Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFMA |
Texto Completo: | https://tedebc.ufma.br/jspui/handle/tede/tede/4026 |
Resumo: | The accumulation of bone mass begins in fetal life, extends throughout childhood and has its peak in adolescence. Thus, it is important to assess the bone health of adolescents in order to prevent osteopenia / osteoporosis, diseases considered as public health issues of great economic impact. This thesis consists of two articles. In the first, the prevalence and factors associated with low bone mineral density (BMD) of adolescents among adolescents was estimated. This study was carried out with 2515 adolescents aged 18-19 years from the São Luís birth cohort of 1997/98. Cross-sectional study where sociodemographic conditions, lifestyle, sleep quality, physical activity and depression were studied. It was found that 0.8% of the adolescents had low BMD of the body, 0.9% had low BMD of the femoral head and 3.7% had low BMD of the lumbar spine. Male adolescents (p<0.001), attending elementary school (p<0.001), with an income of up to one minimum wage (p=0.015) and those considered physically inactive (p=0.017) had lower lumbar spine BMD. In the second article, the association between birth weight and BMD in adolescence was investigated. Cohort study, using data from two moments (birth and 18/19 years) from the research Coortes RPS. For the analysis of BMD, the Z-score index (whole body) measured by densitometry by double emission of X-rays was used. A theoretical model was constructed using the directed acyclic graphs and to evaluate the association between birth weight and BMD, regression was used. multiple linear. Of the 2112 adolescents, 8.2% had low birth weight and low BMD for age was 2.8%. The mean Z-score for the whole body was 0.19 (± 1.00). After adjustment, it was observed that the greater the weight at birth, the greater the BMD in adolescence (Coef .: 0.10; 95% CI: 0.02 - 0.18; p = 0.014). Birth weight appears to affect BMD in adolescence. Studies have shown that higher birth weight values were associated with higher BMD values for the whole body, and that male individuals, with high school education, family income of up to one minimum wage and those sedentary had lower BMD of the lumbar spine. These are important findings to support public health policies since a reduction in BMD is strongly associated with an increased risk of fracture and / or osteopenia / osteoporosis. |
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SIMÕES, Vanda Maria Ferreirahttp://lattes.cnpq.br/4024829764707677SIMÕES, Vanda Maria Ferreirahttp://lattes.cnpq.br/4024829764707677COSTA, Af Ali Uthant Moreira Lima dahttp://lattes.cnpq.br/0928099290368157VIOLA, Poliana Cristina de Almeida Fonsecahttp://lattes.cnpq.br/5614190872397840LAMY FILHO, Fernandohttp://lattes.cnpq.br/3977956820339735CARVALHO, Carolina Abreu dehttp://lattes.cnpq.br/0369417229006032http://lattes.cnpq.br/6725521453656520ARAÚJO, Allanne Pereira2022-08-25T14:00:52Z2022-02-25ARAÚJO, Allanne Pereira. Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98. 2022.133 f. Tese (Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2022.https://tedebc.ufma.br/jspui/handle/tede/tede/4026The accumulation of bone mass begins in fetal life, extends throughout childhood and has its peak in adolescence. Thus, it is important to assess the bone health of adolescents in order to prevent osteopenia / osteoporosis, diseases considered as public health issues of great economic impact. This thesis consists of two articles. In the first, the prevalence and factors associated with low bone mineral density (BMD) of adolescents among adolescents was estimated. This study was carried out with 2515 adolescents aged 18-19 years from the São Luís birth cohort of 1997/98. Cross-sectional study where sociodemographic conditions, lifestyle, sleep quality, physical activity and depression were studied. It was found that 0.8% of the adolescents had low BMD of the body, 0.9% had low BMD of the femoral head and 3.7% had low BMD of the lumbar spine. Male adolescents (p<0.001), attending elementary school (p<0.001), with an income of up to one minimum wage (p=0.015) and those considered physically inactive (p=0.017) had lower lumbar spine BMD. In the second article, the association between birth weight and BMD in adolescence was investigated. Cohort study, using data from two moments (birth and 18/19 years) from the research Coortes RPS. For the analysis of BMD, the Z-score index (whole body) measured by densitometry by double emission of X-rays was used. A theoretical model was constructed using the directed acyclic graphs and to evaluate the association between birth weight and BMD, regression was used. multiple linear. Of the 2112 adolescents, 8.2% had low birth weight and low BMD for age was 2.8%. The mean Z-score for the whole body was 0.19 (± 1.00). After adjustment, it was observed that the greater the weight at birth, the greater the BMD in adolescence (Coef .: 0.10; 95% CI: 0.02 - 0.18; p = 0.014). Birth weight appears to affect BMD in adolescence. Studies have shown that higher birth weight