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Postmenopozal Kadınlarda Sirkadiyen Kan Basıncı Ritmi ile Kemik Mineral Yoğunluğu Arasındaki İlişki

Relationship Between Circadian Rhythm of Blood Pressure and Bone Mineral Density in Postmenopausal Women

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DOI: 
DOI 10.5262/tndt.2011.1001.04
Abstract (2. Language): 
ObjectI ve: The prevalence of atherosclerosis and osteoporosis increase with age. An association has been demonstrated between cardiovascular diseases and low bone mineral density. We aimed to investigate the association between bone mineral density and nondipping pattern in postmenopausal women. MaterI al and Metho ds: Eighty-four patients aged lower than 65 and and menopausal for more than a year were included in the study. Ambulatory blood pressures were recorded for 24 hours, and lumbar spine and femoral neck bone mineral density were measured by DEXA in all patients. Res ults : According to ambulatory blood pressure measurement results, 29 patients (34.5%) were dipper and 55 patients (65.5%) were nondipper. The mean vertebral T-scores were significantly lower in nondipper patients compared to dipper patients (-1.67±0.96 vs -1.06±1.1, p=0.02). However, the mean femur T-scores were not significantly different between the groups, although it was lower in the nondipper group (-1.22±0.81 vs -0.65±1.16, p=0.05). The mean vertebral and femoral Z-scores were similar in the groups (vertebral Z-score; dipper group; -0.31 ± 0.95, nondipper group; -0.39±1.18, p> 0.05, femur Z-score; dipper group; 0.38±1,27, nondipper group; 0.17±1.03, p> 0.05). ConclusIo n: We showed a significant association between decreased bone mineral density and blunted nighttime blood pressure decrease, which is one of the earliest markers of atherosclerosis. Further studies are warranted to explain this association.
Abstract (Original Language): 
Amaç: Atheroskleroz ve osteoporoz sıklıkları yaşla birlikte artmaktadır. Yapılan çalışmalarda kardiyovasküler hastalıklar ile düşük kemik yoğunluğu arasında bir ilişki olduğu gösterilmiştir. Bu çalışmada menapoz sonrası kadınlarda kemik mineral yoğunluğu ile nondipper arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yönte mler : Çalışmaya 65 yaş altı, bir yıldır menopozda olan 84 hasta alındı. Hastalara 24 saatlik ayaktan kan basıncı ölçümü ve DEXA yöntemi ile vertebra ve femur boynu kemik mineral yoğunluğu ölçümleri yapıldı. Bulgular: Yirmi dört saatlik ayaktan kan basıncı ölçümleri sonucuna göre, 29 hasta (%34,5) dipper, 55 hasta (%65,5) nondipper idi. Nondipper grupta dipper grup ile karşılaştırıldığında ortalama vertebra T skoru anlamlı olarak daha düşük bulundu (dipper grupta; -1,06±1,10, nondipper grupta; -1,67±0,96, p=0,02). Ancak femur T skoru nondipper grupta daha düşük olmasına rağmen her iki grup arasında istatistiksel olarak anlamlı bir fark yoktu (dipper grupta; -0,65±1,16, nondipper grupta; -1,22±0,81, p=0,05). Vertabra ve femur Z skorları ise her iki grupta da benzerdi (vertebra Z skoru; dipper grupta; -0,31±0,95, nondipper grupta; -0,39±1,18, p> 0.05, femur Z skoru; dipper grupta; 0,38±1,27, nondipper grupta; 0,17±1,03, p> 0.05). Sonuç: Çalışmamızda atherosklerozun erken göstergelerinden biri olan geceleyin kan basıncı düşüşündeki azalma ile kemik mineral yoğunluğunda azalma arasında belirgin bir ilişki olduğunu gösterdik. Bu ilişkiyi açıklamaya yönelik yeni çalışmaların yapılması gerekmektedir.
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