Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFG |
Texto Completo: | http://repositorio.bc.ufg.br/tede/handle/tede/10949 |
Resumo: | Evaluation of bone mineral density and fracture risk estimation in men living with HIV. Introduction: HIV carriers are at increased risk of developing chronic noncommunicable diseases at an early age. The reduction of bone mineral density, before the age of 50 years, is described in this population. Few studies evaluate the magnitude of osteoporosis in men with HIV, as well as screening strategies in this segment. Objectives: To estimate the prevalence and to investigate risk factors for changes in bone mineral density (BMD); compare osteoporosis prediction model, with bone-densitometry as the gold standard; to evaluate the risk of fractures using an algorithm in HIV-positive men. Method: Cross-sectional study, population of men with HIV, over 40 years old, using ART, attended in Goiânia-Goiás. Participants answered a standardized questionnaire, performed clinical evaluation and laboratory tests. All investigated bone mineral density through dual energy X-ray absorptiometry (DXA). Osteoporosis was defined as bone mineral density less than / equal to 2.5 standard deviations (SD), considering as a reference a young, healthy population categorized by sex. Osteopenia was defined as a reduction between 1 and 2.4 SD of bone mineral density according to WHO criteria. The Osteoporosis Self-Assessment Tool (which uses weight and age data) was evaluated in the prediction of osteoporosis and Low BMD. A ROC curve was constructed to assess OST performance. Results: The participants' age ranged from 40 to 72 years, with a mean of 49.6 (SD = 7.5). The prevalence of low bone mineral density was 56.8% (95% CI: 49.25-64, 13%) and osteoporosis 16% (95% CI 11.0 - 22.1). The risk of fractures in 10-years ranged from 1.1% to 20%, with a median of 1.9%. The factors associated with bone density reduction were the use of tenofovir disproxil fumarate and low BMI. The osteoporosis prediction instrument (OST) presented values of area under the curve of 0.71 and 0.67 in the prediction of osteoporosis and low bone mineral density. The cutoff point 7 obtained the best performance in predicting osteoporosis. The instrument revealed low to moderate predictive power over low bone mineral density and osteoporosis compared to DXA. Conclusion: There was a high prevalence of BMD reduction and overweight in a population of relatively young men with HIV. |
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Turchi, Marília Dalvahttp://lattes.cnpq.br/3769826743537934Turchi, Marília DalvaSiqueira Júnior, João BoscoTeles, Sheila AraújoSilva, Nilzio Antonio daAlbuquerque, Maria de Fátima Pessoa Militao dehttp://lattes.cnpq.br/5332142738112912Sousa, Clarissa Alencar de2020-11-27T11:55:17Z2020-11-27T11:55:17Z2018-12-17SOUSA, C. A. Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV. 2018. 97 f. Tese (Doutorado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2018.http://repositorio.bc.ufg.br/tede/handle/tede/10949Evaluation of bone mineral density and fracture risk estimation in men living with HIV. Introduction: HIV carriers are at increased risk of developing chronic noncommunicable diseases at an early age. The reduction of bone mineral density, before the age of 50 years, is described in this population. Few studies evaluate the magnitude of osteoporosis in men with HIV, as well as screening strategies in this segment. Objectives: To estimate the prevalence and to investigate risk factors for changes in bone mineral density (BMD); compare osteoporosis prediction model, with bone-densitometry as the gold standard; to evaluate the risk of fractures using an algorithm in HIV-positive men. Method: Cross-sectional study, population of men with HIV, over 40 