Postmenopozal Kadınlarda Balık tüketiminin Kemik Mineral Yoğunluğu Üzerine Etkisi

Amaç: Bu çalışmada amaç; balık tüketimi sıklığı ile osteoporoz (OP) arasındaki ilişkiyi değerlendirmektir. Materyal ve metot: Bu çalışmada 45 ile 75 yaş aralığında post menapozal kadın hastaların kayıtları incelendi. Çalışma kriterleine uyan 152 post menapozal kadın hasta çalışmaya dahil edildi. Olgular, haftalık balık tüketim alışkanlığı 250 gram ve üzerinde olanlar Grup 1 ve balık tüketim alışkanlığı haftalık 250 gramın altında olanlar Grup 2 olarak sınıflandırılmıştır. Osteoporoz tanısında yaygın olarak Dual Enerji X Ray Absorbsiyometri (DEXA) yöntemi kullanıldığından, bu çalışmada da kemik mineral içeriğini (gram:g) iki enerji X-ray absorbsiyometri (DEXA) cihazı verilerine göre sınıflandırma yapıldı. Olguların tüm vücut ve total kalça taramaları aracılığıyla KMY (g/cm2) değerleri elde edildi. KMY (tüm vücut ve total kalçadeğerleri incelendi; ancak L2-L4 esas alındı) ve T-SKOR ise L2-L4 değerlerine göre klinik tanılar; osteoporoz, osteopeni ve normal olarak sınıflandırıldıBulgular: Olguların 45’i (%29,60) Grup 1’de, 107’sinin ise (%70,40) Grup 2’de yer alandığı tespit edildi. Grup 1’deki olguların %19,73 (n:30) ve Grup 2’deki olguların %1,97 (n:3) KMY normal değerlerde tespit edildi. Bu değer balık tüketim alışkanlığı olmayan gruba göre karşılaştırıldığında istatistiksel olarak (p<0,05) anlamlı olarak bulundu. Osteoporoz tespit edilen olgular Grup 1’de %10,20 (n:5) ve Grup 2’de ise %89,79 (n:44), osteopeni Grup 1’deki olguların %14,28 (n:10) ve Grup 2’deki olguların %85,72’sinde (n:60) tespit edilmiştir. Bu değerler arasında fark olmakla birlikte balık tüketim alışkanlığı olmayan gruba göre karşılaştırıldığında istatistiksel olarak anlamlı (p>0,05) değildi. Ancak balık tüketim alışkanlığı olan Grup 1’deki sadece beş olguda osteoporoz ile uyumlu olduğu görüldü. Elde edilen değerler istatistiksel olarak anlamlı (p<0,05) olduğu tespit edildi.Sonuç:  Bu çalışma verilerine göre; menopoz sonrası dönemdeki kadınlarda haftalık balık tüketiminin 250 gram ve üzerinde olan olgularda KMY üzerine olumlu etki yaptığı ve oteoporoz riskini azalttığı tespit edildi.  

Effect of Fish Consumption on Bone Mineral Density in Postmenopausal Women

Aim: The goal in this study is determine relation of fish consumption frequency and osteoporosis (OP).Material and method: This study was conducted to examine the records of postmenopausal women between the ages of 45-75. 152 patients who met the study criteria were included in the study. The cases were classified as Group 1 with weekly fish consumption 250 grams or more and Group 2 with fish consumption below 250 grams per week. Because dual energy X-ray absorptiometry (DEXA) method was widely used for osteoporosis, bone mineral desity (grams: g) was classified according to dual energy X-ray absorptiometry (DEXA) data. BMD values (g / cm2) were obtained through the whole body and total hip scans of the cases. BMD (L2-L4) and T-SCOR were clinically diagnosed according to L2-L4 values; normal, osteopenia and osteoporosis.Result: Forty-five (29.60%) cases were found in Group 1, and 107 (70,40%) were in Group 2. 19.73% (n: 30) of the cases in Group 1 and 1.97% (n: 3) of the cases in Group 2 were found at normal values. This value was statistically significant (p <0,05) when compared to the group without fish consumption habit. Osteoporosis was detected in 10,20% (n: 5) of Group 1, 89,79% (n: 44) of Group 2, 14,28% (n: 10) of osteopenia Group 1 cases and Group 85.72% (n: 60) of the 2 cases were detected. The difference between these values was not statistically significant (p> 0,05) when compared to the group without fish consumption habits. However, only five cases of fish consumption habit in Group 1 were found to be compatible with osteoporosis. The obtained values were found to be statistically significant (p <0.05). Conclusion: this study data has demonstrated a positive effect on BMD and to decrease the risk of osteoporosis in postmenopausal women weekly fish consumption 250 grams or more.

