes several hormones known to regulate the activity of other endocrine glands, hence the name “master gland”. Neuroendocrinology of bone is a new and emerging field based on the theory that pituitary hormones can directly affect bone remodeling and metabolism. Therefore, the present study aims to determine for the first time in a homogenous Arabian cohort, the associations of the major hormones of the anterior pituitary gland and other hormones with indices of bone mineral density among known T2DM (type 2 diabetes mellitus) and postmenopausal Saudi women, with or without osteoporosis.MethodsIn this cross‐sectional study, a total of 363 postmenopausal Saudi women [N=161 without osteoporosis, age (years) 54.7±7.6, BMI (body mass index) (kg/m2) 34.6±5.7; N=202 with osteoporosis, age 59.0±8.7, BMI 32.3±6.4] were randomly selected from the Osteoporosis Registry database of the Chair for Biomarkers of Osteoporosis (CBCD) in King Saud University, Riyadh, Saudi Arabia. Serum calcium was measured routinely. Parathyroid hormone (PTH), follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), testosterone, estrogen, prostaglandin and insulin‐growth factor 1 (IGF1) were measured using commercially available assay kits following manufacturers’ instructions. Serum 25(OH)D was measured using electrochemiluminiscence assay. Bone mineral density (BMD) and corresponding T‐scores were assessed using dual x‐ray absorptiometry (DXA).ResultsAge‐ and BMI‐adjusted comparisons revealed that levels of testosterone and estrogen were significantly lower in the osteoporosis group than those without (p‐values 0.05 and 0.02, respectively). Circulating ACTH levels were significantly higher in the osteoporosis group than their counterparts (p=0.002). In all subjects, FSH was inversely and significantly associated with T‐Score (spine) (R=−0.27; p&lt;0.05) and BMD (femur) (R=−0.35; p&lt;0.05). Post‐stratification, ACTH was significantly associated with BMD (spine) (R=0.62; p&lt;0.05). No significant associations between hormones and BMD were seen in the non‐osteoporosis group. In all subjects and using stepwise linear regression, ACTH and IGF1 predicted 32% of the variance in T‐Score of the spine (p=0.002). Furthermore, ACTH and TSH predicted 29% of the variance in T‐Score of the femur (p=0.002). Lastly, ACTH and IGF1 predicted 37.4% of the variances observed in BMD (femur) (p=0.001).ConclusionAmong the anterior pituitary hormones, the stress hormone regulator, ACTH, seems to influence BMD the most, at least among Saudi women with T2DM, irrespective of osteoporosis status. An imbalance of this hormone may predispose T2DM individuals to decreased BMD and subsequent osteoporosis. Whether these findings apply to the non‐T2DM population needs further investigation.Support or Funding InformationDeanship of Scientific Research, Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia Stepwise regression analysis using T‐score and BMD as dependent variables Dependent Predictor β R2 P‐Value T‐Score Spine Model 2 0.320 0.002 ACTH −3.07 0.003 IGF1 2.90 0.007 T‐Score Femur Model 2 0.288 0.002 ACTH −2.90 0.001 TSH 1.29 0.031 BMD Spine None BMD Femur left Model 2 0.374 0.001 ACTH −0.25 0.007 IGF1 0.45 0.029 BMD Femur Right None

Influence of bone mineral density in circulating adipokines among postmenopausal Arab women.

Osteoporosis and osteopenia has a significant link with substantial fracture risk. Epidemiological data revealed a protective role of adipose tissue on bone biology in postmenopausal osteoporosis. The current study assessed the associations between select adipokines and bone mineral density (BMD) in postmenopausal women. A total of 175 Saudi postmenopausal women were selected and categorized based on their BMD (normal & low-BMD). Circulating levels of select adipokines (adiponectin, resistin, leptin, and adipsin), insulin, 25(OH)D and RANKl were determined using commercially available assay kits. BMD was measured by dual-energy X-ray absorptiometry (DXA). Overall and among low-BMD subjects, adiponectin consistently showed a significant inverse association with BMD (overall −0.34, p < 0.01; low BMD group −0.34, p < 0.01). In multiple regression, adiponectin (−0.29 ± 0.06, p < 0.00) and resistin (−0.08 ± 0.04, p < 0.05) were inversely significant with BMD overall, but after stratification the significance was lost for resistin (−0.05 ± 0.04, p < 0.224) whereas adiponectin remained (−0.22 ± 0.07, p < 0.02) in low-BMD subjects. Adipsin, leptin and lipocalin-2 showed no significant associations. Findings of the present study revealed that only adiponectin showed a significantly strong inverse association with low BMD, suggesting that insulin sensitivity may influence bone health in Arab postmenopausal women.

Bone mineral density among postmenopausal Saudi women in Riyadh city – A primary care level cross-sectional survey

Objectives: This study aimed to estimate the prevalence of osteopenia and osteoporosis and to identify the associated risk factors among postmenopausal Saudi women. Methods: A community-based cross-sectional study was conducted included 501 menopausal women from 15 primary health-care centers randomly selected to be representative of various sectors of Riyadh City and three shopping malls located in Riyadh. A tested questionnaire was used to collect information about the related risk factor. Bone mineral density (BMD) of the calcaneus bone was measured using an ultrasound bone densitometer, and serum Vitamin D was measured using an autoanalyzer. BMD was classified into different categories, according to the World Health Organization classification. Descriptive statistics and logistic regression performed. Results: Mean + standard deviation age was 57.7 + 6.2 years with a range of 44–81. The prevalence of low BMD in the current study (osteopenia and osteoporosis) was 18% and 6%, respectively. The age (odds ratio [OR] = 1.07, 95% confidence interval [CI]: 1.01–1.13) and waist–hip ratio (OR = 0.94, 95% CI: 0.90–0.99) were significantly independent associated with osteopenia; also age (OR = 1.16, 95% CI: 1.09–1.24) and joint pain history (OR = 6.08, 95% CI: 2.01–18.3) were significantly independent associated with osteoporosis; and age (OR 1.08, 95% CI: 1.04–1.11) and joint pain history (1.99, 1.05–3.79) were significantly independent associated with low BMD status. Conclusions: The prevalence of low BMD among postmenopausal women was found to be lower than that reported by other studies in Saudi Arabia. Age was the crucial factor associated with Low BMD status. Further community-based studies are required to assess the community prevalence of low BMD and implement strategies to reduce the burden of its related consequences.

Early Detection and Prevention of Osteoporosis Among Pre- and Postmenopausal Women in Saudi Arabia.

Osteoporosis is difficult to treat and is still incurable, and thus prevention is critically important. The aim of this study was to find out the high-risk women for osteoporosis and to correlate their bone mineral density (BMD) with their investigated risk factors. Cross-sectional design was used and it was conducted among 200 pre- and postmenopausal Saudi women. The study documented that postmenopausal females had high prevalence of osteopenia and majority of them had low serum calcium. Significant correlation was found between low BMD and family history of osteoporosis; increased BMD was seen in women, who consumed calcium-rich foods, exposure to sun light, and longer fertility period. Majority of the women 94.5% had inadequate knowledge on preventive measures of osteoporosis. The high prevalence of osteopenia in postmenopausal women indicates the ultimate importance of early intervention to prevent development of osteoporosis in later life.