years old, using ART, attended in Goiânia-Goiás. Participants answered a standardized questionnaire, performed clinical evaluation and laboratory tests. All investigated bone mineral density through dual energy X-ray absorptiometry (DXA). Osteoporosis was defined as bone mineral density less than / equal to 2.5 standard deviations (SD), considering as a reference a young, healthy population categorized by sex. Osteopenia was defined as a reduction between 1 and 2.4 SD of bone mineral density according to WHO criteria. The Osteoporosis Self-Assessment Tool (which uses weight and age data) was evaluated in the prediction of osteoporosis and Low BMD. A ROC curve was constructed to assess OST performance. Results: The participants' age ranged from 40 to 72 years, with a mean of 49.6 (SD = 7.5). The prevalence of low bone mineral density was 56.8% (95% CI: 49.25-64, 13%) and osteoporosis 16% (95% CI 11.0 - 22.1). The risk of fractures in 10-years ranged from 1.1% to 20%, with a median of 1.9%. The factors associated with bone density reduction were the use of tenofovir disproxil fumarate and low BMI. The osteoporosis prediction instrument (OST) presented values of area under the curve of 0.71 and 0.67 in the prediction of osteoporosis and low bone mineral density. The cutoff point 7 obtained the best performance in predicting osteoporosis. The instrument revealed low to moderate predictive power over low bone mineral density and osteoporosis compared to DXA. Conclusion: There was a high prevalence of BMD reduction and overweight in a population of relatively young men with HIV.Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV. Introdução: Portadores de HIV apresentam risco aumentado de desenvolver doenças crônicas não transmissíveis em idade precoce, dentre elas redução da densidade mineral óssea. Poucos estudos avaliam a magnitude da osteoporose em homens com HIV, bem como as estratégias de triagem nesse segmento. Objetivos: Estimar a prevalência e investigar fatores de risco para redução da densidade mineral óssea (DMO); avaliar acurácia de predição de osteoporose, tendo como padrão-ouro a densitometria óssea; estimar o risco de fraturas mediante a utilização de algoritmo em homens HIV positivos Método: Estudo transversal, em população de homens com HIV, acima de 40 anos, em uso de TARV, atendidos em Goiânia-Goiás. Os participantes responderam questionário padronizado, fizeram avaliação clínica e exames laboratoriais. Todos fizeram investigação da densidade mineral óssea através de absorciometria por raios-X com dupla energia (DXA). A osteoporose foi definida como densidade mineral óssea menor/igual que 2,5 desvios padrão (DP), considerando como referência uma população jovem, saudável e categorizada por sexo. A osteopenia foi definida por uma redução entre 1 e 2,4 DP da densidade mineral óssea de acordo com critérios da WHO. O instrumento Osteoporosis Self-Assessment Tool foi avaliado na predição de osteoporose e Baixa DMO. Foi construída curva ROC para avaliar o desempenho do OST. Resultados: A idade dos participantes variou de 40 a 72 anos, com média de 49,6 (DP=7,5) A prevalência de redução da densidade mineral óssea foi de 56,8% (IC95%: 49,25–64,13%) e de osteoporose de 16% (IC95% 11,0 – 22,1). O risco de fraturas em 10-anos variou de 1,1% a 20%, com mediana de 1,9%. Os fatores associados à redução da densidade óssea foram o uso de tenofovir disoproxil fumarato e baixo IMC. O instrumento OST apresentou valores de área sob a curva de 0,71 e 0,67 na predição de osteoporose e baixa densidade mineral óssea. O ponto de corte 7 obteve o melhor desempenho na predição de osteoporose. O instrumento revelou poder de predição baixo a moderado em relação à baixa densidade mineral óssea e osteoporose comparado ao DXA. Conclusão: Verificou-se alta prevalência de