Odnos između insulinske rezistencije, mineralne gustine kostiju i rizika od frakture kod žena u postmenopauziBackground/Aim. Skeletal muscles and bones are essential tissues that, in addition to supporting the body, are the primary site of postprandial gl

  • Danijela Bazić Sretenović University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
  • Mirjana Veselinović University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
  • Tamara Nikolić Turnić University of Kragujevac, Faculty of Medical Sciences, Department of Clinical Pharmacy, Kragujevac, Serbia
  • Anja Azanjac University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
  • Aleksandra Korićanac General Hospital Kraljevo, Department of Internal Medicine, Kraljevo, Serbia
  • Aleksandra Tomić Lučić University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
DOI: https://doi.org/10.2298/VSP210216041B
Ključne reči: kost, gustina, kost, prelomi, insulin, rezistencija, postmenopauza, rizik, procena, srbija

Sažetak


Uvod/Cilj. Skeletni mišići i kosti su važna tkiva koja, osim uloge u držanju tela, predstavljaju i primarno mesto preuzimanja glukoze nakon obroka, što je značajno povezano sa rezistencijom na insulin. Cilj rada bio je da se utvrdi uticaj insulinske rezistencije na mineralnu gustinu kosti (MGK) i rizik od nastanka preloma, kao i da se ispita veza između karakteristika mišića i MGK i insulinske rezistencije kod žena u postmenopauzi u Srbiji. Metode. Homeostatski model – rezistencija na insulin (HOMA-IR), izračunat je kod žena u postmenopauzi koje su bile podeljene u dve grupe. Granične vrednosti (cut-off) insulinske rezistencije za grupu sa „niskim HOMA-IR” bila je < 2, a za grupu sa „visokim HOMA-IR” > 2. Masno tkivo (MT), bezmasno tkivo (BT) i MGK mereni su na kuku i kičmenom stubu pomoću denzitometra sa dvoenergetskom X-zračnom apsorpciometrijom. Rezultati. MT i BT su imali očigledan uticaj na MGK. Smanjenje BT i nakupljanje masti bilo je povezano sa višom učestalošću nastanka rezistencije na insulin. Primećena je pozitivna korelacija između HOMA-IR i MGK na kičmi i kuku, ali nije postojala korelacija između insulinske rezistencije i rizika od nastanka preloma. Zaključak. MT i BT imaju značajan uticaj na MGK. Potvrđena je povezanost između MT, BT, MGK i nastanka insulinske rezistencije kod žena u postmenopauzi. Međutim, žene sa višim nivoom insulinske rezistencije i većim MGK nemaju niži rizik od nastanka preloma.

Reference

DeFronzo RA, Tripathy D. Skeletal muscle insulin resistance is the primary defect in type 2 diabetes. Diabetes Care 2009; 32(Suppl 2): S157‒63.

Kalamari M, Leek F, Wang NX, Koh HR, Roy NC, Cameron-Smith D, et al. Association of Insulin Resistance with Bone Strength and Bone Turnover in Menopausal Chinese-Singaporean Women without Diabetes. Int J Environ Res Public Health 2018; 15(5): 889.

Sciorati C, Rigamonti E, Manfredi AA, Rovere-Querini P. Cell death, clearance and immunity in the skeletal muscle. Cell Death Differ 2016; 23(6): 927‒37.

Hamrick MW. The skeletal muscle secretome: an emerging player in muscle-bone crosstalk. Bonekey Rep 2012; 1: 60.

Shanbhogue VV, Finkelstein JS, Bouxsein ML, Yu EW. Associa-tion Between Insulin Resistance and Bone Structure in Nondi-abetic Postmenopausal Women. J Clin Endocrinol Metab 2016; 101(8): 3114‒22.

Nikolić S, Ćurić NJ, Mijović R, Ilinčić B, Ben D. Significance and role of homeostatic model assessment in the evaluation of glu-cose regulation mechanisms. Med Pregl 2017; 70(5‒6): 155‒61.

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28(7): 412‒9.

Ho-Pham LT, Nguyen ND, Lai TQ, Nguyen TV. Contributions of lean mass and fat mass to bone mineral density: a study in postmenopausal women. BMC Musculoskelet Disord 2010; 11: 59.

