Association of Pelvic Organ Prolapse and Changes in Bone Imaging Biomarkers in Postmenopausal Women with Low Bone Mineral Density

Background: To test the hypothesis that pelvic organ prolapse (POP) and osteoporosis are both manifestations of a connective tissue disorder, we evaluated whether there is an association between presence of POP and bone imaging biomarkers in postmenopausal women with low bone mineral density (BMD)....

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Main Authors: María Pérez Arguedas, Ernesto Bas Esteve, Alenda Jiménez García, Francisco Nohales Alfonso, Ana Jimenez-Pastor, Luis Martí-Bonmatí
Format: Article
Language:English
Published: IMR Press 2024-04-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/51/4/10.31083/j.ceog5104092
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author María Pérez Arguedas
Ernesto Bas Esteve
Alenda Jiménez García
Francisco Nohales Alfonso
Ana Jimenez-Pastor
Luis Martí-Bonmatí
author_facet María Pérez Arguedas
Ernesto Bas Esteve
Alenda Jiménez García
Francisco Nohales Alfonso
Ana Jimenez-Pastor
Luis Martí-Bonmatí
author_sort María Pérez Arguedas
collection DOAJ
description Background: To test the hypothesis that pelvic organ prolapse (POP) and osteoporosis are both manifestations of a connective tissue disorder, we evaluated whether there is an association between presence of POP and bone imaging biomarkers in postmenopausal women with low bone mineral density (BMD). Methods: A blind analytical, observational, and prospective cross-sectional study recruited 89 postmenopausal women with low BMD. Women were divided into those with absent/minimal or with moderate-to-severe POP. An X-ray of the spine was performed followed by a computational image analysis to quantify textural features on each vertebral body. Statistical analysis with a stepwise binary logistic regression model was used. Results: After 10 steps, the final model showed significance (p < 0.05) in the Omnibus coefficients test. The model classification results were high with over 80% success rates for both groups and an accuracy of 83%. The verification table showed that 39 of the 46 non-prolapsed patients were classified correctly, while 7 women were classified as having prolapsed. Among the 43 patients that had prolapsed, 35 patients were correctly classified while 8 were wrongly classified. The logistic regression analysis confirmed that both groups (prolapsed and non-prolapsed patients) can be differentiated using bone biomarkers on plain films. Most of the significant changes were found on the dorsal vertebrae. Conclusions: Pelvic organ prolapse is related to changes in bone imaging biomarkers, besides BMD. These results support the hypothesis that both pelvic prolapse and osteoporosis have a common causal origin.
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spelling doaj-art-caf1ddf4f9644b4f84192e06ebce94ef2025-08-20T02:54:40ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632024-04-015149210.31083/j.ceog5104092S0390-6663(24)02342-XAssociation of Pelvic Organ Prolapse and Changes in Bone Imaging Biomarkers in Postmenopausal Women with Low Bone Mineral DensityMaría Pérez Arguedas0Ernesto Bas Esteve1Alenda Jiménez García2Francisco Nohales Alfonso3Ana Jimenez-Pastor4Luis Martí-Bonmatí5Department of Obstetrics and Gynaecology, Manises Hospital, 46940 Valencia, SpainDepartment of Obstetrics and Gynaecology, La Fe Polytechnic and University Hospital, 46026 Valencia, SpainDepartment of Obstetrics and Gynaecology, Manises Hospital, 46940 Valencia, SpainDepartment of Obstetrics and Gynaecology, La Fe Polytechnic and University Hospital, 46026 Valencia, SpainQuibim (Quantitative Imaging Biomarkers in Medicine), 46021 Valencia, SpainDepartment of Radiology, La Fe Polytechnic and University Hospital, 46026 Valencia, SpainBackground: To test the hypothesis that pelvic organ prolapse (POP) and osteoporosis are both manifestations of a connective tissue disorder, we evaluated whether there is an association between presence of POP and bone imaging biomarkers in postmenopausal women with low bone mineral density (BMD). Methods: A blind analytical, observational, and prospective cross-sectional study recruited 89 postmenopausal women with low BMD. Women were divided into those with absent/minimal or with moderate-to-severe POP. An X-ray of the spine was performed followed by a computational image analysis to quantify textural features on each vertebral body. Statistical analysis with a stepwise binary logistic regression model was used. Results: After 10 steps, the final model showed significance (p < 0.05) in the Omnibus coefficients test. The model classification results were high with over 80% success rates for both groups and an accuracy of 83%. The verification table showed that 39 of the 46 non-prolapsed patients were classified correctly, while 7 women were classified as having prolapsed. Among the 43 patients that had prolapsed, 35 patients were correctly classified while 8 were wrongly classified. The logistic regression analysis confirmed that both groups (prolapsed and non-prolapsed patients) can be differentiated using bone biomarkers on plain films. Most of the significant changes were found on the dorsal vertebrae. Conclusions: Pelvic organ prolapse is related to changes in bone imaging biomarkers, besides BMD. These results support the hypothesis that both pelvic prolapse and osteoporosis have a common causal origin.https://www.imrpress.com/journal/CEOG/51/4/10.31083/j.ceog5104092pelvic organ prolapseosteoporosiscollagen metabolism alterationimaging biomarkersosteoporotic bone fractures
spellingShingle María Pérez Arguedas
Ernesto Bas Esteve
Alenda Jiménez García
Francisco Nohales Alfonso
Ana Jimenez-Pastor
Luis Martí-Bonmatí
Association of Pelvic Organ Prolapse and Changes in Bone Imaging Biomarkers in Postmenopausal Women with Low Bone Mineral Density
Clinical and Experimental Obstetrics & Gynecology
pelvic organ prolapse
osteoporosis
collagen metabolism alteration
imaging biomarkers
osteoporotic bone fractures
title Association of Pelvic Organ Prolapse and Changes in Bone Imaging Biomarkers in Postmenopausal Women with Low Bone Mineral Density
title_full Association of Pelvic Organ Prolapse and Changes in Bone Imaging Biomarkers in Postmenopausal Women with Low Bone Mineral Density
title_fullStr Association of Pelvic Organ Prolapse and Changes in Bone Imaging Biomarkers in Postmenopausal Women with Low Bone Mineral Density
title_full_unstemmed Association of Pelvic Organ Prolapse and Changes in Bone Imaging Biomarkers in Postmenopausal Women with Low Bone Mineral Density
title_short Association of Pelvic Organ Prolapse and Changes in Bone Imaging Biomarkers in Postmenopausal Women with Low Bone Mineral Density
title_sort association of pelvic organ prolapse and changes in bone imaging biomarkers in postmenopausal women with low bone mineral density
topic pelvic organ prolapse
osteoporosis
collagen metabolism alteration
imaging biomarkers
osteoporotic bone fractures
url https://www.imrpress.com/journal/CEOG/51/4/10.31083/j.ceog5104092
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