Associações entre consumo alimentar, saúde óssea e composição corporal: uma análise transversal em mulheres na pós-menopausa

• Autor(a) principal: Vidigal, Camila Vilarinho
• Data de Publicação: 2023
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/17172
• topic: Nutrição; Escore trabecular ósseo; Menopausa; Obesidade; Osteoporose; Qualidade óssea; subject.br-rjbn

Menopause confirms the end of female reproductive life and is characterized by important hormonal changes. These hormonal alterations contribute to the increase and redistribution of body fat and to the loss of bone and muscle mass, which favors the development of diseases such as obesity, osteoporosis and sarcopenia. Furthermore, the simultaneous presence of these conditions can be observed, although their prevalence in the postmenopausal population is still unknown. Habits and lifestyle related to food intake, physical activity, alcohol consumption and smoking are also related to the development of obesity, osteoporosis and sarcopenia. This study had two main objectives: 1. To investigate the relationship between food intake and body composition with bone microarchitecture in postmenopausal women. 2. To verify the prevalence of osteopenic obesity and associated factors in postmenopausal women. This is a cross-sectional study, carried out between June 2019 and March 2020, with postmenopausal women for at least 12 months and aged 50 years or older, treated at the climacteric and osteoporosis outpatient clinic of a university hospital. Sociodemographic, lifestyle, clinical conditions and food intake information were collected through the application of questionnaires. An anthropometric and biochemical evaluation was performed. Body composition and bone mineral density (BMD) were analysed by dual-energy X-ray absorptiometry (DXA). The body composition variables evaluated were: percentage of body fat (BF) (%), fat mass index (FMI) (kg/m²), abdominal visceral fat (AVF) (cm²) and appendicular skeletal muscle mass index (ASMI) (kg/m²). The trabecular bone score (TBS) was used to indirectly assess bone microarchitecture. Osteopenic obesity was diagnosed considering waist circumference (WC) and BMD. Tests were applied to compare exposure variables and covariates between the categories of the outcome variable bone microarchitecture (article 1) and osteopenic obesity (article 2). Adjusted binary logistic regression analyses in 3 models were conducted to verify the association between the study exposure variables, bone microarchitecture and osteopenic obesity. A significance level of 5% was considered for all tests. The evaluated women were mostly elderly, without a partner, black/brown, with low education, did not use alcoholic beverages, non smokers, were sufficiently active, used calcium and vitamin D supplementation and did not use drugs that alter bone metabolism. Partially degraded/degraded bone microarchitecture was positively associated with body mass (OR 1.19 [CI95% 1.05 – 1.36]) (p = 0.007) and inversely associated with BF% (OR 0 .72 [CI95% 0.57 – 0.91]) (p = 0.005), ASMI (OR 0.24 [CI95% 0.07 – 0.80]) (p = 0.021) and animal protein (OR 0.86 [CI95% 0.75 – 0.98]) (p = 0.024) and magnesium intake (OR 0.96 [CI95 % 0.93 – 0.99]) (p = 0.020). A prevalence of 47.1% of osteopenic obesity was identified in the evaluated women. The presence of osteopenic obesity was positively associated with C-reactive protein (CRP) levels (OR 1.21 [CI95% 1.01 – 1.43] p = 0.035). Women with lower rates of AVF (OR 0.96 [CI95% 0.93 – 0.99] p = 0.006) and ASMI (OR 0.11 [CI95% 0.01 – 0.83] p = 0.032) were less likely to have osteopenic obesity, and those with lower protein intake (OR 1.07 [CI95% 1.02 – 1.13] p = 0.009) were more likely to have this condition. In summary, the comprehensive analysis of bone health, considering parameters such as body mass, BF%, IMMEA and animal protein and magnesium intake, emerges as a fundamental approach to evaluate bone microarchitecture. Furthermore, the high incidence of osteopenic obesity in postmenopausal women emphasizes the need for early identification and attention to factors such as AVF, ASMI, CRP and protein intake.