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Analysis of body composition and metabolic parameters depending on the presence of osteoporosis in women over 65 years of age

dc.contributor.advisorTomić-Lučić, Aleksandra
dc.contributor.otherĐukić, Aleksandar
dc.contributor.otherPetronijević, Milan
dc.contributor.otherVeselinović, Mirjana
dc.creatorBazić Sretenović, Danijela
dc.date.accessioned2023-09-06T12:19:06Z
dc.date.available2023-09-06T12:19:06Z
dc.date.issued2021
dc.identifier.urihttp://eteze.kg.ac.rs/application/showtheses?thesesId=8649
dc.identifier.urihttps://fedorakg.kg.ac.rs/fedora/get/o:1608/bdef:Content/download
dc.identifier.urihttps://nardus.mpn.gov.rs/handle/123456789/21668
dc.description.abstractUvod: Osteoporoza je sistemski i skeletni poremećaj čija je osnovna odlika smanjenje koštane mase i oštećenje mikroarhitekture koštanog tkiva. U postmenopauzalnoj osteoporozi, uticaj bezmasnog tkiva (LM) na mineralnu koštanu gustinu (BMD) je poznat a postoje kontradiktorni rezultati u pogledu uticaja mase masnog tkiva (FM). Povezana je sa povećanim rizik od nastanka koštanih preloma i posledica koje one nose i kao takva predstavlja značajan zdravstveni i socio-ekonomski problem savremenog, razvijenog društva. Sarkopenija predstavlja gubitak mase skeletnih mišića i mišićne snage koji dolazi sa godinama i najčešće se javlja nakon 40-e godine života kada se u proseku gubi oko 0.5% mišićne mase godišnje. Osobe sa sarkopenijom imaju veću incidencu pojave i razvoja osteoporoze što utiče na to da kvalitet života kod ovih osoba bude smanjen. Pored toga, skeletni mišići i kosti su tkiva koja, osim toga što učestvuju u držanju tela, su i primarno mesto unosa glukoze nakon obroka, a što je značajno povezano sa rezistencijom na insulin. Cilj: Cilj istraživanja bio je da se utvrdi koja od komponenti telesnog sastava ima najveći uticaj na BMD, uticaj mišićne snage i fizičke performanse na BMD, i proceni njihov uticaj na rizik od preloma. Pored toga, cilj je bio utvrdti uticaj insulinske rezistencije na BMD i njen rizik za nastanak preloma, kao i dokaže postojanje veza između mišićnih karakteristika, BMD i insulinske rezistencije kod postmenopauzalnih žena u Srbiji, a sve sa krajnjim ciljem prevencije sarkopenije i nastanak frkatura, korigovanje terapijskog pristupa i higijensko-dijetetski režim kod starijih osoba. Metode: Studija je dizajnirana kao klinička, neintervenciska, opservaciona studija preseka i obuhvatila je 66 žena starijih od 65 godina koje su odabrane slučajnim uzorkovanjem. BMD je merena na lumbalnom delu kičmenog stuba, vratu butne kosti i celom telu korišćenjem denzitometra sa dvoenergetskom X-zračnom apsorpciometrijom (DXA). Mišićna snaga je određena testom stiska šake a fizička performansa merenjem brzine hoda (GS) na distanci od 4m. Homeostatski model - rezistencija na insulin (HOMA-IR), izračunat je tako što su ispitanice podeljene u dve grupe. "Cut-off" vrednost insulinske rezistencije za grupu sa „Niskim HOMA-IR“ bila je <2, a za grupu sa "Visokim HOMA-IR" > 2. Rizik od preloma procenjen je pomoću FRAX indeksa 1 i FRAX indeksa 2. Rezultati: Rezultati su pokazali da i masno i bezmasno tkivo imaju uticaj na BMD, ali je uticaj bezmasnog tkiva bio značajniji bez obzira na lokalizaciju skeleta. HGT i GS su imali značajan stepen pozitivne korelacije sa BMD. LM, HGT i GS su bili u značajnoj negativnoj korelaciji sa 10-ogodišnjom verovatnoćom preloma za veće prelome osteoporoze, kao i prelome kuka. Međutim, masna masa je imala značajnu negativnu korelaciju samo sa prelomima kuka. Smanjenje LM i nakupljanje masti povezano je sa većom učestalošću nastanka rezistencije na insulin. Primećena je pozitivna korelacija između HOMA-IR i BMD na kičmi i kuku, ali nije postojala korelacija između insulinske rezistencije i rizika za nastanak preloma. Zaključak: LM i FM imaju značajan uticj na BMD. Takođe, potvrđena je povezanost između LM, FM, BMD i nastanka insulinske rezistencije kod postmenopauzalnih žena. Međutim, žene sa višim nivoom insulinske rezistencije i većim BMD nemaju manji rizik za nastanak preloma.sr
