Senil Osteoporozda Endotel Fonksiyonunun Değerlendirilmesi

Abstract

ABSTRACT CavanĢir Vahabov, The Evaluation of Endothelial Function In Senile Osteoporosis, Hacettepe University Medical Faculty, Thesis in Internal Medicine, Ankara 2017. Osteoporosis and cardiovascular diseases, which are common problems with aging, are seen as different diseases but accumulating evidence indicates that they may share similar pathophysiological mechanisms. One of the early predictor of atherosclerosis is endothelial dysfunction. Although in the literature, there are some studies about the relationship between postmenapausal osteoporosis and endothelial dysfunction; no study was found about the relationship between senile osteoporosis and endothelial dysfunction. The aim of this study was to evaluate the relationship between endothelial dysfunction and normal, osteopenic and osteoporotic groups, which will be evidence of a common pathogenesis of senile osteoporosis and vascular diseases. In this study, 93 patients aged 70 years and over, who were admitted to the geriatric medicine outpatient clinic between 1 July 2016 and 31 December 2016 were included. All patients underwent comprehensive geriatric assessment and were evaluated for osteoporosis or ostepenia and cardiovascular risk factors. The causes of secondary osteoporosis and documented coronary artery disease, peripheral artery disease, diabetes mellitus, dementia, cronic inflammatory diseases and malignancy that may affect endothelial function were excluded. Values of serum total blood count, biochemistry, thyroid stimulating hormone (TSH), fasting plasma glucose (FPG), parathormone which routinely concluded in the last six months and T score in bone mineral density (BMD) in the last 1 year were noted. Patients were classified into three groups according to BMD results. Normal, osteopenia, and osteoporosis diagnoses were made according to the criteria of world health organization (WHO). Endothelial function was measured by flow-madiated dilation (FMD) which is a noninvasive method. Within 93 patients, 59 (63.4%) were women, 34 (36.6%) were men, and mean age was 74.5±4.6. Groups were equally matched for cardiovascular risk factors. Among the groups 23 (%29) normal, 37 (39.8%) osteopenic and 29 (31.2%) osteoporotic patients madian FMD results were 11 (IQR 7.3-15.0), 7.1 (IQR 4.2-12.3), 7 (IQR 5.0-9.5), respectively (p=0.013). In paired comparisons endothelial function was worse in osteopenia and osteoporosis than in normal group (p values 0.018 vs. 0.005; respectively). Our findings revealed that osteoporosis is associated with endothelial dysfunction in older people. These results are important in demonstrating vascular factors in the pathogenesis of senile osteoporosis. Key Words: Senile osteoporosis, endothelial dysfunction, cardiovascular diseases, atherosclerosis, flow-mediated dilation (FMD)