Avaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase grave
Autor(a) principal: | |
---|---|
Data de Publicação: | 2022 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Manancial - Repositório Digital da UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/25894 |
Resumo: | Psoriasis is a disease of systemic involvement and insidious nature, which occurs with sub-clinical chronic inflammation, leading to a higher risk of comorbidities. The trabecular bone score, in turn, is an index for estimating bone microarchitecture by means of analysis in lumbar vertebrae, and is a predictor of fracture risk, regardless of bone mineral density. Therefore, this work aims to evaluate the trabecular bone score, bone mineral density, and body composition in patients diagnosed with psoriasis being followed up at the dermatology outpatient clinic of Santa Maria University Hospital. This is a cross-sectional study, with patients over 18 years of age and diagnosed with severe psoriasis at follow-up from July 2021 to March 30, 2022. Patients with diabetes mellitus, chronic kidney disease, hypertension, body mass index greater than 35, and a diagnosis of psoriasis more than 15 years ago were excluded. The clinical variables analyzed were gender, age, menopause, smoking, alcohol consumption, duration of disease, age at diagnosis, immunosuppression/use of oral corticosteroids, current treatment, diagnosis of other autoimmune diseases, abdominal circumference, weight, height, and body mass index. Through bone densitometry and body composition examinations, the mineral density in the femur and lumbar spine, trabecular bone score, android to gynoid ratio, body fat index, and appendicular muscle mass index were measured. The sample contains 17 patients, nine female and eight male, aged between 24 and 70 years, with a diagnosis of severe psoriasis. The median time of illness in the analyzed group was 10 years. One patient had degraded microarchitecture, six patients were diagnosed with osteopenia, and one patient had osteoporosis. There was a statistically significant difference in the prevalence of altered bone mass for the patients over 50 years old in the sample when compared to the general population of the same age group. The data suggest that there may need to be several years of bone exposure to psoriatic skin disease before significant bone loss emerges. The densitometric evaluation associated with the trabecular bone score is of great value, as patients with psoriasis without joint disease may also show signs of bone loss, even without a significant decrease in bone mass when compared to healthy controls. In addition, psoriasis has a high psychosocial burden and, in its severe form, can predispose patients to obesity. There is also evidence of benefit in earlier screening for bone changes in patients with severe psoriasis over the age of 50 years, with the inclusion of bone assessment in the management of the disease to screen for potential fractures and consequent reduction in overall morbidity associated with psoriatic disease. |
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2022-08-16T12:42:27Z2022-08-16T12:42:27Z2022-07-19http://repositorio.ufsm.br/handle/1/25894Psoriasis is a disease of systemic involvement and insidious nature, which occurs with sub-clinical chronic inflammation, leading to a higher risk of comorbidities. The trabecular bone score, in turn, is an index for estimating bone microarchitecture by means of analysis in lumbar vertebrae, and is a predictor of fracture risk, regardless of bone mineral density. Therefore, this work aims to evaluate the trabecular bone score, bone mineral density, and body composition in patients diagnosed with psoriasis being followed up at the dermatology outpatient clinic of Santa Maria University Hospital. This is a cross-sectional study, with patients over 18 years of age and diagnosed with severe psoriasis at follow-up from July 2021 to March 30, 2022. Patients with diabetes mellitus, chronic kidney disease, hypertension, body mass index greater than 35, and a diagnosis of psoriasis more than 15 years ago were excluded. The clinical variables analyzed were gender, age, menopause, smoking, alcohol consumption, duration of disease, age at diagnosis, immunosuppression/use of oral corticosteroids, current treatment, diagnosis of other autoimmune diseases, abdominal circumference, weight, height, and body mass index. Through bone densitometry and body composition