RESUMEN

OBJETIVO: Verificar a prevalência de risco de fratura estimada pela ultrassonometria óssea de calcâneo (UOC) em uma população de idosas e sua associação com fatores de risco. MÉTODOS: Estudo transversal com amostra selecionada aleatoriamente e submetida a questionário estruturado sobre fatores de risco para fratura e UOC. RESULTADOS: Foram estudadas 168 mulheres brancas, menopausadas, com média de idade de 69,56 ± 6,27 anos; 81 por cento da população de estudo tinha exame alterado, sendo 41 por cento consideradas de maior risco. As mulheres com exames alterados tinham menor peso, altura e IMC, e tinham menores valores de SOS, BUA, BQI e T-score. Após ajuste, o IMC manteve significância para UOC alterada (OR = 3,37, IC 1,19-9,56, p = 0,02) e a história prévia de fraturas para UOC da faixa de maior risco (OR = 4,44, IC 1,16-16,96, p = 0,03). CONCLUSÃO: Observamos alta prevalência de risco para fraturas determinado pela UOC, superior ao de outros estudos brasileiros, e sua associação com IMC e história prévia de fraturas.

OBJECTIVE: To verify the prevalence of women with risk of fractures estimated by ultrasonometry of the calcaneus (UOC) in a population of elderly women and its association with clinical risk factors. METHODS: Cross-sectional study of which sample was randomly selected and submitted to a structured questionnaire about risk factors for fractures. All women underwent UOC. RESULTS: We studied 168 Caucasian postmenopausal women, with a mean age of 69.56 ± 6.27 years; 81 percent of these women had abnormal test results and 41 percent of the abnormal results were considered higher risk. Women with abnormal test results had lower weight, height and BMI, and had lower values of SOS, BUA, BQI and T-score. After adjustment, BMI remained significant for abnormal UOC (OR = 3.37, 95 percent CI: 1.19 9.56, p = 0.02), and history of previous fractures for UOC of the higher risk range (OR = 4.44, 95 percent CI: 1.16-16.96, p = 0.03). CONCLUSION: We observed a high prevalence of risk of fractures determined by the UOC. Our prevalence was higher than those in other Brazilian studies. There was an association between UOC and BMI and previous history of fractures.

Asunto(s)

RESUMEN

Introdução e Objetivos: A ultrassonometria óssea de calcâneo (UOC) é capaz de estimar o risco para fraturas por fragilidade de forma semelhante a densitometria óssea. Embora existam muitos dispositivos no mercado, o Sonost 2000 tem sido amplamente utilizado em campanhas de saúde em nosso país, ainda que não existam dados na literatura que comprovem ou comparem sua acuracia com os modelos mais amplamente pesquisados. Este estudo tem por objetivo verificar o poder deste aparelho para discriminar fraturas vertebrais por fragilidade óssea em uma população de mulheres brasileiras na pós-menopausa. Metodologia: Foi feito estudo transversal com 149 mulheres brancas menopausadas selecionadas aleatoriamente. Todas responderam um questionário estruturado sobre história médica, fizeram radiografia de coluna (RX) e UOC entre maio e dezembro de 2007. Resultados: A prevalência de fraturas nos raios X foi de 49,7% (n=74). De acordo com o T-score da UOC, 79,9% tinham exame alterado. Mulheres com fratura radiográfica eram mais idosas, com maior tempo desde menopausa e apresentaram menores valores em todos os parâmetros ultrassonométricos. O exame apresentou sensibilidade de 87,8% e especificidade de 28% para UOC alterado, e de 80% e 45% para a maior faixa de risco da UOC, respectivamente. A AUC foi mais significativa para velocidade do som (SOS) e atenuação do som (BUA). Conclusões: Nosso estudo mostra boa sensibilidade do Sonost 2000 para rastreamento de populações femininas acima de 60 anos e propõe a utilização da UOC no rastreamento de populações de risco.

