The association between the metabolic syndrome and bone mineral density in pre- and post-menopausal farm workers

Marais, Sumine (2016-12)

Thesis (MSc)--Stellenbosch University, 2016.

Thesis

ENGLISH ABSTRACT: Introduction and aims: The prevalence of the metabolic syndrome (MetS) is increasing, both globally and in South Africa. Albeit so, limited data have been published in the South African context. One of the factors that appear to influence the prevalence of the MetS is menopausal status, with both the MetS, and menopausal status influencing bone mineral density (BMD); however, the reported results are inconsistent. Therefore, the aim of this study was to determine the prevalence of the metabolic syndrome, investigating bone health as well as the interactions between the MetS, menopausal status and bone health, in a farm working female population in the Western Cape. Methods: A total of n=80 females were recruited and classified with the MetS, using the International Diabetes Federations’ definition. The data collected included basic anthropometric measurements, blood pressure, BMD, and several questionnaires to obtain information regarding physical activity, demographic information, menstrual-, diet- and family health- history. The blood parameters that were measured included alkaline phosphatase (ALP), vitamin D, parathyroid hormone (PTH), oestradiol (E2), fasting insulin (FI), fasting glucose (FG) and a lipid profile. Results: A relatively high prevalence of the MetS (55.0%) was reported in the current study. When investigating the separate MetS risk factors, most of the study participants had three risk factors (32.5%), with increased BP being the most prevalent MetS risk factor (72.5%). Factors that differed between MetS and Non-MetS sub-groups (according to menopausal status and age) included waist circumference (WC), high-density lipoprotein-cholesterol (HDL-c), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Significant associations between body mass (BM) and E2, and body mass index (BMI) and E2, were limited to the PreM (20-39 years) age group with the MetS (r=0.58, p=0.03, and r=0.60, p=0.02). A total of 78.8% of the study participant had normal BMD. When correlating BM and speed of sound (SOS), significant associations were limited to the PreM (≥40 years) group (MetS: r=0.56, p=0.04, Non-MetS: r=0.76, p=0.00), and significant associations between BMI and SOS were noted in both PreM groups (MetS PreM 20-39 years: r=0.53, p=0.05, Non-MetS PreM ≥40 years: r=0.73, p=0.00). The significant correlations between FI and ALP (r=0.72, p=0.00), FG and ALP (r=0.89, p=0.00), and triglycerides with ALP (r=0.82, p=0.00) were limited to the PreM (≥40 years) group. Conclusion: The prevalence of the MetS was higher than that reported by previous South African studies. Irrespective of metabolic and menopausal status, most of the participants of the current study population had normal BMD. Key words: Metabolic syndrome, bone mineral density, menopause

AFRIKAANS OPSOMMING: Inleiding en doelwit: Die voorkoms van die metaboliese sindroom (MetS) is beide globaal en in Suid Afrika toenemend. Daarbenewens is daar beperkte data in die Suid-Afrikaanse konteks. Een van die faktore wat die voorkoms van die MetS beïnvloed is die menopousale status, waar beide die MetS en menopousale status beenmineraaldigtheid (BMD) beïnvloed. Die resultate wat hier rapporteer word varieer egter. Die doelstelling van hierdie studie was om die voorkoms van die MetS in ‘n plaaswerker vroue populasie in die Wes-Kaap te ondersoek, hulle been-gesondheid te bepaal asook te ondersoek of daar korrelasies is tussen die metabolise sindroom, menopousale status en been-gesondheid te korreleer. Metodes: ‘n Totaal van n=80 vroue is gewerf en geklassifiseer deur gebruik te maak van die Internasionale Diabetes Federasie se kriteria vir die MetS. Die data wat versamel was sluit onder andere in basiese antropometriese metings, bloeddruk, BMD, asook verskeie vraelyste om inligting oor fisiese aktiwiteit, demografiese inligting, menstruele-, dieet- en familie gesondheidgeskiedenis te versamel. Die bloedparameters wat bepaal was sluit in alkaliese fosfatase (ALP), vitamien D, paratiroïed hormoon (PTH), estradiol (E2), vastende insulien (VI), vastende glukose (FG), en ‘n lipiedprofiel. Resultate: ‘n Relatiewe hoë voorkoms van die MetS (55.0%) is in hierdie studie waargeneem. Indien die individuele MetS risiko faktore in ag geneem word, het die meerderheid deelnemers drie risiko faktore gehad (32.5%), met verhoogde bloeddruk wat die mees algemene MetS risiko faktor (72.5%) was. Sommige van die faktore wat tussen die MetS en Nie-MetS verskil het (volgens menopousale status en ouderdom) sluit in; middel-omtrek (MO), hoë digtheidslipoproteïen (HDL-c), sistoliese bloeddruk (SBD) en diastoliese bloeddruk (DBD). Betekenisvolle verwantskappe is waargeneem tussen liggaamsmassa indeks (LMI) en E2, LMI en E2 is beperk tot die PreM (20-39 jaar) ouderdoms- en die MetS groepe (r=0.58, p=0.03 en r=0.60, p=0.02). ‘n Totaal van 78.8% van die studie populasie het normale BMD gehad. Wanneer liggaamsmassa (LM) en die spoed van klank (SvK) teenoor mekaar gekorreleer is, is betekenisvolle verwantskappe beperk gewees tot die PreM (≥40 jaar) groep (MetS: r=0.56, p=0.04, Nie-MetS: r=0.76, p=0.00), en betekenisvolle verwantskappe tussen LMI en SvK in beide PreM groepe (MetS PreM 20-39 jaar: r=0.53, p=0.05, Nie-MetS PreM ≥40 jaar: r=0.73, p=0.00). Die betekenisvolle korrelasies tussen VI en ALP (r=0.72, p=0.00), FG en ALP (r=0.89, p=0.00), en trigliseriede met ALP (r=0.82, p=0.00) is beperk tot die PreM (≥40 jaar) groep. Gevolgtrekking: Die voorkoms van die MetS was hoër as voorheen gerapporteerde Suid Afrikaanse studies. Ongeag die metaboliese en menopousale status het meeste deelnemers normale BMD gehad. Sleutelwoorde: Metaboliese sindroom, beenmineraaldightheid, menopouse

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/100315
This item appears in the following collections: