Artículos de revistas
Factors Associated With Osteoporosis In Brazilian Women: A Population-based Household Survey
Registro en:
Archives Of Osteoporosis. , v. 8, n. 1/Fev, p. - , 2013.
18623522
10.1007/s11657-013-0138-z
2-s2.0-84880784989
Autor
Baccaro L.F.
De Souza Santos Machado V.
Costa-Paiva L.
Sousa M.H.
Osis M.J.
Pinto-Neto A.M.
Institución
Resumen
The aging of Brazilian population has been well-documented. A longer time since menopause, poor self-perception of health, and having arthrosis and balance problems are factors associated with postmenopausal osteoporosis. Poor self-perception of health, menopausal treatment with natural remedies, smoking, and decreased functional capacity are associated with early onset of the disease. Purpose: This study aims to evaluate the prevalence of osteoporosis and its associated factors in Brazilian women over 50 years of age and to obtain information on factors related to the early onset of the disease. Methods: A cross-sectional study with 622 women over 50 years of age residing in Campinas/Brazil was conducted between May 10 and October 31, 2011 in the form of a population survey. A questionnaire was applied by trained interviewers. Osteoporosis was classified either as self-reported or as osteoporosis diagnosed by bone densitometry. Statistical analysis was carried out by chi-square test, Poisson regression analysis, and Cox multiple regression model. Results: The mean age of the women was 64.1 years. The prevalence of self-reported osteoporosis was 21.3 %. A longer time since menopause (prevalence ratios (PR), 1.04; 95 % CI, 1.03-1.05; p < 0.001); self-perception of health as fair/poor/very poor (PR, 1.73; 95 % CI, 1.29-2.33; p < 0.001); having arthrosis (PR, 1.83; 95 % CI, 1.30-2.59; p < 0.002) and having problems maintaining balance when taking a bath or going down stairs (PR, 1.52; 95 % CI, 1.07-2.14; p = 0.020) were associated with osteoporosis. The variables associated with early onset of the disease were: self-perception of health as fair/poor/very poor (coefficient, 0.77; p < 0.001), menopausal treatment with natural remedies (coefficient, 1.01; p < 0.001), smoking or having smoked >20 cigarettes/day (coefficient, 1.02; p = 0.003), and problems in running/lifting something heavy/practicing sports/doing heavy work (coefficient, 0.60; p = 0.029). Conclusions: The results of this study have improved understanding of the factors associated with osteoporosis in the Brazilian population and may help identify those women who should undergo bone densitometry. © 2013 International Osteoporosis Foundation and National Osteoporosis Foundation. 8 1/Fev
(2008) Síntese de Indicadores Sociais, , http://www.ibge.gov.br/home/estatistica/populacao/condicaodevida/ indicadoresminimos/sinteseindicsociais2008/indic_sociais2008.pdf, Instituto Brasileiro de Geografia e Estatística (IBGE) Estudos e pesquisas Accessed 26 June 2012 Parahyba, M.I., Veras, R., Melzer, D., Disability among elderly women in Brazil (2005) Rev Saúde Pública, 39, pp. 383-391. , 15997313 10.1590/S0034-89102005000300008 Johnell, O., Kanis, J., Epidemiology of osteoporotic fractures (2005) Osteoporos Int, 16 (SUPPL. 2), pp. 3-S7. , 15365697 10.1007/s00198-004-1702-6 Abrahamsen, B., Rejnmark, L., Nielsen, S.P., Ten-year prediction of osteoporosis from baseline bone mineral density: Development of prognostic thresholds in healthy postmenopausal women. The Danish Osteoporosis Prevention Study (2006) Osteoporos Int, 17, pp. 245-251. , 16155732 10.1007/s00198-005-1989-y Pinheiro, M.M., Camargos, B.M., Borba, V.Z.C., Lazaretti-Castro, M., Frax™: Building an idea to Brazil (2009) Arq Bras Endocrinol Metab, 53 (6), pp. 783-790. , 10.1590/S0004-27302009000600015 Pinheiro, M.M., Ciconelli, R.M., Martini, L.A., Ferraz, M.B., Clinical risk factors for osteoporotic fractures in Brazilian women and men: The Brazilian Osteoporosis Study (BRAZOS) (2009) Osteoporos Int, 20, pp. 399-408. , 1:STN:280:DC%2BD1M7jtlSgtQ%3D%3D 18597037 10.1007/s00198-008-0680-5 Riera-Espinoza, G., Epidemiology of osteoporosis in Latin America 2008 (2009) Salud Publica Mex, 51 (SUPPL. 