Osteoporosis in climacteric women, prevalence and associated risk factors
DOI:
https://doi.org/10.1016/j.rccot.2021.02.007Keywords:
osteoporosis, prevalence, climacteric, women, risk factorsAbstract
Background: Osteoporosis is recognized as a multifactorial systemic skeletal disorder, characterized by low bone mass and loss of bone tissue microarchitecture, which compromises its resistance, with the consequent increase in bone fragility and increased susceptibility to fractures. The aim of the study is to determine the prevalence of osteoporosis and associated risk factors in women in climacteric.
Materials and methods: Observational, descriptive cross-sectional study. Of a population of 705 women, belonging to the menopause and climacteric program, 618 (87.65%) were enrolled. Women of 40 years or more were included, in climacteric, and with risk factors for bone loss or fractures, residents in Quindío (Colombia); attended between May 2015 and August 2017 in a private institution of high complexity in Armenia (Quindío). Oophorectomized women, with cancer, were receiving radiotherapy or chemotherapy. Sampling was done for convenience. Socio-demographic and clinical variables were measured. Measures of central tendency and dispersion or average were described. A bivariate analysis was performed between the presence of osteoporosis and the associated factors, the Odds ratio (OR) was calculated with its respective 95% confidence interval (95% CI).
Results: The average age was 57.46 ± 7.38 years. The prevalence of osteoporosis in the general population was 34.46% (n=213); being superior in those over 60 years (63.38%, n=135) with respect to minors (36.61%, n = 78). In those over 70 it was 65.92%. The prevalence of vertebral fracture in those over 60 years was 17.96%. The incidence of hip fracture was 9.22%. The incidence of wrist fracture was 12.13%. Bone mineral density was normal in 20.38% (n = 126). Osteopenia was found in 45.14% (n = 279). The risk factors significantly related to osteoporosis were: age over 60 years, vitamin D deficiency, postmenopausal time greater than 10 years and not receiving hormone replacement therapy.
Discussion: The presence of osteoporosis is a common problem in women in climacteric. The prevalence increases as the age of women increases. When taking into account each of the factors involved, you should try to know that relationship, in order to be able to treat them together.
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References
WHO Scientific Group on the Prevention and Management of Osteoporosis (?2000): Geneva, Switzerland)? (?2003)? Prevention and management of osteoporosis: report of a WHO scientific group. World Health Organization. https://apps.who.int/iris/handle/10665/42841.
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Prevention, Diagnosis and Therapy. JAMA. 2001;285(6):785-95. https://doi.org/10.1001/jama.285.6.785
Kwan P. Osteoporosis: from osteoscience to neuros- cience and beyond. Mech Ageing Dev. 2015;145:26-38, https://doi.org/10.1016/j.mad.2015.02.001
Ardila E. Epidemiology of osteoporosis in Colombia. Bone. 2001;29:297. https://doi.org/10.1016/S8756-3282(01)00518-X
Carmona F. Osteoporosis en Santa Fe de Bogotá. Santa Fe de Bogotá. Colombia: Instituto Nacional de Salud. 1999.
Gauthier A, Kanis JA, Jiang Y, Martin M, Compston JE, Borgs- tröm F, Cooper C, McCloskey EV. Epidemiological burden of postmenopausal osteoporosis in the UK from 2010 to 2021: esti- mations from a disease model. Arch Osteoporos. 2011:179-88, https://doi.org/10.1007/s11657-011-0063-y
Hagen G, Magnussen J, Tell G, Omsland T. Esti- mating the future burden of hip fractures in Norway. A NOREPOS study. Bone. 2020;131:115156, https://doi.org/10.1016/j.bone.2019.115156
The third National Health and Nutrition Examination Survey 1988-94. Center of Disease Control website.
