الفهرس | Only 14 pages are availabe for public view |
Abstract This study aimed to determine the relationship between osteoarthritis, either localized or generalized, osteoporosis and bone turnover markers in postmenopausal women. The study included one hundred postmenopausal patients who had general good health and diagnosed as knee osteoarthritis patients. Patients were divided into two groups (localized and generalized) according to Dougadous crieteria. All patients underwent the following:- Complete history taking. General examination. Local examination was done for both knees, lumbosacral spine, hand joints. Neurological examination. Laboratory investigations that included the measurement of urinary and serum calcium and phosphorus (total and ionized), serum osteocalcin and serum bone- specific alkaline phosphates. Radiological investigations including plain x-ray radiographs for hand ( Posterior Anterior view), both knees (anteriorposterior and lateral views) and lumbo-sacral spine (lateral view) and assessment of bone mineral density of the lumbar spine (L2-L4), total hip and distal forearm by dual energy x-ray absorptiometry technique using DEXA machine. Summary 139 The results of this study revealed the following: The age among the studied patients was of a mean of 57.8 ± SD 4.269 with 85% of them were housewives, age at menopause was of a mean of 50.50 ± SD 3.69. Menopause duration was of a mean of 7.30 ± SD 4.23 BMI was of a mean of 35.91 ± SD 6.90 and 66% of patients were diagnosed as localized OA while 33% of them were diagnosed generalized OA. The lowest BMD values were at L2 – L4 T-score (Mean 1.01 ± SD –1.69). There was statistical significant increase in patients with localized OA more than in patients with generalized OA regarding age at menopause. There was statistical significant increase in patients with localized OA in comparison with patients with generalized OA regarding serum calcium. There was statistical significant increase in patients with generalized OA in comparison with patients with localized OA regarding serum urinary phosphorus, serum osteocalcin and serum bone – specific alkaline phosphatase. There was statistical significant increase in T-score at L2 – L4 spine in patients with generalized OA when compared with patients with localized OA. A statistical significant increase of L2 – L4 T-score among each grade was observed between grades 0 and II, grades 0 and III, grades I & III, and grades II and III was observed. Summary 140 A statistical significant increase of L2 – L4 spine T- score among each grade was observed between grades I and IV, grades II and IV and grades III and IV. A statistical significant increase of femoral head T-score among each grade was observed between grade I and III, grades I and IV, grades II and IV and grades III and IV. A statistical significant increase of distal radious T-score among each grade was observed between grades I and II, grades I and III, grades I and IV, grades II and III, grades II and IV and grades III and IV. There was statistical significant increase in BMD values among radiological grades of hand as follows: T-Score at femoral head (grade 0 versus grade I and grade 0 versus II). T- score at distal radius (grade 0 versus grade II). Serum calcium was statistically significantly negatively correlated with T- scores at L2 – L4 spine, femoral head & distal radius. Serum phosphorus was statistically significantly negatively correlated with T-scores of femoral head and distal radius. Urinary calcium was statistically significantly negatively correlated with L2 – L4 spine T-score. There was a positive correlation between urinary phosphorus and BMD values among the studied patients reaching a significant level for femoral head T-score. Summary 141 There was a positive correlation between serum osteocalcin and BMD values among the studied patients reaching a significant level for L2 – L4 spine T-score. Serum bone- specific alkaline phasphatase among the studied patients was statistically significantly negatively correlated with T-score of L2 – L4 spine, femoral head and distal radius. |