RESUMEN

PURPOSE: To investigate the relationship between quality of life and spinal fracture in women aged over 60 living in Southern Brazil. METHODS: A case-control study was conducted with the application of the WHOQOL-bref questionnaire to 100 women living in the city of Chapecó (SC), aged over 60, postmenopausal, white or Caucasian, with no important cognitive impairment or a history of diseases known to affect bone metabolism, or malignant neoplasias. The population was divided into two groups depending on the presence or absence of fractures in the spine radiography. We analyzed variables related to the current and previous medical history, life habits and family history of fractures, and the domains and facets that compose the WHOQOL-bref. All participants were informed about the objectives and methodologies adopted and gave written informed consent to participate in the study. RESULTS: The mean age of the women in the fracture group was older than that of women with fractures (p<0.05). Also women with fractures tended to belong to a higher social class, to have more years of study, a higher family income, and a greater use of alcoholic drinks (p<0.05). In the evaluation of the WHOQOL-bref domains, the fracture group had the highest average in the psychological field (χ=63.6±3.0) and the lowest in the environment field (χ=9.3±58.8). In the group without fracture, the highest average also occurred in the psychological domain (χ=67.2±9.3) and the lowest in the field of social relations (χ=57.5±7.7). Statistical analysis showed no significant correlation between the averages of the facets that make up the areas between the groups with and without fractures. CONCLUSIONS: This study suggests that there is no impairment of quality of life among older women with vertebral fractures, but the relation between QL and time of occurrence and severity of the fractures should be better evaluated. Both groups had higher scores in the psychological domain, showing that the respondents rely on personal beliefs, spirituality and religion, accept their physical appearance while maintaining self-esteem and the ability to think, to learn and to concentrate despite the presence of this disease. There was no statistically significant difference between groups or between domains in the same group.

Asunto(s)

RESUMEN

OBJETIVO: Verificar a relação entre qualidade de vida e fratura vertebral em mulheres com mais de 60 anos em uma cidade do Sul do Brasil. MÉTODOS: Realizado estudo caso-controle com aplicação do questionário WHOQOL-bref em 100 mulheres residentes na cidade Chapecó (SC), com idade superior a 60 anos, na pós-menopausa de raça branca ou caucasoide, sem prejuízo cognitivo importante ou história pessoal doenças que sabidamente afetem o metabolismo ósseo ou neoplasias malignas. A população foi dividida em dois grupos dependendo da existência ou não de fraturas vertebrais na radiografia de coluna. Foram analisadas variáveis relacionadas à historia médica atual e pregressa, hábitos de vida e história familiar de fraturas, e os domínios e facetas que compõe o WHOQOL-bref. RESULTADOS: Observou-se que as mulheres com fratura tinham maior média de idade do que as sem fraturas (p<0,05). Também pareceu haver tendência a pertencerem a classe social mais alta, terem mais anos de estudo, maior renda familiar, e maior frequência de utilização de bebida alcoólica (p>0,05). Na avaliação dos domínios que compõem o WHOQOL-bref, a maior média deste grupo foi no psicológico (..=63,6±13,0), e a menor no meio ambiente (..=58,8±9,3). No grupo sem fratura, a maior média também ocorreu no domínio psicológico (..=67,2±9,3), já a menor ocorreu no das relações sociais (..=57,5±7,7). A análise estatística não mostrou correlação significativa entre as médias das facetas que compõem os domínios entre os grupos com e sem fraturas...

PURPOSE: To investigate the relationship between quality of life and spinal fracture in women aged over 60 living in Southern Brazil. METHODS: A case-control study was conducted with the application of the WHOQOL-bref questionnaire to 100 women living in the city of Chapecó (SC), aged over 60, postmenopausal, white or Caucasian, with no important cognitive impairment or a history of diseases known to affect bone metabolism, or malignant neoplasias. The population was divided into two groups depending on the presence or absence of fractures in the spine radiography. We analyzed variables related to the current and previous medical history, life habits and family history of fractures, and the domains and facets that compose the WHOQOL-bref. All participants were informed about the objectives and methodologies adopted and gave written informed consent to participate in the study. RESULTS: The mean age of the women in the fracture group was older than that of women with fractures (p<0.05). Also women with fractures tended to belong to a higher social class, to have more years of study, a higher family income, and a greater use of alcoholic drinks (p<0.05). In the evaluation of the WHOQOL-bref domains, the fracture group had the highest average in the psychological field (..=63.6± 3.0) and the lowest in the environment field (..=9.3±58.8). In the group without fracture, the highest average also occurred in the psychological domain (..=67.2± 9.3) and the lowest in the field of social relations (..=57.5±7.7). Statistical analysis showed no significant correlation between the averages of the facets that make up the areas between the groups with and without fractures...