values were associated with higher BMD values for the whole body, and that male individuals, with high school education, family income of up to one minimum wage and those sedentary had lower BMD of the lumbar spine. These are important findings to support public health policies since a reduction in BMD is strongly associated with an increased risk of fracture and / or osteopenia / osteoporosis.O acúmulo de massa óssea tem seu início na vida fetal, estende-se por toda a infância e apresenta seu pico máximo na adolescência. Assim, é importante avaliar a saúde óssea de adolescentes com o intuito de prevenir osteopenia/osteoporose, doenças consideradas como questões de saúde pública de grande impacto econômico. A presente tese é composta por dois artigos. No primeiro, estimou-se a prevalência e fatores associados à baixa densidade mineral óssea (DMO) de adolescentes. Este estudo foi realizado com 2515 adolescentes de 18-19 anos da coorte de nascimentos de São Luís de 1997/98. Estudo transversal onde foram estudadas condições sociodemográficas, hábitos de vida, qualidade do sono, atividade física e depressão. Verificou-se que 0,8% dos adolescentes apresentaram baixa DMO do corpo inteiro, 0,9% tiveram baixa DMO da cabeça de fêmur e 3,7% obtiveram baixa DMO da coluna lombar. Adolescentes do sexo masculino (p<0,001), cursando o ensino fundamental (p<0,001), com renda de até um salário mínimo (p=0,015) e aqueles sedentários (p=0,017) apresentaram menor DMO de coluna lombar. No segundo artigo, investigou-se a associação entre o peso ao nascer e a DMO na adolescência. Estudo de coorte, utilizando dados de dois momentos (nascimento e aos 18/19 anos) da pesquisa Coortes RPS. Para análise da DMO foi utilizado o índice Z-escore (corpo inteiro) medido pela densitometria por dupla emissão de raios X. Foi construído modelo teórico usando os gráficos acíclicos direcionados e para avaliar a associação entre o peso ao nascer e a DMO foi usada regressão linear múltipla. Dos 2112 adolescentes, 8,2% apresentaram baixo peso ao nascer e 2,8% estavam com baixa DMO para a idade. O Z-escore médio de corpo inteiro foi de 0,19(±1,00). O maior peso ao nascer foi associado de forma linear e direta aos valores de DMO na adolescência (Coef.: 0,10; IC95%: 0,02 - 0,18), mesmo após ajuste para as variáveis renda familiar (Coef.: -0,33; IC95%: 0,66 - 0,03) e a mãe saber ler e escrever (Coef.: 0,23; IC95%: 0,03 - 0,43). Os estudos demonstram que valores maiores de peso ao nascer estiveram associados com maiores valores de DMO de corpo inteiro, e que indivíduos do sexo masculino, com ensino médio, renda familiar de até um salário mínimo e aqueles sedentários apresentaram menor DMO de coluna lombar. Estes são achados importantes para subsidiar políticas de saúde pública uma vez que uma redução na DMO está fortemente associada a um risco aumentado de fratura e/ou osteopenia/osteoporose.Submitted by Daniella Santos (daniella.santos@ufma.br) on 2022-08-25T14:00:52Z No. of bitstreams: 1 ALLANNEARAÚJO.pdf: 1609127 bytes, checksum: 426b39a72843d3c640c42abc6eec9006 (MD5)Made available in DSpace on 2022-08-25T14:00:52Z (GMT). No. of bitstreams: 1 ALLANNEARAÚJO.pdf: 1609127 bytes, checksum: 426b39a72843d3c640c42abc6eec9006 (MD5) Previous issue date: 2022-02-25CNPqapplication/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA/CCBSUFMABrasilDEPARTAMENTO DE SAÚDE PÚBLICA/CCBSadolescente;densidade mineral óssea;peso ao nascer;adolescent;bone mineral density;birth weight.Saúde PúblicaDensidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98Bone mineral density in adolescents: contribution of the São Luís birth cohort 1997/98info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALALLANNEARAÚJO.pdfALLANNEARAÚJO.pdfapplication/pdf1609127http://tedebc.ufma.br:8080/bitstream/tede/4026/2/ALLANNEARA%C3%9AJO.pdf426b39a72843d3c640c42abc6eec9006MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82255http://tedebc.ufma.br:8080/bitstream/tede/4026/1/license.txt97eeade1fce43278e63fe063657f8083MD51tede/40262022-08-25 11:00:52.635oai:tede2: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Biblioteca Digital de Teses e Dissertaçõeshttps://tedebc.ufma.br/jspui/PUBhttp://tedebc.ufma.br:8080/oai/requestrepositorio@ufma.br||repositorio@ufma.bropendoar:21312022-08-25T14:00:52Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false |
dc.title.por.fl_str_mv |
Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98 |
dc.title.alternative.eng.fl_str_mv |
Bone mineral density in adolescents: contribution of the São Luís birth cohort 1997/98 |
title |
Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98 |
spellingShingle |
Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98 ARAÚJO, Allanne Pereira adolescente; densidade mineral óssea; peso ao nascer; adolescent; bone mineral density; birth weight. Saúde Pública |
title_short |
Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98 |
title_full |
Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98 |
title_fullStr |
Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98 |
title_full_unstemmed |
Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98 |
