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Wiener klinische Wochenschrift

, Volume 128, Issue 3–4, pp 114–119 | Cite as

Assessment of smoking for low bone mineral density in postmenopausal Turkish women

  • Ugur Ugurlu
  • Umit NaykiEmail author
  • Cenk Nayki
  • Pasa Ulug
  • Mehmet Kulhan
  • Yusuf Yildirim
original article

Summary

Objective

To investigate the effect of cigarette smoking on bone mineral density (BMD) in postmenopausal Turkish women.

Study design

A total of 175 postmenopausal Turkish women admitted to Tepecik Training and Research Hospital for a routine menopausal checkup were included in this study. All participants completed a questionnaire regarding their age, educational status, parity, number of abortus, time since menopause, caffeine intake, tobacco use, alcohol consumption, history of a previous fracture related to trauma, and taking any medication for menopause and osteoporosis. Of all subjects, 23.3 % (n = 39) were smokers and 77.7 % (n = 136) were nonsmokers. T-scores and Z-scores of vertebra and femur neck were assessed using dual energy X-ray absorptiometry (DXA). For analyzing the results, Student t-test, one-way ANOVA, Mann–Whitney U test, Pearson correlation, and Kruskal–Wallis test were performed.

Results

Femur T-scores (− 0.78 ± 1.07 vs. − 0.32 ± 1.56) and vertebra T-scores (− 2.26 ± 1.23 vs. − 1.82 ± 1.04) were significantly lower in smoking women than nonsmoking women (p < 0.05). However, there were no significant difference between duration of smoking, number of cigarettes consumed per day, and BMD (p > 0.05)

Conclusion

Cigarette smoking is one of the modifiable risk factors influencing bone density in postmenopausal Turkish women. “Cessation of cigarette” should be recommended for lifestyle modifications to prevent postmenopausal osteoporosis.

