Relation of parity and homocysteine to bone mineral density of postmenopausal women.

Osteoporosis is a major problem in contemporary society. However, there is not enough data on multiparity and osteoporosis from developing and/or undeveloped countries on a large scale. Selection of participants in this study was aimed at the detection of bone status in healthy (normal bone mineral density) postmenopausal (n = 46, 55.3 +/- 6.7 years) and osteoporotic postmenopausal women (n: 33) of similar age. Bone mineral density (BMD) was evaluated using dual energy X-ray absorptiometry. At the DEXA evaluation, 33 women had osteoporotic (T score below -2.5) and 46 had normal BMD values. The number of pregnancies was found to range from 3 to 12 (with an overall mean of 6.7 +/- 2.5), while 2.6 +/- 1.9 (range, 1-7) were miscarriages in all of the 33 postmenopausal osteoporotic women. Serum homocysteine (t-Hcy) and urinary deoxypyridinoline (DPD) levels were significantly higher in osteoporotic postmenopausal women (11.96 +/- 3.84 micromol/L, 15.4 +/- 7.0 nM/mM cr) than in non-osteoporotic postmenopausal women (10.93 +/- 3.6 micromol/L, 10.6 +/- 9.1 nM/mM cr), p < 0.05, p < 0.01, respectively. Surprisingly, in postmenopausal osteoporotic women the homocysteine (t-Hcy) levels were positively associated with the number of deliveries (multiparity; 6.7 +/- 2.5), and positively associated with the number of curettages (2.6 +/- 1.9), r = 0.401, p < 0.038 and r = 0.520, p < 0.029, respectively. The mechanism linking serum t-Hcy to the number of pregnancies is unclear, and the relationship may only be by chance. In conclusion, the present study firstly suggests that the number of pregnancies has an effect on the t-Hcy levels. In addition, our study indicates that there is a significant negative correlation between the number of pregnancies and the lumbar spine BMD.

Plummer-Vinson syndrome and dilation therapy: a report of two cases.

Plummer-Vinson syndrome is known as the association of postcricoid dysphagia, upper esophageal web, and iron deficiency anemia. Although correction of iron deficiency may result in resolution of dysphagia and sometimes disappearance of the webs, dilation therapy is usually necessary to remove webs and relieve dysphagia. We report two cases of Plummer-Vinson syndrome. Both patients presented with significant and longstanding dysphagia, sideropenia, glossitis and koilonychia. Our two patients had occasional choking and aspiration episodes at eating and endoscope did not pass through at the level of the upper esophagus. Patients' esophagograms revealed the presence of webs in part of the post-cricoid region. Both patients were treated with esophageal bougienage or balloon dilation, and iron supplementation. The patients were examined periodically for two years after the initial treatment and found to be in good general condition.