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  • Riggs, B.L.; Melton, L.J., 3rd. The worldwide problem of osteoporosis: Insights afforded by epidemiology. Bone 1995, 17, 505–511.
  • Li X, Lei T, Tang Z, Dong J.Analyzing the association between fish consumption and osteoporosis in a sample of Chinese men. Journal of Health, Population and Nutrition. 2017; 36(1):13.
  • Li Z, Fava SL, Otvos J, Lichtenstein AH,Carrasco WV, McNamara JR, Ordovas JM,Schaefer EJ. Fish Consumption Shifts Lipoprotein Subfractions to a Less Atherogenic Pattern in Humans. J. Nutr. 134: 1724–1728, 2004.
  • Cashman, K.D. Diet, nutrition, and bone health. J. Nutr. 2007,137(11),2507–2512.
  • Park H, Heo J, Park Y. Calcium from plant sources is beneficial to lowering the risk of osteoporosis in postmenopausal korean women. Nutr. Res. 2011, 31, 27–32.
  • Tartibian B, Hajizadeh MB, Kanaley J, Sadeghi K. Long-term aerobic exercise and omega-3 supplementation modulate osteoporosis through inflammatory mechanisms in post-menopausal women: a randomized, repeated measures study. Nutr. Metab. 2011; 8:71.
  • Caughey GE, Mantzioris E, Gibson RA, Cleland LG, James MJ. The effect on human tumor necrosis factor alpha and interleukin 1 beta production of diets enriched in n-3 fatty acids from vegetable oil or fish oil. Am. J. Clin. Nutr. 1996, 63, 116–122.
  • Coetzer H, Claassen N, van Papendorp DH, Kruger MC. Calcium transport by isolated brush border and basolateral membrane vesicles: Role of essential fatty acid supplementation. Prostaglandins Leukot. Essent. Fatty Acids 1994, 50, 257–266.
  • Baggio B, Budakovic A, Nassuato MA, Vezzoli G, Manzato E, Luisetto G, Zaninotto M. Plasma phospholipid arachidonic acid content and calcium metabolism in idiopathic calcium nephrolithiasis. Kidney Int. 2000, 58, 1278–1284.
  • Atar HH, Alçiçek Z. Su Ürünleri Tüketimi ve Sağlik. TAF Preventive Medicine Bulletin 2009;8 (2):173-176. Parhami F, Alan Garfinkel A, Linda L. Demer. Role of Lipids in Osteoporosis. Arteriosclerosis, Thrombosis, and Vascular Biology. 2000;20:2346-2348.
  • Aydın H, Dilek MK, Aydın K. Trends in Fish and Fishery Products Consumption in Turkey. Turkish Journal of Fisheries and Aquatic Sciences 2011;11:499-506.
  • Zalloua PA, Hsu YH, Terwedow H, et al. Impact of seafood and fruit consumption on bone mineral density. Maturitas, 2007;56:1–11.
  • Braxton DM, Candace MK, Jennifer LS, Reina P, Richard LB. Genetic and environmental determinants of bone mineral density in Mexican Americans: results from the San Antonio Family Osteoporosis Study. Bone 2003;33(5):839-846.
  • Choi E, Park Y. The Association between the Consumption of Fish/Shellfish and the Risk of Osteoporosis in Men and Postmenopausal Women Aged 50 Years or Older. Nutrients 2016;8:113.
  • Zalloua PA, Hsu YH, Terwedow H, Zang T, Wu D, Tang G, et al. Impact of seafood and fruit consumption on bone mineral density. Maturitas 2007, 56, 1–11.
  • Chen, Y, Ho S, Lam S. Higher sea fish intake is associated with greater bone mass and lower osteoporosis risk in postmenopausal chinese women. Osteoporos. Int. 2010, 21, 939–946. Farina, E.K.; Kiel, D.P.; Roubenoff, R.; Schaefer, E.J.; Cupples, L.A.; Tucker, K.L. Protective effects of fish intake and interactive effects of long-chain polyunsaturated fatty acid intakes on hip bone mineral density in older adults: The framingham osteoporosis study. Am. J. Clin. Nutr. 2011, 93, 1142–1151. Hannan MT1, Felson DT, Dawson-Hughes B, Tucker KL, Cupples LA, Wilson PW, Kiel DP. Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res. 2000;15(4):710-20.
  • Virtanen, J.; Mozaffarian, D.; Cauley, J.; Mukamal, K.; Robbins, J.; Siscovick, D. Fish consumption, bone mineral density, and risk of hip fracture among older adults: The cardiovascular health study. J. Bone Miner. Res. 2010, 25, 1972–1979.
  • Mahaffey, K.R. Fish and shellfish as dietary sources of methylmercury and the ω-3 fatty acids, eicosahexaenoic acid and docosahexaenoic acid: Risks and benefits. Environ. Res. 2004, 95, 414–428.
  • Virtanen JK, Mozaffarian D, Cauley JA, Mukamal JK, Robbins J, Siscovick DS. Fish Consumption, Bone Mineral Density, and Risk of Hip Fracture Among Older Adults: The Cardiovascular Health Study Journal of Bone and Mineral Research, 20102;9:1972–1979.