dc.description.abstractIntroduction: Osteoporosis is a systemic and skeletal disorder whose main feature is a decrease in bone mass and damage to the microarchitecture of bone tissue. In postmenopausal osteoporosis, the effect of adipose tissue (LM) on bone mineral density (BMD) is known, and there are contradictory results regarding the effect of adipose tissue mass (FM). It is associated with an increased risk of bone fractures and the consequences they carry. As such, it represents a significant health and socio-economic problem of modern, developed society. Sarcopenia is a loss of skeletal muscle mass and muscle strength that comes with age and mostly often occurs after the age of 40 when about 0.5% of muscle mass is lost per year. People with sarcopenia have a higher incidence of the occurrence and development of osteoporosis, which affects the quality of life in these people to be reduced. In addition, skeletal muscle and bone are tissues that, in addition to participating in body posture, are also the primary site of postprandial glucose uptake, which is significantly associated with insulin resistance. Aim: The study aimed to determine which components of body composition have the most significant impact on BMD, the impact of muscle strength and physical performance on BMD, and assess their impact on fracture risk. In addition, the aim was to determine the impact of insulin resistance on BMD and its risk of fracture, as well as to prove the existence of links between muscle characteristics, BMD, and insulin resistance in postmenopausal women in Serbia, all with the ultimate goal of preventing sarcopenia and fractures. Therapeutic approach and hygienic-dietary regime in the elderly. Methods: A designed study was to be a clinical, non-interventional, observational crosssectional study and included 66 women over 65 who were selected by random sampling. BMD was measured on the lumbar spine, femoral neck, and whole-body using a dual-energy X-ray absorptiometry (DXA) densitometer. Muscle strength was determined by a handgrip test and physical performance by measuring walking speed (GS) at a distance of 4m. Homeostatic model - insulin resistance (HOMA-IR) was calculated by dividing the subjects into two groups. The cut-off value of insulin resistance for the group with "Low HOMA-IR" was <2, and for the group with "High HOMA-IR"> 2. Fracture risk was assessed using FRAX index 1 and FRAX index 2. Results: The results showed that both adipose and adipose tissue affected BMD, but the effect of adipose tissue was more significant regardless of skeletal localization. HGT and GS had a significant degree of positive correlation with BMD. LM, HGT, and GS were significantly negatively correlated with a 10-year fracture probability for larger osteoporosis fractures as well as hip fractures. However, the fat mass had a significant negative correlation only with hip fractures. Decreased LM and fat accumulation are associated with a higher incidence of insulin resistance. A positive correlation was observed between HOMA-IR and BMD in the spine and hip, but there was no correlation between insulin resistance and fracture risk. Conclusion: LM and FM have a significant impact on BMD. Also, the connection between LM, FM, BMD, and the development of insulin resistance in postmenopausal women has been confirmed. However, women with higher levels of insulin resistance and higher BMD do not have a lower risk of fractures.en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Крагујевцу, Факултет медицинских наукаsr
dc.rightsopenAccessen
dc.sourceУниверзитет у Крагујевцуsr
dc.subjectosteoporozasr
dc.subjectosteoporosisen
dc.subjectsarkopenijasr
dc.subjectHOMA-IRsr
dc.subjecttelesni sastavsr
dc.subjectpostmenopauzasr
dc.subjectsarcopeniaen
dc.subjectHOMA-IRen
dc.subjectbody compositionen
dc.subjectpostmenopausalen
dc.titleAnaliza telesnog sastava i metaboličkih parametara u zavisnosti od postojanja osteoporoze kod žena preko 65 godina starostisr
dc.title.alternativeAnalysis of body composition and metabolic parameters depending on the presence of osteoporosis in women over 65 years of ageen
dc.typedoctoralThesis
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/151866/Disertacija.pdf
dc.identifier.rcubhttps://hdl.handle.net/21.15107/rcub_nardus_21668


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