Naslov (srp)

Povezanost nivoa vitamina D i pojave sarkopenije i osteopenije kod žena sa metaboličkim sindromom u postmenopauzi : doktorska disertacija

Autor

Vuksanović, Miljanka, 1972-

Doprinosi

Beljić-Živković, Teodora, 1959-
Vujović, Svetlana, 1962-
Žarković, Miloš, 1960-
Trbojević, Božo, 1948-

Opis (srp)

Niska koncentracija serumskog 25-hidroksivitamina D (25OHvitD) je povezana sa gubitkom koštane gustine i rizikom od pada kod žena u postmenopauzi. Ispitati koncetraciju 25OHvitD kod žena u postmenopauzi i njegov uticaj na telesni sastav, koštanu gustinu, mišićnu snagu, metabolički sindrom. METOD: Ovo je bila opservaciona, analitička studija, koja je uključila postmenopauzalne žene od 45 - 70 godina starosti. Uključene su žene koje su prvi put došle na merenje koštane gustine dvostruko-energetskom apsorpciometrijom X-zracima (DXA). Procenjivani su: obim struka (OS), indeks telesne maste (ITM), koštana gustina (BMD), glukoza, insulinska rezistencija (HOMA-IR), 25OHD, test mišićne snage (HGT), indeks telesne masti (FMI) i apendikularna mišićna masa (AMM) pomoću DXA aparata. REZULTATI: Prosečna starost žena je bila 57,16±5,71 godina. Početak menopauze kod ispitanica je bio sa 49,59±4,02 godina. Trajanje menopauze u proseku je bilo 7,51±4,99 godina. Prema dobijenom indeksu telesne mase (ITM) 28,03±4,65kg/m2, ispitivane postmenopauzalne žene bile su preterano uhranjene i imale su obim struka (OS) 91,56±10,85cm. Prosečna vrednost 25(OH)D iznosila je 39,43±16,73 nmol/L. Nije bilo ispitanica sa normalnim koncentracijama vitamina D. Insuficijenciju vitamina D imalo je 76,2 %. Pacijentkinje su imale osteopeniju. Prosečna mišićna snaga iznosila je 12,44±2,24kg i bila je statistički značajno niža u odnosu na normative za životnu dob(t = -21.65; p <0,001). Indeks skeletne mišićne mase (SMI) iznosio je 6,72±0,91kg/m2, tako da kod pacijentkinja nije potvrđena sarkopenija. Nađena je pozitivna korelacija između 25(OH)D i testa mišićne snage (R=0,227; p=0,022). Metabolički sindrom imalo je čak 69% ispitanica i potvrđena je korelacija 25OHD sa parametrima metaboličkog sindroma, obimom struka (R2=0,094; p=0,004), glikemijom našte (R2=-0,046; p=0,030), insulinskom rezistencijom (HOMA-IR) (R=-0,238; p=0,017) i indeksom telesne mase (R2=0,080; p=0,002). Procenat telesnih masti iznosio je 43,54±4,83% , statistički značajno više u odnosu na referente vrednosti za istu životnu dob (z=-2.575; p= 0.005). ZAKLJUČAK: Umereno gojazne posmenopauzalne žene imaju insuficijenciju vitamin D koja je povezana sa većim obimom struka, smajenom mišićnom snagom, većim procentom telesnih masti i parametrima metaboličkog sindroma.

Opis (srp)

Medicina - Endokrinologija / Medicine- Endocrinology Datum odbrane: 19.06.2017.

Opis (eng)

Visceral fat is more harmful than subcutaneous fat. It was found that there is 45% more visceral fat in women with hypovitaminosis D, compared to women with normal vitamin D levels. Women with high amounts of visceral fat have an increased risk of metabolic syndrome (MetS), insulin resistance and low level of serum vitamin D. METHODS: This was observational, analytical study of postmenopausal women aged 45 - 70 years. The assessed parameters were: body mass index (BMI), waist circumference (WC), 25- hydroxyvitamin D (25OHD) status, glucose, serum insulin and HOMA-IR, bone mineral density (BMD), muscle strength (HGT), total fat mass (FM), fat mass index (FMI) and appendicular muscle mass (AMM) measured by DXA and. RESULTS: The average age of women was 57.16 ± 5.71 years. Start menopausal patients was 49.59 ± 4.02 with the years. Duration of menopause was 7.51 ± 4.99 years. According to the obtained body mass index (BMI) 28.03 ± 4,65kg/m2, postmenopausal woman was excess body weight with waist circumference (WC) 91.56 ± 10,85cm. The average value of 25(OH)D was 39.43 ± 16.73 nmol/L. There were no patients with normal concentrations of vitamin D insufficiency of vitamin D had 76.2%. Patients had osteopenia. The average muscle strength was 12.44 ± 2,24kg and was significant lower than the normative age (t = -21.65, p <0.001). The index of skeletal muscle mass (SMI) was 6.72 ± 0,91kg/m2 so that has not been confirmed sarcopenia. There was a positive correlation between 25 (OH) D and muscle strength (R = 0.227; p = 0.022). The metabolic syndrome had a 69% of patients and was confirmed 25OHD correlation with the parameters of the metabolic syndrome, waist circumference (R2 = 0.094; p = 0.004) and fasting glucose (R2 = -0.046, p = 0.030), insulin resistance (HOMA-IR) (R = -0.238, p = 0.017) and body mass index (R2 = 0.080; p = 0.002). Percentage body fat was 43.54 ± 4.83%, significant increase compared to the reference values for the same age (Z = -2.575; p = 0.005). CONCLUSIONS: Postmenopausal moderately obese women have vitamin D insufficiency associated with greater waist circumference, low muscle strength, increased body fat and parameters of the metabolic syndrome.

Jezik

srpski

Datum

2016

Licenca

Ovo delo je licencirano pod uslovima licence
Creative Commons CC BY-NC-ND 2.0 AT - Creative Commons Autorstvo - Nekomercijalno - Bez prerada 2.0 Austria License.

http://creativecommons.org/licenses/by-nc-nd/2.0/at/legalcode

Predmet

OSNO - Opšta sistematizacija naučnih oblasti, Endokrini sistem

25-hidroksivitamin D, test mišične snage, dinapenija, postmenopauza, metaboličkisindrom, indeks telesne masti

616.4-055.2(043.3)

OSNO - Opšta sistematizacija naučnih oblasti, Endokrini sistem

25-hydroxyvitamin D, hand grip strength, dynapenia, postmenopause, metabolicsyndrome, fat mass index