1), pp. 52-S55. , 19287895 10.1590/S0036-36342009000700009 Kanis, J.A., Johnell, O., Oden, A., Johansson, H., McCloskey, E., FRAX and the assessment of fracture probability in men and women from the UK (2008) Osteoporos Int, 19, pp. 385-397. , 1:STN:280:DC%2BD1c7nvF2ntA%3D%3D 2267485 18292978 10.1007/s00198-007- 0543-5 Lebrão, M.L., Duarte, Y.A.O., (2003) SABE-Saúde, Bem-estar e Envelhecimento - O Projeto SABe No Município de São Paulo: Uma Abordagem Inicial, , Organização Pan-Americana da Saúde Brasília Vigilância de Fatores de Risco e Proteção Para Doenças Crônicas Não Transmissíveis Por Entrevistas Telefônicas (VIGITEL), , http://portal.saude.gov.br/portal/arquivos/pdf/167_Q2008.pdf, Ministério da Saúde-Brasil Accessed 26 June 2012 Guralnik, J.M., Fried, L.P., Simonsick, E.M., Kasper, J.D., Lafferty, M.E., (1995) The Women's Health and Aging Study: Health and Social Characteristics of Older Women with Disability, , http://www.grc.nia.nih.gov/branches/ledb/whasbook/title.htm, National Institute on aging, Bethesda, MD. NIH Pub. No. 95-4009 Accessed 26 June 2012 Altman, D.G., (1999) Practical Statistics for Medical Research, , CRC Boca Raton Barros, A.J., Hirakata, V.N., Alternatives for logistic regression in cross-sectional studies: An empirical comparison of models that directly estimate the prevalence ratio (2003) BMC Med Res Methodol, 3, p. 21. , 521200 14567763 10.1186/1471-2288-3-21 Lee, E.T., (1980) Statistical Methods for Survival Data Analysis, , Lifetime Learning Belmont Riggs, B.L., Khosla, S., Melton III, L.J., A unitary model for involutional osteoporosis: Estrogen deficiency causes both type i and type II osteoporosis in postmenopausal women and contributes to bone loss in aging men (1998) J Bone Miner Res, 13, pp. 763-773. , 1:STN:280:DyaK1c3nt1aksg%3D%3D 9610739 10.1359/jbmr.1998.13.5.763 Ohta, H., Sugimoto, I., Masuda, A., Decreased bone mineral density associated with early menopause progresses for at least ten years: Cross-sectional comparisons between early and normal menopausal women (1996) Bone, 18, pp. 227-231. , 1:STN:280:DyaK283mtFOrsg%3D%3D 8703577 10.1016/8756-3282(95)00480-7 Gerdhem, P., Obrant, K.J., Bone mineral density in old age: The influence of age at menarche and menopause (2004) J Bone Miner Metab, 22, pp. 372-375. , 15221497 10.1007/s00774-004-0497-z Van Staa, T.P., Geusens, P., Bijlsma, J.W., Clinical assessment of long-term risk of fracture in patients with rheumatoid arthritis (2006) Arthritis Rheum, 54, pp. 3104-3112. , 17009229 10.1002/art.22117 Haugeberg, G., Uhlig, T., Falch, J.A., Halse, J.I., Kvien, T.K., Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis: Results from 394 patients in the Oslo County Rheumatoid Arthritis register (2000) Arthritis Rheum, 42, pp. 522-530. , 10.1002/1529-0131(200003)43:3<522: AID-ANR7>3.0.CO;2-Y Kim, S.Y., Schneeweiss, S., Liu, J., Risk of osteoporotic fracture in a large population based cohort of patients with rheumatoid arthritis (2010) Arthritits Res and Ther, 12, p. 154. , 10.1186/ar3107 Huusko, T.M., Korpela, M., Karppi, P., Avikainen, V., Kautiainen, H., Sulkava, R., Threefold increase risk of hip fractures with rheumatoid arthritis in central Finland (2001) Ann Rheum Dis, 60, pp. 521-522. , 1:STN:280:DC%2BD3M3oslyisg%3D%3D 11302878 10.1136/ard.60.5.521 Baskan, B.M., Sivas, F., Alemdaroǧlu, E., Duran, S., Ozoran, K., Association of bone mineral density and vertebral deformity in patients with rheumatoid arthritis (2007) Rheumatol Int, 27, pp. 579-584. , 17287933 10.1007/s00296-007-0323-8 Broy, S.B., Tanner, S.B., Official Positions for FRAX® clinical regarding rheumatoid arthritis from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX® (2011) J Clin Densitom, 14, pp. 184-189. , FRAX(®)Position Development Conference Members 21810523 10.1016/j.jocd.2011.05.012 Smulders, E., Schreven, C., Weerdesteyn, V., Van Den Hoogen, F.H., Laan, R., Van Lankveld, W., Fall incidence and fall risk factors in people with rheumatoid arthritis (2009) Ann Rheum Dis, 68, pp. 1795-1796. , 1:STN:280:DC%2BD1MnosF2guw%3D%3D 19822719 10.1136/ard.2009.109009 Lane, N.E., Epidemiology, etiology and diagnosis of osteoporosis (2006) Am J Obstet Gynecol, 194 (SUPPL. 