redução de DMO e obesidade em população de homens com HIV, relativamente jovens.Submitted by Franciele Moreira (francielemoreyra@gmail.com) on 2020-11-27T11:31:30Z No. of bitstreams: 2 license_rdf: 805 bytes, checksum: 4460e5956bc1d1639be9ae6146a50347 (MD5) Tese - Clarissa Alencar de Sousa - 2018.pdf: 2969355 bytes, checksum: 092d863cdfac0e6cef9258e628d126e2 (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2020-11-27T11:55:17Z (GMT) No. of bitstreams: 2 license_rdf: 805 bytes, checksum: 4460e5956bc1d1639be9ae6146a50347 (MD5) Tese - Clarissa Alencar de Sousa - 2018.pdf: 2969355 bytes, checksum: 092d863cdfac0e6cef9258e628d126e2 (MD5)Made available in DSpace on 2020-11-27T11:55:17Z (GMT). No. of bitstreams: 2 license_rdf: 805 bytes, checksum: 4460e5956bc1d1639be9ae6146a50347 (MD5) Tese - Clarissa Alencar de Sousa - 2018.pdf: 2969355 bytes, checksum: 092d863cdfac0e6cef9258e628d126e2 (MD5) Previous issue date: 2018-12-17Fundação de Amparo à Pesquisa do Estado de GoiásporUniversidade Federal de GoiásPrograma de Pós-graduação em Medicina Tropical e Saúde Publica (IPTSP)UFGBrasilInstituto de Patologia Tropical e Saúde Pública - IPTSP (RG)Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessOsteopeniaOsteoporoseDensidade mineral óssea reduzidaAntirretroviralPrevalênciaHIVOsteoporosisOsteopeniaReduced bone mineral densityAntiretroviralPrevalenceHIVCIENCIAS DA SAUDE::MEDICINAAvaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIVEvaluation of bone mineral density and fracture risk estimation in men living with HIVinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis70500500500500281783reponame:Repositório Institucional da UFGinstname:Universidade Federal de Goiás (UFG)instacron:UFGLICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repositorio.bc.ufg.br/tede/bitstreams/eae1c464-7ca5-469f-9392-6ab4a9536b9e/download8a4605be74aa9ea9d79846c1fba20a33MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.bc.ufg.br/tede/bitstreams/fb37ae96-161e-4bd6-844a-ab17f045f790/download4460e5956bc1d1639be9ae6146a50347MD52ORIGINALTese - Clarissa Alencar de Sousa - 2018.pdfTese - Clarissa Alencar de Sousa - 2018.pdfapplication/pdf2969355http://repositorio.bc.ufg.br/tede/bitstreams/73b1716a-3e65-4176-8234-29b807e97f2f/download092d863cdfac0e6cef9258e628d126e2MD53tede/109492020-11-27 08:55:17.631http://creativecommons.org/licenses/by-nc-nd/4.0/Attribution-NonCommercial-NoDerivatives 4.0 Internationalopen.accessoai:repositorio.bc.ufg.br:tede/10949http://repositorio.bc.ufg.br/tedeRepositório InstitucionalPUBhttp://repositorio.bc.ufg.br/oai/requesttasesdissertacoes.bc@ufg.bropendoar:2020-11-27T11:55:17Repositório Institucional da UFG - Universidade Federal de Goiás (UFG)falseTk9URTogUExBQ0UgWU9VUiBPV04gTElDRU5TRSBIRVJFClRoaXMgc2FtcGxlIGxpY2Vuc2UgaXMgcHJvdmlkZWQgZm9yIGluZm9ybWF0aW9uYWwgcHVycG9zZXMgb25seS4KCk5PTi1FWENMVVNJVkUgRElTVFJJQlVUSU9OIExJQ0VOU0UKCkJ5IHNpZ25pbmcgYW5kIHN1Ym1pdHRpbmcgdGhpcyBsaWNlbnNlLCB5b3UgKHRoZSBhdXRob3Iocykgb3IgY29weXJpZ2h0Cm93bmVyKSBncmFudHMgdG8gRFNwYWNlIFVuaXZlcnNpdHkgKERTVSkgdGhlIG5vbi1leGNsdXNpdmUgcmlnaHQgdG8gcmVwcm9kdWNlLAp0cmFuc2xhdGUgKGFzIGRlZmluZWQgYmVsb3cpLCBhbmQvb3IgZGlzdHJpYnV0ZSB5b3VyIHN1Ym1pc3Npb24gKGluY2x1ZGluZwp0aGUgYWJzdHJhY3QpIHdvcmxkd2lkZSBpbiBwcmludCBhbmQgZWxlY3Ryb25pYyBmb3JtYXQgYW5kIGluIGFueSBtZWRpdW0sCmluY2x1ZGluZyBidXQgbm90IGxpbWl0ZWQgdG8gYXVkaW8gb3IgdmlkZW8uCgpZb3UgYWdyZWUgdGhhdCBEU1UgbWF5LCB3aXRob3V0IGNoYW5naW5nIHRoZSBjb250ZW50LCB0cmFuc2xhdGUgdGhlCnN1Ym1pc3Npb24gdG8gYW55IG1lZGl1bSBvciBmb3JtYXQgZm9yIHRoZSBwdXJwb3NlIG9mIHByZXNlcnZhdGlvbi4KCllvdSBhbHNvIGFncmVlIHRoYXQgRFNVIG1heSBrZWVwIG1vcmUgdGhhbiBvbmUgY29weSBvZiB0aGlzIHN1Ym1pc3Npb24gZm9yCnB1cnBvc2VzIG9mIHNlY3VyaXR5LCBiYWNrLXVwIGFuZCBwcmVzZXJ2YXRpb24uCgpZb3UgcmVwcmVzZW50IHRoYXQgdGhlIHN1Ym1pc3Npb24gaXMgeW91ciBvcmlnaW5hbCB3b3JrLCBhbmQgdGhhdCB5b3UgaGF2ZQp0aGUgcmlnaHQgdG8gZ3JhbnQgdGhlIHJpZ2h0cyBjb250YWluZWQgaW4gdGhpcyBsaWNlbnNlLiBZb3UgYWxzbyByZXByZXNlbnQKdGhhdCB5b3VyIHN1Ym1pc3Npb24gZG9lcyBub3QsIHRvIHRoZSBiZXN0IG9mIHlvdXIga25vd2xlZGdlLCBpbmZyaW5nZSB1cG9uCmFueW9uZSdzIGNvcHlyaWdodC4KCklmIHRoZSBzdWJtaXNzaW9uIGNvbnRhaW5zIG1hdGVyaWFsIGZvciB3aGljaCB5b3UgZG8gbm90IGhvbGQgY29weXJpZ2h0LAp5b3UgcmVwcmVzZW50IHRoYXQgeW91IGhhdmUgb2J0YWluZWQgdGhlIHVucmVzdHJpY3RlZCBwZXJtaXNzaW9uIG9mIHRoZQpjb3B5cmlnaHQgb3duZXIgdG8gZ3JhbnQgRFNVIHRoZSByaWdodHMgcmVxdWlyZWQgYnkgdGhpcyBsaWNlbnNlLCBhbmQgdGhhdApzdWNoIHRoaXJkLXBhcnR5IG93bmVkIG1hdGVyaWFsIGlzIGNsZWFybHkgaWRlbnRpZmllZCBhbmQgYWNrbm93bGVkZ2VkCndpdGhpbiB0aGUgdGV4dCBvciBjb250ZW50IG9mIHRoZSBzdWJtaXNzaW9uLgoKSUYgVEhFIFNVQk1JU1NJT04gSVMgQkFTRUQgVVBPTiBXT1JLIFRIQVQgSEFTIEJFRU4gU1BPTlNPUkVEIE9SIFNVUFBPUlRFRApCWSBBTiBBR0VOQ1kgT1IgT1JHQU5JWkFUSU9OIE9USEVSIFRIQU4gRFNVLCBZT1UgUkVQUkVTRU5UIFRIQVQgWU9VIEhBVkUKRlVMRklMTEVEIEFOWSBSSUdIVCBPRiBSRVZJRVcgT1IgT1RIRVIgT0JMSUdBVElPTlMgUkVRVUlSRUQgQlkgU1VDSApDT05UUkFDVCBPUiBBR1JFRU1FTlQuCgpEU1Ugd2lsbCBjbGVhcmx5IGlkZW50aWZ5IHlvdXIgbmFtZShzKSBhcyB0aGUgYXV0aG9yKHMpIG9yIG93bmVyKHMpIG9mIHRoZQpzdWJtaXNzaW9uLCBhbmQgd2lsbCBub3QgbWFrZSBhbnkgYWx0ZXJhdGlvbiwgb3RoZXIgdGhhbiBhcyBhbGxvd2VkIGJ5IHRoaXMKbGljZW5zZSwgdG8geW91ciBzdWJtaXNzaW9uLgo= |
dc.title.pt_BR.fl_str_mv |
Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV |
dc.title.alternative.eng.fl_str_mv |
Evaluation of bone mineral density and fracture risk estimation in men living with HIV |
title |
Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV |
spellingShingle |
Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV Sousa, Clarissa Alencar de Osteopenia Osteoporose Densidade mineral óssea reduzida Antirretroviral Prevalência HIV Osteoporosis Osteopenia Reduced bone mineral density Antiretroviral Prevalence HIV CIENCIAS DA SAUDE::MEDICINA |
title_short |
Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV |
title_full |
Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV |
title_fullStr |
Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV |
title_full_unstemmed |
Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV |
title_sort |
Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV |
author |
Sousa, Clarissa Alencar de |
author_facet |
Sousa, Clarissa Alencar de |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Turchi, Marília Dalva |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3769826743537934 |
dc.contributor.referee1.fl_str_mv |
Turchi, Marília Dalva |
dc.contributor.referee2.fl_str_mv |
Siqueira Júnior, João Bosco |
dc.contributor.referee3.fl_str_mv |
Teles, Sheila Araújo |
dc.contributor.referee4.fl_str_mv |
Silva, Nilzio Antonio da |
dc.contributor.referee5.fl_str_mv |
Albuquerque, Maria de Fátima Pessoa Militao de |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5332142738112912 |
dc.contributor.author.fl_str_mv |
Sousa, Clarissa Alencar de |
contributor_str_mv |
Turchi, Marília Dalva Turchi, Marília Dalva Siqueira Júnior, João Bosco Teles, Sheila Araújo Silva, Nilzio Antonio da Albuquerque, Maria de Fátima Pessoa Militao de |
dc.subject.por.fl_str_mv |
Osteopenia Osteoporose Densidade mineral óssea reduzida Antirretroviral Prevalência HIV |
topic |
Osteopenia Osteoporose Densidade mineral óssea reduzida Antirretroviral Prevalência HIV Osteoporosis Osteopenia Reduced bone mineral density Antiretroviral Prevalence HIV CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Osteoporosis Osteopenia Reduced bone mineral density Antiretroviral Prevalence HIV |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Evaluation of bone mineral density and fracture risk estimation in men living with HIV. Introduction: HIV carriers are at increased risk of developing chronic noncommunicable diseases at an early age. The reduction of bone mineral density, before the age of 50 years, is described in this population. Few