Jiang Y, Zhang Y, Jin M, Gu Z, Pei Y, Meng P. Aged-Related Changes in Body Composition and Association between Body Composition with Bone Mass Density by Body Mass Index in Chinese Han Men over 50-year-old. PLoS One 2015; 10(6): e0130400.

Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, et al. A review of the measurement of grip strength in clini-cal and epidemiological studies: towards a standardized ap-proach. Age Ageing 2011; 40(4): 423–9.

Mathiowetz V. Comparison of Rolyan and Jamar dynamome-ters for measuring grip strength. Occup Ther Int 2002; 9(3): 201–9.

Beaudart C, Rolland Y, Cruz-Jentoft AJ, Bauer JM, Sieber C, Cooper C, et al. Assessment of Muscle Function and Physical Performance in Daily Clinical Practice: A position paper en-dorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Calcif Tissue Int 2019; 105(1): 1‒14.

Hars M, Biver E, Chevalley T, Herrmann F, Rizzoli R, Ferrari S, et al. Low Lean Mass Predicts Incident Fractures Inde-pendently From FRAX: a Prospective Cohort Study of Re-cent Retirees. J Bone Miner Res 2016; 31(11): 2048‒56.

Lippuner K, Johansson H, Kanis JA, Rizzoli R. FRAX assessment of osteoporotic fracture probability in Switzerland. Osteopo-rosis Int 2010; 21(3): 381–9.

Liu PY, Ilich JZ, Brummel-Smith K, Ghosh S. New insight into fat, muscle, and bone relationship in women: determining the threshold at which body fat assumes a negative relationship with bone mineral density. Int J Prev Med 2014; 5(11): 1452–63.

Ijuin M, Douchi T, Matsuo T, Yamamoto S, Uto H, Nagata Y. Dif-ference in the effects of body composition on bone mineral density between pre- and postmenopausal women. Maturitas 2002; 43(4): 239–44.

Schaap LA, Koster A, Visser M. Adiposity, muscle mass, and muscle strength in relation to functional decline in older per-sons. Epidemiol Rev 2013; 35: 51–65.

Kim SW, Lee HA, Cho EH. Low handgrip strength is associat-ed with low bone mineral density and fragility fractures in postmenopausal healthy Korean women. J Korean Med Sci 2012; 27(7): 744‒7.

Bayramoglu M, Sozay S, Karatas M, Kilinc S. Relationships be-tween muscle strength and bone mineral density of three body regions in sedentary postmenopausal women. Rheumatol Int 2005; 25(7): 513‒7.

Lundin H, Sääf M, Strender LE, Nyren S, Johansson SE, Salminen H. Gait speed and one-leg standing time each add to the pre-dictive ability of FRAX. Osteoporos Int 2017; 28(1): 179‒87.

Sakazaki T, Koike T, Yanagimoto Y, Oshida Y. Association be-tween gait speed and bone strength in community-dwelling postmenopausal Japanese women. Environ Health Prev Med 2012; 17(5): 394–400.

Park HS, Lim JS, Lim SK. Determinants of Bone Mass and In-sulin Resistance in Korean Postmenopausal Women: Muscle Area, Strength, or Composition? Yonsei Med J 2019; 60(8): 742‒50.

Srikanthan P, Crandall CJ, Miller-Martinez D, Seeman TE, Greendale GA, Binkley N, et al. Insulin resistance and bone strength: findings from the study of midlife in the United States. J Bone Miner Res 2014; 29(4): 796‒803.

Chapman NM, Chi H. Dietary fat inflames CD4+ T cell memory in obesity. Cell Metab 2017; 25(3): 490‒2.

Mauro C, Smith J, Cucchi D, Coe D, Fu H, Bonacina F, et al. Obesity-induced metabolic stress leads to biased effector memory CD4+ T cell differentiation via PI3K p110δ-Akt-mediated signals. Cell Metab 2017; 25(3): 593‒609.

Objavljeno
2022/09/21
Broj časopisa
Vol. 79 Br. 7 (2022): Vojnosanitetski pregled
Rubrika
Originalni članak