2), pp. 3-S11. , 1:CAS:528:DC%2BD28XhtVamtLk%3D 16448873 10.1016/j.ajog.2005.08.047 Schmitt, N.M., Schmitt, J., Dören, M., The role of physical activity in the prevention of osteoporosis in postmenopausal women - An update (2009) Maturitas, 63, pp. 34-38. , 19356867 10.1016/j.maturitas.2009.03.002 Lunt, M., Masaryk, P., Scheidt-Nave, C., The effects of lifestyle, dietary dairy intake and diabetes on bone density and vertebral deformity prevalence: The EVOS study (2001) Osteoporos Int, 12, pp. 688-698. , 1:STN:280:DC%2BD3MrjtlWltw%3D%3D 11580083 10.1007/s001980170069 Wilsgaard, T., Emaus, N., Ahmed, L.A., Lifestyle impact on lifetime bone loss in women and men: The Tromsø Study (2009) Am J Epidemiol, 169, pp. 877-886. , 19174426 10.1093/aje/kwn407 Dook, J.E., James, C., Henderson, N.K., Price, R.I., Exercise and bone mineral density in mature female athletes (1997) Med Sci Sports Exerc, 29, pp. 291-296. , 1:STN:280:DyaK2s3islClsQ%3D%3D 9139166 10.1097/00005768-199703000-00002 Marini, H., Minutoli, L., Polito, F., Effects of the phytoestrogen genistein on bone metabolism in osteopenic postmenopausal women: A randomized trial (2007) Ann Intern Med, 146, pp. 839-847. , 17577003 10.7326/0003-4819-146-12-200706190-00005 Liu, J., Ho, S.C., Su, Y.X., Chen, W.Q., Zhang, C.X., Chen, Y.M., Effect of long-term intervention of soy isoflavones on bone mineral density in women: A meta-analysis of randomized controlled trials (2009) Bone, 44, pp. 948-953. , 1:CAS:528:DC%2BD1MXktFagsbc%3D 19168161 10.1016/j.bone.2008.12.020 Lazar, Jr.F., Costa-Paiva, L., Morais, S.S., Pedro, A.O., Pinto-Neto, A.M., The attitude of gynecologists in São Paulo, Brazil 3 years after the Women's Health Initiative study (2007) Maturitas, 56, pp. 129-141. , 16901660 10.1016/j.maturitas.2006.06.022 Law, M.R., Hackshaw, A.K., A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: Recognition of a major effect (1997) BMJ, 315, pp. 841-846. , 1:STN:280:DyaK1c%2FhsVygsg%3D%3D 9353503 10.1136/bmj.315.7112.841 Kanis, J.A., Johnell, O., Oden, A., Smoking and fracture risk: A meta-analysis (2005) Osteoporos Int, 16, pp. 155-162. , 1:STN:280:DC%2BD2M%2FksVentA%3D%3D 15175845 10.1007/s00198-004-1640-3 Vestergaard, P., Mosekilde, L., Fracture risk associated with smoking: A meta-analysis (2003) J Intern Med, 254, pp. 572-583. , 1:STN:280:DC%2BD3srmvFShtA%3D%3D 14641798 10.1111/j.1365-2796.2003.01232. x Slemenda, C.W., Hui, S.L., Longcope, C., Johnston, Jr.C.C., Cigarette smoking, obesity, and bone mass (1989) J Bone Miner Res, 4, pp. 737-741. , 1:STN:280:DyaK3c%2Flt1Onug%3D%3D 2816518 10.1002/jbmr.5650040513 Kato, I., Toniolo, P., Akhmedkhanov, A., Koenig, K.L., Shore, R., Zeleniuch-Jacquotte, A., Prospective study of factors influencing the onset of natural menopause (1998) J Clin Epidemiol, 51, pp. 1271-1276. , 1:STN:280:DyaK1M7osVKhsQ%3D%3D 10086819 10.1016/S0895-4356(98)00119-X Krall, E.A., Dawson-Hughes, B., Smoking and bone loss among postmenopausal women (1991) J Bone Miner Res, 6, pp. 331-338. , 1:STN:280:DyaK3MzhsVahsA%3D%3D 1858519 10.1002/jbmr.5650060404 Management of osteoporosis in postmenopausal women: 2010 position statement of the North American Menopause Society (2010) Menopause, 17, pp. 25-54. , The North American Menopause Society 10.1097/gme.0b013e3181c617e6 (2010) Clinician's Guide to Prevention and Treatment of Osteoporosis, , National Osteoporosis Foundation National Osteoporosis Foundation Washington, DC