studies evaluate the magnitude of osteoporosis in men with HIV, as well as screening strategies in this segment. Objectives: To estimate the prevalence and to investigate risk factors for changes in bone mineral density (BMD); compare osteoporosis prediction model, with bone-densitometry as the gold standard; to evaluate the risk of fractures using an algorithm in HIV-positive men. Method: Cross-sectional study, population of men with HIV, over 40 years old, using ART, attended in Goiânia-Goiás. Participants answered a standardized questionnaire, performed clinical evaluation and laboratory tests. All investigated bone mineral density through dual energy X-ray absorptiometry (DXA). Osteoporosis was defined as bone mineral density less than / equal to 2.5 standard deviations (SD), considering as a reference a young, healthy population categorized by sex. Osteopenia was defined as a reduction between 1 and 2.4 SD of bone mineral density according to WHO criteria. The Osteoporosis Self-Assessment Tool (which uses weight and age data) was evaluated in the prediction of osteoporosis and Low BMD. A ROC curve was constructed to assess OST performance. Results: The participants' age ranged from 40 to 72 years, with a mean of 49.6 (SD = 7.5). The prevalence of low bone mineral density was 56.8% (95% CI: 49.25-64, 13%) and osteoporosis 16% (95% CI 11.0 - 22.1). The risk of fractures in 10-years ranged from 1.1% to 20%, with a median of 1.9%. The factors associated with bone density reduction were the use of tenofovir disproxil fumarate and low BMI. The osteoporosis prediction instrument (OST) presented values of area under the curve of 0.71 and 0.67 in the prediction of osteoporosis and low bone mineral density. The cutoff point 7 obtained the best performance in predicting osteoporosis. The instrument revealed low to moderate predictive power over low bone mineral density and osteoporosis compared to DXA. Conclusion: There was a high prevalence of BMD reduction and overweight in a population of relatively young men with HIV. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018-12-17 |
dc.date.accessioned.fl_str_mv |
2020-11-27T11:55:17Z |
dc.date.available.fl_str_mv |
2020-11-27T11:55:17Z |
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info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
SOUSA, C. A. Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV. 2018. 97 f. Tese (Doutorado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2018. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tede/10949 |
identifier_str_mv |
SOUSA, C. A. Avaliação da densidade mineral óssea e estimativa de risco de fraturas em homens vivendo com HIV. 2018. 97 f. Tese (Doutorado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2018. |
url |
http://repositorio.bc.ufg.br/tede/handle/tede/10949 |
dc.language.iso.fl_str_mv |
por |
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por |
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70 |
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500 500 500 500 |
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28 |
dc.relation.cnpq.fl_str_mv |
178 |
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3 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Goiás |
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Programa de Pós-graduação em Medicina Tropical e Saúde Publica (IPTSP) |
dc.publisher.initials.fl_str_mv |
UFG |
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Brasil |
dc.publisher.department.fl_str_mv |
Instituto de Patologia Tropical e Saúde Pública - IPTSP (RG) |
publisher.none.fl_str_mv |
Universidade Federal de Goiás |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UFG instname:Universidade Federal de Goiás (UFG) instacron:UFG |
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