Asunto(s)

RESUMEN

OBJECTIVE: To verify the prevalence of women with risk of fractures estimated by ultrasonometry of the calcaneus (UOC) in a population of elderly women and its association with clinical risk factors. METHODS: Cross-sectional study of which sample was randomly selected and submitted to a structured questionnaire about risk factors for fractures. All women underwent UOC. RESULTS: We studied 168 Caucasian postmenopausal women, with a mean age of 69.56 ± 6.27 years; 81% of these women had abnormal test results and 41% of the abnormal results were considered higher risk. Women with abnormal test results had lower weight, height and BMI, and had lower values of SOS, BUA, BQI and T-score. After adjustment, BMI remained significant for abnormal UOC (OR = 3.37, 95% CI: 1.19 9.56, p = 0.02), and history of previous fractures for UOC of the higher risk range (OR = 4.44, 95% CI: 1.16-16.96, p = 0.03). CONCLUSION: We observed a high prevalence of risk of fractures determined by the UOC. Our prevalence was higher than those in other Brazilian studies. There was an association between UOC and BMI and previous history of fractures.

Asunto(s)

RESUMEN

Fractures are the main problems related to bone fragility in postmenopausal women and account for the increase in the risk of new fractures, mortality, and costs. This study's objective was to verify the occurrence of vertebral fragility fracture and correlate it with demographic, behavioral, and clinical factors in a Brazilian population. The cross-sectional study was based on a random sample of elderly women living in Chapecó, Santa Catarina State, Brazil. The sample consisted of 186 white women over 60 years of age. Of these, 48.9% had asymptomatic vertebral fractures, with higher prevalence in T11-12 and L4-5. Adjusted analysis showed a gradient between age and vertebral fracture, while fracture prevalence was 2.3 times higher in women over 80 years. Fracture prevalence was 1.44 times higher in sedentary as compared to non-sedentary women. Due to the high prevalence of asymptomatic vertebral fractures, the authors suggest the use of spinal x-rays in elderly women for fracture screening and prevention.

Asunto(s)

RESUMEN

Fraturas são o principal agravo relacionado à fragilidade óssea na pós-menopausa, representando aumento de risco de novas fraturas, mortalidade e custos. Nosso objetivo foi verificar a ocorrência de fratura vertebral por fragilidade e relacioná-la com fatores demográficos, comportamentais e clínicos em uma população brasileira. Foi feito um estudo transversal com seleção por amostragem aleatória estratificada de mulheres idosas residentes em Chapecó, Santa Catarina, Brasil. A amostra foi constituída por 186 mulheres brancas com idade acima de 60 anos. Destas, 48,9 por cento tinham fraturas vertebrais assintomáticas, com maiores prevalências em T11-12 e L4-5. Na análise ajustada, observa-se que existe gradiente entre idade e fratura vertebral, chegando a ser 2,3 vezes maior a prevalência de fraturas entre as mulheres com idade superior a 80 anos. As sedentárias apresentaram prevalência de fratura 1,44 vez maior do que as não sedentárias. Devido à alta prevalência de fraturas vertebrais encontrada, sugerimos a realização de radiografia de coluna para mulheres idosas para rastreamento e prevenção de agravos.

Fractures are the main problems related to bone fragility in postmenopausal women and account for the increase in the risk of new fractures, mortality, and costs. This study's objective was to verify the occurrence of vertebral fragility fracture and correlate it with demographic, behavioral, and clinical factors in a Brazilian population. The cross-sectional study was based on a random sample of elderly women living in Chapecó, Santa Catarina State, Brazil. The sample consisted of 186 white women over 60 years of age. Of these, 48.9 percent had asymptomatic vertebral fractures, with higher prevalence in T11-12 and L4-5. Adjusted analysis showed a gradient between age and vertebral fracture, while fracture prevalence was 2.3 times higher in women over 80 years. Fracture prevalence was 1.44 times higher in sedentary as compared to non-sedentary women. Due to the high prevalence of asymptomatic vertebral fractures, the authors suggest the use of spinal x-rays in elderly women for fracture screening and prevention.

Asunto(s)

RESUMEN

A prevalência de osteoporose vem aumentando nas últimas décadas, tornando-se um dos grandes problemas de saúde pública no mundo. Desde 1994, a Organização Mundial de Saúde adotou a densitometria óssea como padrão-ouro para o diagnóstico e monitorização de tratamento da osteoporose. Desde então, consensos vêm sendo elaborados para normatizar o uso desse exame. Este artigo estabelece a comparação entre as recomendações preconizadas no consenso da International Society for Clinical Densitometry (ISCD) de 2003 e 2005, abordando, ainda, a última orientação nacional do Consenso Brasileiro de Osteoporose (CBO) de 2002.

Asunto(s)