Keywords

Smoking Body mass index Postmenopause Osteoporosis 

References

  1. 1.
    Brook JS, Balka EB, Zhang C. The smoking patterns of women in their forties: their relationship to later osteoporosis. Psychol Rep. 2012;110(2):351–62.PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    Riggs BL, Melton LJ III. The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone. 1995;17(5):505–11.CrossRefGoogle Scholar
  3. 3.
    Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Toseson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res. 2007;22(3):465–75.CrossRefPubMedGoogle Scholar
  4. 4.
    Koeck CM, Schwappach DL, Niemann FM, Strassman TJ, Ebner H, Klaushofer K. Incidence and costs of osteoporosis-associated hip fractures in Austria. Wien Klin Wochenschr. 2001;113:371–7.PubMedGoogle Scholar
  5. 5.
    Preisinger E, Leitner G, Uher E, Alacamlioglu Y, Seidi G, Marktl W, et al. Nutrition and osteoporosis: a nutritional analysis of women in postmenopause. Wien Klin Wochenschr. 1995;197:418–22.Google Scholar
  6. 6.
    Nasto LA, Fusco A, Colangelo D, et al. Clinical predictors of vertebral osteoporotic fractures in post-menopausal women: a cross-sectional analysis. Eur Rev Med Pharmacol Sci. 2012;16(9):1227–34.PubMedGoogle Scholar
  7. 7.
    Benson BW, Shulman JD. Inclusion of tobacco exposure as a predictive factor for decreased bone mineral content. Nicotine Tob Res. 2005;7(5):719–24.CrossRefPubMedGoogle Scholar
  8. 8.
    Law MR, Hackshaw AK. A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect. BMJ. 1997;315(7112):841–6.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Hongo M, Itoi E, Sinaki M, et al. Effect of low-intensity back exercise on quality of life and back extensor strength in patients with osteoporosis: a randomized controlled trial. Osteoporos Int. 2007;18(10):1389–95.CrossRefPubMedGoogle Scholar
  10. 10.
    Kanesaki K. Vertebral deformities in female patients with osteoporosis: influence of trauma and bone mineral density. Kurume Med J. 2004;51(3–4):203–13.CrossRefPubMedGoogle Scholar
  11. 11.
    Gardner MJ, Brophy RH, Demetrakopoulos D, et al. Interventions to improve osteoporosis treatment following hip fracture. A prospective, randomized trial. J Bone Joint Surg Am. 2005;87(1):3–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Health Quality Ontario. Utilization of DXA bone mineral densitometry in Ontario. Ont Health Technol Assess Ser. 2006;6:1–180.Google Scholar
  13. 13.
    Genant HK, Cooper C, Poor G, Reid I, Ehrlich G, Kanis J, et al. Interim report and recommendations of the World Health Organization Task-Force for Osteoporosis. Osteoporos Int. 1999;10:259–64.CrossRefPubMedGoogle Scholar
  14. 14.
    Lewiecki EM, Watts NB, McClung MR, Petak SM, Bachrach LK, Shepherd JA, et al. Official positions of the international society for clinical densitometry. J Clin Endocrinol Metab. 2004;89:3651–5.CrossRefPubMedGoogle Scholar
  15. 15.
    Nguyen TV, Center JR, Eisman JA. Osteoporosis: underrated, underdiagnosed, and undertreated. Med J Aus. 2004;180(5):18–22.Google Scholar
  16. 16.
    Cooper C, Wickham C. Cigarette smoking and the risk of age-related fracturs. In: Wald N, Baron J, editors Smoking and hormone-related disorders. Oxford: Oxford University Press; 1990. pp. 93–100.Google Scholar
  17. 17.
    Baheraei A, Pocock NA, Eisman JA, Nguyen ND, Nguyen TV. Bone mineral density, body mass index and cigarette smoking among Iranian women: implications for prevention. BMC Musculooskelet Disord. 2005;6:34.CrossRefGoogle Scholar
  18. 18.
    Ward KD, Klesges RC. A meta-analysis of the effects of cigarette smoking on bone mineral density. Calcif Tissue Int. 2001;68(5):259–70.CrossRefPubMedGoogle Scholar
  19. 19.
    Akhter MP, Iwaniec UT, Haynatzki GR, Fung YK, Cullen DM, Recker RR. Effects of nicotine on bone mass and strength in aged female rats. J Orthop Res. 2003;21(1):14–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Blum M, Harris SS, Must A, Phillips SM, Rand WM, Dawson-Hughes B. Household tobacco smoke exposure is negatively associated with premenopausal bone mass. Osteoporos Int. 2002;13(8):663–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Daniel M, Martin AD, Drinkwater DT. Cigarette smoking, steroid hormones, and bone mineral density in young women. Calcif Tissue Int. 1992;50(4):300–5.CrossRefPubMedGoogle Scholar
  22. 22.
    Johnell O, Nilsson BE. Life-style and bone mineral mass in perimenopausal women. Calcif Tissue Int. 1984;36(4):354–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Flicker L, Hopper JL, Rodgers L, Kaymakcı B, Green RM, Wark JD. Bone density determinants in elderly women: a twin study. J Bone Miner Res. 1995;10(11):1607–13.CrossRefPubMedGoogle Scholar
  24. 24.
    Riebel GD, Boden SD, Whitesides TE, Hutton WC. The effect of nicotine on incorporation of cancellous bone graft in an animal model. Spine. 1995;20(20):2198–202.CrossRefPubMedGoogle Scholar
  25. 25.
    Broulik PD, Jarab J. The effect of chronic nicotine administration on bone mineral content in mice. Horm Metab Res. 1993;25(4):219–21.CrossRefPubMedGoogle Scholar
  26. 26.
    Krall EA, Dawson-Hughes B. Smoking and bone loss among postmenopausal women. J Bone Miner Res. 1991;6(4):331–8.CrossRefPubMedGoogle Scholar
  27. 27.
    Landin-Wilhelmsen K, Wilhelmsen K, Lappas G, et al. Serum intact parathyroid hormone in a random population sample of men and women: relationship to anthropometry, life-style factors, blood pressure, and vitamin D. Calcif Tissue Int. 1995;56:104–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Gordon T. Factors associated with serum alkaline phosphatase level. Arch Pathol Lab Med. 1993;117(2):187–90.PubMedGoogle Scholar
  29. 29.
    Hirota Y, Hirota T, Fukuda K, et al. Association of alcohol intake, cigarette smoking and occupational status with the risk of idiopathic osteonecrosis of the femoral head. Am J Epidemiol. 1993;137(5):530–8.PubMedGoogle Scholar
  30. 30.
    Matsuo K, Hirohata T, Sugioka Y, Ikeda M, Fukuda A. Influence of alcohol intake, cigarette smoking, and occupational status on idiopathic osteonecrosis of the femoral head. Clin Orthop Relat Res. 1988;234:115–23.PubMedGoogle Scholar
  31. 31.
    Klesges RC, Meyers AW, Klesges LM, La Vasque M. Smoking, body weight and their effects on smoking behaviour: a comprehensive review of the literature. Phychol Bull. 1989;106(2):204–30.CrossRefGoogle Scholar
  32. 32.
    Rubin CT, Lanyon LE. Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int. 1985;37(4):411–7.CrossRefPubMedGoogle Scholar
  33. 33.
    Demirbag D, Ozdemir F, Ture M. Effects of coffee consumption and smoking habit on bone mineral density. Rheumotol Int. 2006;26(6):530–5.CrossRefGoogle Scholar
  34. 34.
    Svejme O, Ahlborg HG, Nilsson JA, Karlsson MK. Low BMD is an independent predictor of fracture and early menopause of mortality in post-menopausal women—a 34-year prospective study. Maturitas. 2013;74(4):341–5.CrossRefPubMedGoogle Scholar
  35. 35.
    Khan A, Fortier M; Menopause and Osteoporosis Working Group, Fortier M, Reid R, Abramson BL, et al. Osteoporosis in menopause. J Obstet Gynaecol Can. 2014;36(9):839–40.Google Scholar
  36. 36.
    Khoo CC, Woo J, Leung PC, Kwok A, Kwok T. Determinants of bone mineral density in older postmenopausal Chinese women. Climacteric. 2011;14(3):378–83.CrossRefPubMedGoogle Scholar
  37. 37.
    Nahas EA, Kawakami MS, Nahas-Netto J, Butros Dde A, Cangussu LM, Rodrigues AB. Assessment of risk factors for low bone mineral density in Brazilian postmenopausal women. Climacteric. 2011;14(2):220–7.CrossRefPubMedGoogle Scholar
  38. 38.
    Jones G, Scott FS. A cross-sectional study of smoking on bone mineral density in premenopausal parous women: effect of body mass index, breastfeeding, and sports participation. J Bone Miner Res. 1999;14(9):1628–33.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • Ugur Ugurlu
    • 1
  • Umit Nayki
    • 2
    • 3
    Email author
  • Cenk Nayki
    • 2
  • Pasa Ulug
    • 2
  • Mehmet Kulhan
    • 1
  • Yusuf Yildirim
    • 1
    • 2
  1. 1.Department of Obstetrics and GynecologyTepecik Training and Research HospitalIzmirTurkey
  2. 2.Department of Obstetrics and Gynecology, School of MedicineErzincan UniversityErzincanTurkey
  3. 3.ErzincanTurkey

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