The relationships between blood pressure, blood glucose, and bone mineral density in postmenopausal Turkish women

Abstract

Huseyin Altug Cakmak,1 Burcu Dincgez Cakmak,2 Ayse Ender Yumru,3 Serkan Aslan,4 Asim Enhos,1 Ali Kemal Kalkan,4 Ebru Inci Coskun,5 Abdullah Serdar Acikgoz,6 Suat Karatas3 1Department of Cardiology, Mustafakemalpasa Government Hospital, Bursa, 2Department of Obstetric and Gynecology, Rize Kackar Government Hospital, Rize, 3Department of Obstetric and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital, 4Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 5Department of Obstetric and Gynecology, Inonu University, Malatya, 6Department of Obstetric and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Background: Hypertension, diabetes mellitus, and osteoporosis are important comorbidities commonly seen in postmenopausal women. The aim of the present study was to investigate the relationships between blood pressure, blood glucose, and bone mineral density (BMD) in postmenopausal Turkish women.Methods: In this cross-sectional study, 270 consecutive patients who were admitted to an outpatient clinic with vasomotor symptoms and/or at least 1 year of amenorrhea were included. The patients were categorized into three groups according to their blood pressure and metabolic status as follows: normotensive, hypertensive nondiabetics, and hypertensive diabetics. The T- and z-scores of the proximal femur and lumbar vertebrae were measured with the dual-energy X-ray absorptiometry method to assess the BMD of the study groups.Results: Lumbar vertebral T-scores (P<0.001), lumbar vertebral z-scores (P<0.003), and proximal femoral T-scores (P<0.001) were demonstrated to be significantly lower in the hypertensive diabetic group compared to the hypertensive nondiabetic and normotensive groups. Systolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.382; P=0.001), lumbar vertebral z-scores (r=-0.290; P=0.001), and proximal femoral T-scores (r=-0.340; P=0.001). Moreover, diastolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.318; P=0.001), lumbar vertebral z-scores (r=-0.340; P=0.001), and proximal femoral T-scores (r=-0.304; P=0.001). Hypertension (odds ratio [OR]: 2.541, 95% confidence interval [CI]: 1.46–3.48, P=0.003), diabetes mellitus (OR: 2.136, 95% CI: 1.254–3.678, P=0.006), and age (OR: 1.069, 95% CI: 1.007–1.163, P=0.022) were found to be significant independent predictors of osteopenia in a multivariate analysis, after adjusting for other risk parameters.Conclusion: The present study is the first to evaluate the relationships between blood pressure, blood glucose, and BMD in postmenopausal Turkish women. Moreover, both hypertension and diabetes were demonstrated as significant independent predictors of osteopenia in postmenopausal Turkish women. Clinicians should be aware of the high risk of developing osteopenia in diabetic hypertensive postmenopausal women. Keywords: hypertension, type 2 diabetes mellitus, postmenopausal, bone mineral density