title: The relationships between blood pressure, blood glucose, and bone mineral density in postmenopausal Turkish women.
abstract: BACKGROUND
  Hypertension, diabetes mellitus, and osteoporosis are important comorbidities commonly seen in postmenopausal women. The aim of the present study was to investigate the relationships between blood pressure, blood glucose, and bone mineral density (BMD) in postmenopausal Turkish women.
  
  
  METHODS
  In this cross-sectional study, 270 consecutive patients who were admitted to an outpatient clinic with vasomotor symptoms and/or at least 1 year of amenorrhea were included. The patients were categorized into three groups according to their blood pressure and metabolic status as follows: normotensive, hypertensive nondiabetics, and hypertensive diabetics. The T- and z-scores of the proximal femur and lumbar vertebrae were measured with the dual-energy X-ray absorptiometry method to assess the BMD of the study groups.
  
  
  RESULTS
  Lumbar vertebral T-scores (P<0.001), lumbar vertebral z-scores (P<0.003), and proximal femoral T-scores (P<0.001) were demonstrated to be significantly lower in the hypertensive diabetic group compared to the hypertensive nondiabetic and normotensive groups. Systolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.382; P=0.001), lumbar vertebral z-scores (r=-0.290; P=0.001), and proximal femoral T-scores (r=-0.340; P=0.001). Moreover, diastolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.318; P=0.001), lumbar vertebral z-scores (r=-0.340; P=0.001), and proximal femoral T-scores (r=-0.304; P=0.001). Hypertension (odds ratio [OR]: 2.541, 95% confidence interval [CI]: 1.46-3.48, P=0.003), diabetes mellitus (OR: 2.136, 95% CI: 1.254-3.678, P=0.006), and age (OR: 1.069, 95% CI: 1.007-1.163, P=0.022) were found to be significant independent predictors of osteopenia in a multivariate analysis, after adjusting for other risk parameters.
  
  
  CONCLUSIONS
  The present study is the first to evaluate the relationships between blood pressure, blood glucose, and BMD in postmenopausal Turkish women. Moreover, both hypertension and diabetes were demonstrated as significant independent predictors of osteopenia in postmenopausal Turkish women. Clinicians should be aware of the high risk of developing osteopenia in diabetic hypertensive postmenopausal women.
authors.affiliation: Department of Cardiology, Mustafakemalpasa Government Hospital, Bursa, Turkey.
authors.forename: Huseyin Altug
authors.initials: HA
authors.lastname: Cakmak
authors.affiliation: Department of Obstetric and Gynecology, Rize Kackar Government Hospital, Rize, Turkey.
authors.forename: Burcu Dincgez
authors.initials: BD
authors.lastname: Cakmak
authors.affiliation: Department of Obstetric and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ayse Ender
authors.initials: AE
authors.lastname: Yumru
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Aslan
authors.affiliation: Department of Cardiology, Mustafakemalpasa Government Hospital, Bursa, Turkey.
authors.forename: Asim
authors.initials: A
authors.lastname: Enhos
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali Kemal
authors.initials: AK
authors.lastname: Kalkan
authors.affiliation: Department of Obstetric and Gynecology, Inonu University, Malatya, Turkey.
authors.forename: Ebru Inci
authors.initials: EI
authors.lastname: Coskun
authors.affiliation: Department of Obstetric and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Abdullah Serdar
authors.initials: AS
authors.lastname: Acikgoz
authors.affiliation: Department of Obstetric and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Karatas
keywords: bone mineral density; hypertension; postmenopausal; type 2 diabetes mellitus