The relationship of absolute poverty and bone mineral density in postmenopausal Iranian women.

OBJECTIVE: It is increasingly recognized that socioeconomic inequalities play an important role in bone health, with significantly higher fracture rates being reported in lower income groups. But the relationship between absolute poverty and bone mineral density (BMD) and/or osteoporosis has not been investigated. METHODS: A total of 1135 postmenopausal women under absolute poverty lines who received financial support from the Imam Khomeini Relief Foundation (IKRF) and 406 randomly selected healthy postmenopausal women were screened for osteoporosis using BMD testing. RESULTS: At all BMD sites, women under the absolute poverty lines had the lowest mean BMD values (p < 0.0001). According to the WHO criteria, 252 subjects under absolute poverty lines (22.4%) and 35 healthy postmenopausal women from the general population (8.7%) were considered osteoporotic (p < 0.0001). After adjustment for lifestyle factors for osteoporosis in logistic regression models, absolute poverty was associated with the age-adjusted prevalence of femoral neck osteoporosis and lumbar osteoporosis [OR = 2.50 (CI, 1.38-4.51; p = 0.002); OR = 2.40 (CI, 1.56-3.70; p < 0.0001), respectively]. CONCLUSION: Postmenopausal women under the absolute poverty lines had lower BMDs at all skeletal sites, independent of established osteoporosis risk factors.

Elevated high sensitivity C-reactive protein is associated with type 2 diabetes mellitus: the Persian Gulf Healthy Heart Study.

Previous studies have suggested that low-grade systemic inflammation is involved in the pathogenesis of type 2 diabetes mellitus. However, limited information is available about the relationship of diabetes mellitus and inflammation in Asia. We examined the association between high-sensitivity C-reactive protein (CRP) levels and diabetes in a general Iranian population. In an ancillary study to the Persian Gulf Healthy Heart Study, a cohort study of men and women aged > or = 25 years, a random sample of 1754 (49.2 percent males, 50.8 percent females) subjects were evaluated. High sensitivity C-reactive protein was measured by enzyme-linked immunosorbent assay. Elevated serum CRP was defined as more than 3.0 mg/l. The diabetes classification was based on the criteria of the American Diabetes Association. A total of 8.6 percent of the subjects (8.0 percent of males & 9.1 percent of females; p>0.05) had type 2 diabetes mellitus. Geometric mean of CRP was 1.94 mg/l (3.80 SD) in the studied population. The subjects with diabetes had a higher geometric mean of CRP levels than the subjects with no diabetes [3.67 (SD 3.71) versus 1.85 (3.83) respectively; p<0.0001)]. In multiple logistic regression analysis, diabetes showed a significant age-adjusted association with elevated CRP levels [Odds Ratio = 2.03, Confidence Interval (1.38-2.98); p<0.0001] after adjusting for sex, LDL-cholesterol, HDL-cholesterol blood pressure, smoking and body mass index. In conclusion, beyond traditional cardiovascular risk factors, elevated CRP is significantly correlated with diabetes in general population of the northern Persian Gulf. Further insight into the specific effects of proinflammatory cytokines and acute-phase proteins will be essential for the development of new preventive strategies for diabetes mellitus.

Relationship among insulinlike growth factor I concentrations, bone mineral density, and biochemical markers of bone turnover in postmenopausal women: a population-based study.

OBJECTIVE: : To assess the association among serum insulinlike growth factor I (IGF-I) concentrations, bone mineral density (BMD), and biochemical markers of bone turnover in a large group of postmenopausal women from the general population. DESIGN: : As an extension of a larger epidemiological study, the Iranian Multicentral Osteoporosis Study, a total of 406 healthy postmenopausal women (age, 59.0 +/- 7.6 years) were randomly selected from 13 clusters in Bushehr Port. IGF-I, serum CrossLaps, degradation products of C-terminal telopeptides of type I collagen, and osteocalcin were measured by highly specific enzyme-linked immunosorbent assay. BMD was determined for the lumbar spine (L2-4) and proximal femur using dual-energy x-ray absorptiometry. RESULTS: : The mean (+/- SD) serum IGF-I concentration for all postmenopausal women was 183.35 +/- 65.60 ng/mL. In age-adjusted analyses, there was no correlation between IGF-I and BMD at the lumbar spine and femoral neck. Compared with women in the lowest quartile of IGF-I, women in the highest quartile had a significantly greater means of osteocalcin (P = 0.04) and alkaline phosphatase (P = 0.01). Analysis by quartiles of IGF-I did not reveal an association with serum CrossLaps. CONCLUSIONS: : Circulating IGF-I is associated with biochemical markers of bone formation, but there is no relationship among IGF-I, degradation products of C-terminal telopeptides of type I collagen, and BMD in postmenopausal women. Clearly more work will be needed before serum IGF-I can be used in clinical practice as a risk predictor for postmenopause-associated loss of bone mass.