Papadimitriou N, Tsilidis KK, Orfanos P, Benetou V, Ntzani EE, Soerjomataram I, et al. Burden of hip fracture using disability-adjusted life-years: a poo- led analysis of prospective cohorts in the CHANCES consortium. LANCET PUBLIC HEALTH. 2017;2:E239-46, https://doi.org/10.1016/S2468-2667(17)30046-4
Kerschan-Schindl K, Hackl M, Boschitsch E. Diagnostic Perfor- mance of a Panel of miRNAs (OsteomiR) for Osteoporosis in a Cohort of Postmenopausal Women. Calcif Tissue Int. 2021, https://doi.org/10.1007/s00223-020-00802-3
Kanis JA, McCloskey EV, Johansson H, Cooper C, Riz- zoli R, Reginster JY. Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Com- mittee of Scientific Advisors of the International Osteo- porosis Foundation (IOF). Osteoporos Int. 2013;24:23-57, https://doi.org/10.1007/s00198-012-2074-y
Body JJ, Bergmann P, Boonen S, Boutsen Y, Bru- yere O, Devogelaer JP, et al. Non-pharmacological management of osteoporosis: a consensus of the Bel- gian Bone Club. Osteoporos Int. 2011;22:2769-88, https://doi.org/10.1007/s00198-011-1545-x
Muir J, Ye C, Bhandari M, Adachi J, Thabane L. The effect of regular physical activity on bone mineral den- sity in post-menopausal women aged 75 and over: a retrospective analysis from the Canadian multicentre osteoporosis study. BMC Musculoskelet Disord. 2013;14:253, https://doi.org/10.1186/1471-2474-14-253
Marcucci G, Brandi ML. Rare causes of osteoporo- sis. Clin Cases Miner Bone Metab. 2015;12:151-6, https://doi.org/10.11138/ccmbm/2015.12.2.151
Strand BH, Bergland A, Jørgensen L, Schirmer H, Emaus N, Coo- per R. Do More Recent Born Generations of Older Adults Have Stronger Grip? A Comparison of Three Cohorts of 66- to 84-Year- Olds in the Tromsø Study. J Gerontol A Biol Sci Med Sci. 2019; 74(4):528-533, https://doi.org/10.1093/gerona/gly234
Páez A. Densitometria ósea: utilidad diagnóstica. Revista del Hospital Central de la Policía Nacional. 1999;2:27-32.
Clark P, Tamayo JA, Cisneros F, Rivera FC, Valdés M. Epidemio- logy of osteoporosis in Mexico. Present and future directions. Rev Invest Clin. 2013;65:183-91.
Pinheiro MM, Reis Neto ET, Machado FS, Omura F, Yang JHK, Szejnfeld J, Szejnfeld VL. Risk factors for osteopo- rotic fractures and low bone density in pre and post- menopausal women. Rev Saude Pública. 2010;44:479-85, https://doi.org/10.1590/S0034-89102010000300011
Yang NP, Deng CY, Chou YJ, Chen PQ, Lin CH, Chou P, et al. Estimated prevalence of osteoporosis from a nationwide health insurance database in Taiwan. Health Policy. 2006;75:329-37. https://doi.org/10.1016/j.healthpol.2005.04.009
Thulkar J, Singh S. Overview of research studies on osteoporosis in menopausal women since the last decade J Midlife Health. 2015;6:104-7, https://doi.org/10.4103/0976-7800.165589
Iki M, Kagamimori S, Kagawa Y, Matsuzaki T, Yoneshima H, Marumo F. Bone mineral density of the spine, hip and dis- tal forearm in representative samples of the Japanese female population: Japanese population-based osteoporosis (JPOS) study. Osteoporosis International. 2001;12:529-37 https://doi.org/10.1007/s001980170073
Crandall CJ, Vasan S, LaCroix A, LeBoff MS, Cauley JA, Rob- bins JA, Jackson RD, Bauer DC. Bone Turnover Markers Are Not Associated With Hip Fracture Risk: A Case-Control Study in the Women's Health Initiative. J Bone Miner Res. 2018;33:1199-208. https://doi.org/10.1002/jbmr.3471
Avenell A, Gillespie WJ, Gillespie LD, O'Connell D. Vita- min D and vitamin D analogues for preventing frac- tures associated with involutional and post-menopausal osteoporosis. Cochrane Database Syst Rev. 2009:CD000227, https://doi.org/10.1002/14651858.CD000227.pub3
Nuti R, Brandi ML, Checchia G, Di Munno O, Dominguez L, Falas- chi P, Fiore CE, et al. Guidelines for the management of osteopo- rosis and fragility fractures. Intern Emerg Med. 2019;14:85-102, https://doi.org/10.1007/s11739-018-1874-2
Tella SH, Gallagher JC. Prevention and treat- ment of postmenopausal osteoporosis. J Steroid Biochem Mol Biol. 2014;142:155-70, https://doi.org/10.1016/j.jsbmb.2013.09.008
Kanis JA, Cooper C, Rizzoli R, Reginster JY. Scientific Advi- sory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scien- tific Advisors and National Societies of the International Osteoporosis Foundation (IOF). Osteoporos Int. 2019;30:3-44, https://doi.org/10.1007/s00198-018-4704-5
Ilic Stojanovic O, Vuceljic M, Lazovic M, Gajic M, Rado- savljevic N, Nikolic D, et al. Bone mineral density at different sites and vertebral fractures in Serbian postmenopausal women. Climacteric. 2017;20:37-43, https://doi.org/10.1080/13697137.2016.1253054
KomadinaR,SenekoviˇcV,DolencI,AndoljˇsekM,Grabljevec K,VeniˇsekK,etal.Priporoˇcilazazdravljenjezlomakolkav Sloveniji. Zdrav Vestn. 2012;81:183-92.