examinations, the mineral density in the femur and lumbar spine, trabecular bone score, android to gynoid ratio, body fat index, and appendicular muscle mass index were measured. The sample contains 17 patients, nine female and eight male, aged between 24 and 70 years, with a diagnosis of severe psoriasis. The median time of illness in the analyzed group was 10 years. One patient had degraded microarchitecture, six patients were diagnosed with osteopenia, and one patient had osteoporosis. There was a statistically significant difference in the prevalence of altered bone mass for the patients over 50 years old in the sample when compared to the general population of the same age group. The data suggest that there may need to be several years of bone exposure to psoriatic skin disease before significant bone loss emerges. The densitometric evaluation associated with the trabecular bone score is of great value, as patients with psoriasis without joint disease may also show signs of bone loss, even without a significant decrease in bone mass when compared to healthy controls. In addition, psoriasis has a high psychosocial burden and, in its severe form, can predispose patients to obesity. There is also evidence of benefit in earlier screening for bone changes in patients with severe psoriasis over the age of 50 years, with the inclusion of bone assessment in the management of the disease to screen for potential fractures and consequent reduction in overall morbidity associated with psoriatic disease.A psoríase é uma doença de acometimento sistêmico e de caráter insidioso, que ocorre com inflamação crônica subclínica, acarretando maior risco de comorbidades. O escore do osso trabecular, por sua vez, constitui um índice para estimar a microarquitetura óssea por meio da análise em vértebras lombares, sendo preditor de risco de fraturas, independentemente da densidade mineral óssea. Diante disso, este trabalho objetiva avaliar o escore do osso trabecular, a densidade mineral óssea e a composição corporal em pacientes com diagnóstico de psoríase em acompanhamento no ambulatório de dermatologia do Hospital Universitário de Santa Maria. Trata-se de um estudo transversal, com pacientes maiores de 18 anos e diagnóstico de psoríase grave em acompanhamento de julho de 2021 a 30 de março de 2022. Foram excluídos pacientes com diabetes mellitus, doença renal crônica, hipertensão arterial sistêmica, índice de massa corporal maior que 35 e diagnóstico de psoríase há mais de 15 anos. As variáveis clínicas analisadas foram sexo, idade, menopausa, tabagismo, ingestão alcoólica, tempo de doença, idade no diagnóstico, imunossupressão/uso de corticoide oral, tratamento atual, diagnóstico de outras doenças autoimunes, circunferência abdominal, peso, altura e índice de massa corporal. Por intermédio dos exames de densitometria óssea e de composição corporal, foram aferidas a densidade mineral no fêmur e na coluna lombar, o escore do osso trabecular, a taxa androide/ginoide, o índice de gordura corporal e o índice de massa muscular apendicular. A amostra contém 17 pacientes, nove do sexo feminino e oito do sexo masculino, com idade entre 24 e 70 anos, apresentando diagnóstico de psoríase grave. A mediana do tempo de doença no grupo analisado foi de 10 anos. Um paciente apresentou microarquitetura degradada, seis pacientes foram diagnosticados com osteopenia, e um paciente tinha osteoporose. Houve diferença estatisticamente significativa quanto à prevalência de alteração da massa óssea para os pacientes acima de 50 anos na amostra quando comparada com a população em geral de mesma faixa etária. Os dados sugerem que pode haver necessidade de vários anos de exposição óssea à doença de pele psoriática antes que surja uma perda óssea significativa. A avaliação densitométrica associada ao escore do osso trabecular é de grande valia, pois pacientes com psoríase sem doença articular também podem apresentar perda óssea mais precoce quando comparadas à população geral da mesma idade. Ademais, a psoríase tem uma carga psicossocial elevada e, em sua forma grave, pode predispor os pacientes à obesidade. Assim, há indícios do benefício de antecipação do rastreamento das alterações ósseas nos pacientes com psoríase grave acima dos 50 anos, com inclusão da avaliação óssea no manejo da doença para triagem de indivíduos que potencialmente sofrerão fraturas e consequente diminuição da morbidade global associada à doença psoriática.porUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Ciências