{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:42:36Z","timestamp":1792593756730,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,4,10]],"date-time":"2013-04-10T00:00:00Z","timestamp":1365552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Poverty is associated with a great number of diseases, but the prevalence of vitamin D deficiency, secondary hyperparathyroidism and the potential association of osteoporosis, osteoporotic fractures and metabolic syndrome in this situation are less well known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the associations between poverty, bone density, fragility fractures and metabolic syndrome in a population of southern European postmenopausal women. Also, to assess the potential role of vitamin D and parathyroid hormone (<jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content>) levels in these associations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Cross\u2010sectional study was carried out in 1\u00a0250 postmenopausal Caucasian Spanish women. The socio\u2010economic status of the participants was determined after a personal interview, according to the criteria of the Spanish Institute of Statistics. Participants were divided into two socio\u2010economic levels: low (poverty) and medium or high socioeconomic level. The study protocol included a health questionnaire, a complete physical examination, lateral radiograph of the dorsal and lumbar spine and measurement of bone mineral density (<jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>) at the lumbar spine (L2\u2010L4) and proximal femur. Fasting blood was obtained to measure 25\u2010hydroxy\u2010vitamin D (25\u2010<jats:styled-content style=\"fixed-case\">OHD<\/jats:styled-content>), intact <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> and selected biochemical variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Low socio\u2010economic status was associated with 25\u2010<jats:styled-content style=\"fixed-case\">OHD<\/jats:styled-content> insufficiency, higher values of <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content>, higher body weight and body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>), lower values of <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> at the lumbar spine and a higher prevalence of fragility fractures, both vertebral and nonvertebral. Poverty was also associated with higher prevalence of metabolic syndrome, but this association was driven mainly by the higher <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> and not by poverty itself. Both vitamin D insufficiency and elevated <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> were consistently related to poverty and osteoporotic fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Poor postmenopausal women in southern Europe have a high prevalence of metabolic syndrome and osteoporotic fractures. Poverty was associated with higher <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> and metabolic syndrome on the one hand and, on the other, with 25<jats:styled-content style=\"fixed-case\">OHD<\/jats:styled-content> insufficiency, higher <jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content> levels and osteoporosis. 25<jats:styled-content style=\"fixed-case\">OHD<\/jats:styled-content> insufficiency and\/or secondary hyperparathyroidism do not have a significant influence on the presence of metabolic syndrome in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12051","type":"journal-article","created":{"date-parts":[[2012,9,25]],"date-time":"2012-09-25T22:55:25Z","timestamp":1348613725000},"page":"681-686","source":"Crossref","is-referenced-by-count":41,"title":["Osteoporosis and metabolic syndrome according to socio\u2010economic status, contribution of <scp>PTH<\/scp>, vitamin D and body weight: The Canarian Osteoporosis Poverty Study (<scp>COPS<\/scp>)"],"prefix":"10.1111","volume":"78","author":[{"given":"Mar\u00eda del Carmen","family":"Navarro","sequence":"first","affiliation":[{"name":"Research Group on Education and Promotion of Health University of Las Palmas de Gran Canaria Canary Islands Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Saavedra","sequence":"additional","affiliation":[{"name":"Department of Mathematics University of Las Palmas de Gran Canaria Las Palmas de Gran Canaria Canary Islands Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"J\u00f3dar","sequence":"additional","affiliation":[{"name":"Endocrinology Service University Hospital Quir\u00f3n Madrid European University Madrid Madrid Canary Islands Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00aa Jes\u00fas","family":"G\u00f3mez de Tejada","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Seville Seville Canary Islands Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Mirallave","sequence":"additional","affiliation":[{"name":"Research Group on Osteoporosis and Bone Mineral Diseases University of Las Palmas de Gran Canaria Canary Islands Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Sosa","sequence":"additional","affiliation":[{"name":"Research Group on Osteoporosis and Bone Mineral Diseases University of Las Palmas de Gran Canaria Canary Islands Spain"},{"name":"Bone Metabolic Unit Insular University Hospital Las Palmas de Gran Canaria Canary Islands Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,10]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(92)90682-2"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001980050030"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/36.5.1014"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03187466"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra070553"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2010.02.016"},{"key":"e_1_2_5_8_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/BF03403939","article-title":"Public health and poverty","volume":"100","author":"Lessard R.","year":"2009","journal-title":"Canadian Journal of Public Health"},{"key":"e_1_2_5_9_1","doi-asserted-by":"crossref","first-page":"3801","DOI":"10.1210\/jcem.86.8.7783","article-title":"Secondary hyperparathyroidism and bone turnover in elderly blacks and whites","volume":"86","author":"Harris S.S.","year":"2001","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1928"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-008-0697-9"},{"key":"e_1_2_5_12_1","first-page":"84","article-title":"Working group on clinical practice and protocols. Basic data on osteoporosis","volume":"9","author":"Sosa Henriquez M.","year":"2000","journal-title":"Revista Espa\u00f1ola de Enfermedades Metab\u00f3licas \u00d3seas"},{"key":"e_1_2_5_13_1","unstructured":"Spanish National Institute of Statistics(2004)Life conditions questionnaire. Main results. INE. Available athttp:\/\/www.ine.es\/prensa\/np394pdf accessed 1 April 2012."},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114716"},{"issue":"2","key":"e_1_2_5_15_1","first-page":"S1","article-title":"K\/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification","volume":"39","author":"National Kidney Foundation.","year":"2002","journal-title":"American Journal of Kidney Diseases"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01623462"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650080915"},{"key":"e_1_2_5_18_1","volume-title":"Dietary Reference Intakes for Calcium and Vitamin D","author":"Institute of Medicine (US)","year":"2011"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.328"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0385"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.81.3.1129"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-2364"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2006.01685.x"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079907X219562"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114508023416"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.11.1159"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2891-7-4"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-277X.2011.01158.x"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2011.11.002"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-006-0259-y"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.081242"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-12-201112200-00004"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2840-8-7"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2011.04110.x"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1385\/JCD:1:4:385"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001980200059"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcen.12051","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.12051","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:59:43Z","timestamp":1698627583000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.12051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,10]]},"references-count":35,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2013,5]]}},"alternative-id":["10.1111\/cen.12051"],"URL":"https:\/\/doi.org\/10.1111\/cen.12051","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,4,10]]}}}