Felson DT, Zhang Y, Hannan MT, Anderson JJ. Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res. 1993;8:567-73. https://doi.org/10.1002/jbmr.5650080507
Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R. Association of coffee drinking with total and cause- specific mortality. N Engl J Med. 2012;366:1891-904, https://doi.org/10.1056/NEJMoa1112010
Hallström H, Byberg L, Glynn A, Lemming EW, Wolk A, Michaëls- son K. Long-term coffee consumption in relation to fracture risk and bone mineral density in women. Am J Epidemiol. 2013;178:898-909, https://doi.org/10.1093/aje/kwt062
Øyen J, Gram Gjesdal C, Nygård OK, Lie SA, Meyer HE, Apalset EM, et al. Smoking and Body Fat Mass in Relation to Bone Mineral Density and Hip Fractures: The Hordaland Health Study. PLoS One. 2014;9:e92882, https://doi.org/10.1371/journal.pone.0092882
McClung MR. Clinical risk factors and evaluation of the risk of osteoporosis in clinical practice. Ann Med Interne (Paris). 2000;151:392-8.
Bijelic R, Milicevic S, Balaban J. Risk Factors for Osteopo- rosis in Postmenopausal Women. Med Arch. 2017;71:25-8, https://doi.org/10.5455/medarh.2017.71.25-28
Sözen T, Özı ̧sık L, Ba ̧saran NC. An overview and mana- gement of osteoporosis. Eur J Rheumatol. 2017;4:46-56, https://doi.org/10.5152/eurjrheum.2016.048
Maurel DB, Boisseau N, Benhamou CL, Jaffre C. Alcohol and bone: review of dose effects and mechanisms. Osteoporos Int. 2012;23:1-16, https://doi.org/10.1007/s00198-011-1787-7
Zhang X, Yu Z, Yu M, Qu X. Alcohol consumption and hip fracture risk. Osteoporos Int. 2015;26:531-42, https://doi.org/10.1007/s00198-014-2879-y
Fakkert IE, Teixeira N, Abma EM, Slart R, Mourits M, de Bock GH. Bone mineral density and fractures after surgical menopause: systematic review and meta-analysis. BJOG. 2017;124:1525-35, https://doi.org/10.1111/1471-0528.14703
Choi HG, Jung YJ, Lee SW. Increased risk of osteoporosis with hysterectomy: A longitudinal follow-up study using a national sample cohort. Am J Obstet Gynecol. 2019;220:573, https://doi.org/10.1016/j.ajog.2019.02.018, e1-573.e13.
Kemmler W, Häberle L, von Stengel S. Effects of exer- cise on fracture reduction in older adults: a systematic review and meta-analysis. Osteoporos Int. 2013;24:1937-50, https://doi.org/10.1007/s00198-012-2248-7
Rizzoli R, Bianchi ML, Garabédian M, McKay HA, Moreno LA. Maximizing bone mineral mass gain during growth for the prevention of fractures in the ado- lescents and the elderly. Bone. 2010;46:294-305, https://doi.org/10.1016/j.bone.2009.10.005
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