Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women

Revista de Saúde Pública

Marcelo M Pinheiro¹  Edgard T Dos Reis Neto²  Flávia S Machado²  Felipe Omura²  Jeane H K Yang²  Jacob Szejnfeld¹  Vera L Szejnfeld¹ 

[1] ,Universidade Federal de São Paulo Escola Paulista de Medicina São Paulo SP ,Brasil

关键词: Fractures;    Bone;    Bone Density;    Osteoporosis;    Postmenopausal;    Osteoporosis;    Risk Factors;    Cross-Sectional Studies;    Women's Health;    Fraturas Ósseas;    Densidade Óssea;    Osteoporose Pós-Menopausa;    Osteoporose;    Fatores de Risco;    Estudos Transversais;    Saúde da Mulher;    Fracturas Óseas;    Densidad Ósea;    Osteoporosis Posmenopáusica;    Osteoporosis;    Factores de Riesgo;    Estudios Transversales;    Salud de la Mujer;   

DOI  :  10.1590/S0034-89102010000300011

来源: SciELO

【 摘 要 】

OBJECTIVE: To estimate the prevalence and analyze risk factors associated to osteoporosis and low-trauma fracture in women. METHODS: Cross-sectional study including a total of 4,332 women older than 40 attending primary care services in the Greater São Paulo, Southeastern Brazil, between 2004 and 2007. Anthropometrical and gynecological data and information about lifestyle habits, previous fracture, medical history, food intake and physical activity were obtained through individual quantitative interviews. Low-trauma fracture was defined as that resulting from a fall from standing height or less in individuals 50 years or older. Multiple logistic regression models were designed having osteoporotic fracture and bone mineral density (BMD) as the dependent variables and all other parameters as the independent ones. The significance level was set at p<0.05. RESULTS: The prevalence of osteoporosis and osteoporotic fractures was 33% and 11.5%, respectively. The main risk factors associated with low bone mass were age (OR=1.07; 95% CI: 1.06;1.08), time since menopause (OR=2.16; 95% CI: 1.49;3.14), previous fracture (OR=2.62; 95% CI: 2.08;3.29) and current smoking (OR=1.45; 95% CI: 1.13;1.85). BMI (OR=0.88; 95% CI: 0.86;0.89), regular physical activity (OR=0.78; 95% CI: 0.65;0.94) and hormone replacement therapy (OR=0.43; 95% CI: 0.33;0.56) had a protective effect on bone mass. Risk factors significantly associated with osteoporotic fractures were age (OR=1.05; 95% CI: 1.04;1.06), time since menopause (OR=4.12; 95% CI: 1.79;9.48), familial history of hip fracture (OR=3.59; 95% CI: 2.88;4.47) and low BMD (OR=2.28; 95% CI: 1.85;2.82). CONCLUSIONS: Advanced age, menopause, low-trauma fracture and current smoking are major risk factors associated with low BMD and osteoporotic fracture. The clinical use of these parameters to identify women at higher risk for fractures might be a reasonable strategy to improve the management of osteoporosis.

【 授权许可】

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