title_sort |
Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98 |
author |
ARAÚJO, Allanne Pereira |
author_facet |
ARAÚJO, Allanne Pereira |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
SIMÕES, Vanda Maria Ferreira |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4024829764707677 |
dc.contributor.referee1.fl_str_mv |
SIMÕES, Vanda Maria Ferreira |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/4024829764707677 |
dc.contributor.referee2.fl_str_mv |
COSTA, Af Ali Uthant Moreira Lima da |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/0928099290368157 |
dc.contributor.referee3.fl_str_mv |
VIOLA, Poliana Cristina de Almeida Fonseca |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/5614190872397840 |
dc.contributor.referee4.fl_str_mv |
LAMY FILHO, Fernando |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/3977956820339735 |
dc.contributor.referee5.fl_str_mv |
CARVALHO, Carolina Abreu de |
dc.contributor.referee5Lattes.fl_str_mv |
http://lattes.cnpq.br/0369417229006032 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6725521453656520 |
dc.contributor.author.fl_str_mv |
ARAÚJO, Allanne Pereira |
contributor_str_mv |
SIMÕES, Vanda Maria Ferreira SIMÕES, Vanda Maria Ferreira COSTA, Af Ali Uthant Moreira Lima da VIOLA, Poliana Cristina de Almeida Fonseca LAMY FILHO, Fernando CARVALHO, Carolina Abreu de |
dc.subject.por.fl_str_mv |
adolescente; densidade mineral óssea; peso ao nascer; |
topic |
adolescente; densidade mineral óssea; peso ao nascer; adolescent; bone mineral density; birth weight. Saúde Pública |
dc.subject.eng.fl_str_mv |
adolescent; bone mineral density; birth weight. |
dc.subject.cnpq.fl_str_mv |
Saúde Pública |
description |
The accumulation of bone mass begins in fetal life, extends throughout childhood and has its peak in adolescence. Thus, it is important to assess the bone health of adolescents in order to prevent osteopenia / osteoporosis, diseases considered as public health issues of great economic impact. This thesis consists of two articles. In the first, the prevalence and factors associated with low bone mineral density (BMD) of adolescents among adolescents was estimated. This study was carried out with 2515 adolescents aged 18-19 years from the São Luís birth cohort of 1997/98. Cross-sectional study where sociodemographic conditions, lifestyle, sleep quality, physical activity and depression were studied. It was found that 0.8% of the adolescents had low BMD of the body, 0.9% had low BMD of the femoral head and 3.7% had low BMD of the lumbar spine. Male adolescents (p<0.001), attending elementary school (p<0.001), with an income of up to one minimum wage (p=0.015) and those considered physically inactive (p=0.017) had lower lumbar spine BMD. In the second article, the association between birth weight and BMD in adolescence was investigated. Cohort study, using data from two moments (birth and 18/19 years) from the research Coortes RPS. For the analysis of BMD, the Z-score index (whole body) measured by densitometry by double emission of X-rays was used. A theoretical model was constructed using the directed acyclic graphs and to evaluate the association between birth weight and BMD, regression was used. multiple linear. Of the 2112 adolescents, 8.2% had low birth weight and low BMD for age was 2.8%. The mean Z-score for the whole body was 0.19 (± 1.00). After adjustment, it was observed that the greater the weight at birth, the greater the BMD in adolescence (Coef .: 0.10; 95% CI: 0.02 - 0.18; p = 0.014). Birth weight appears to affect BMD in adolescence. Studies have shown that higher birth weight values were associated with higher BMD values for the whole body, and that male individuals, with high school education, family income of up to one minimum wage and those sedentary had lower BMD of the lumbar spine. These are important findings to support public health policies since a reduction in BMD is strongly associated with an increased risk of fracture and / or osteopenia / osteoporosis. |
publishDate |
2022 |
dc.date.accessioned.fl_str_mv |
2022-08-25T14:00:52Z |
dc.date.issued.fl_str_mv |
2022-02-25 |
dc.type.status.fl_str_mv |
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 |
ARAÚJO, Allanne Pereira. Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98. 2022.133 f. Tese (Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2022. |
dc.identifier.uri.fl_str_mv |
https://tedebc.ufma.br/jspui/handle/tede/tede/4026 |
identifier_str_mv |
ARAÚJO, Allanne Pereira. Densidade mineral óssea em adolescentes: contribuição da coorte de nascimentos de São Luís 1997/98. 2022.133 f. Tese (Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2022. |
url |
https://tedebc.ufma.br/jspui/handle/tede/tede/4026 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
dc.publisher.program.fl_str_mv |
PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA/CCBS |
dc.publisher.initials.fl_str_mv |
UFMA |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
DEPARTAMENTO DE SAÚDE PÚBLICA/CCBS |
publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
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