da SaúdeUFSMBrasilCiências da SaúdeAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessPsoríaseEscore do osso trabecularDensidade mineral ósseaComposição corporalPsoriasisTrabecular bone scoreBone mineral densityBody compositionCNPQ::CIENCIAS DA SAUDEAvaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase graveEvaluation of trabecular bone score, bone mineral density and body composition in patients with severe psoriasisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisBeck, Maristela de Oliveirahttp://lattes.cnpq.br/5466354015919916Ribeiro, Tiango AguiarBoza, Juliana Catuccihttp://lattes.cnpq.br/4355085709351658Ues, Bruna400000000001600600600600600bbbabd09-6e2a-41b2-9620-6ee13ecef722d39fee3b-0f31-491d-a4c9-befb6695834012dc2ba8-83b0-42cc-a97a-6bbda3077d640b0ff8b0-0eca-484d-8b84-c20a5e9231bfreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMCC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.ufsm.br/bitstream/1/25894/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81956http://repositorio.ufsm.br/bitstream/1/25894/3/license.txt2f0571ecee68693bd5cd3f17c1e075dfMD53ORIGINALDIS_PPGCS_2022_UES_BRUNA.pdfDIS_PPGCS_2022_UES_BRUNA.pdfDissertaçãoapplication/pdf1128196http://repositorio.ufsm.br/bitstream/1/25894/1/DIS_PPGCS_2022_UES_BRUNA.pdfcc6470c7f7b9ad51205df7be71f797f5MD511/258942022-08-16 09:42:27.445oai:repositorio.ufsm.br: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ório Institucionalhttp://repositorio.ufsm.br/PUBhttp://repositorio.ufsm.br/oai/requestopendoar:39132022-08-16T12:42:27Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Avaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase grave |
dc.title.alternative.eng.fl_str_mv |
Evaluation of trabecular bone score, bone mineral density and body composition in patients with severe psoriasis |
title |
Avaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase grave |
spellingShingle |
Avaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase grave Ues, Bruna Psoríase Escore do osso trabecular Densidade mineral óssea Composição corporal Psoriasis Trabecular bone score Bone mineral density Body composition CNPQ::CIENCIAS DA SAUDE |
title_short |
Avaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase grave |
title_full |
Avaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase grave |
title_fullStr |
Avaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase grave |
title_full_unstemmed |
Avaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase grave |
title_sort |
Avaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase grave |
author |
Ues, Bruna |
author_facet |
Ues, Bruna |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Beck, Maristela de Oliveira |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/5466354015919916 |
dc.contributor.referee1.fl_str_mv |
Ribeiro, Tiango Aguiar |
dc.contributor.referee2.fl_str_mv |
Boza, Juliana Catucci |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/4355085709351658 |
dc.contributor.author.fl_str_mv |
Ues, Bruna |
contributor_str_mv |
Beck, Maristela de Oliveira Ribeiro, Tiango Aguiar Boza, Juliana Catucci |
dc.subject.por.fl_str_mv |
Psoríase Escore do osso trabecular Densidade mineral óssea Composição corporal |
topic |
Psoríase Escore do osso trabecular Densidade mineral óssea Composição corporal Psoriasis Trabecular bone score Bone mineral density Body composition CNPQ::CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Psoriasis Trabecular bone score Bone mineral density Body composition |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE |
description |
Psoriasis is a disease of systemic involvement and insidious nature, which occurs with sub-clinical chronic inflammation, leading to a higher risk of comorbidities. The trabecular bone score, in turn, is an index for estimating bone microarchitecture by means of analysis in lumbar vertebrae, and is a predictor of fracture risk, regardless of bone mineral density. Therefore, this work aims to evaluate the trabecular bone score, bone mineral density, and body composition in patients diagnosed with psoriasis being followed up at the dermatology outpatient clinic of Santa Maria University Hospital. This is a cross-sectional study, with patients over 18 years of age and diagnosed with severe psoriasis at follow-up from July 2021 to March 30, 2022. Patients with diabetes mellitus, chronic kidney disease, hypertension, body mass index greater than 35, and a diagnosis of psoriasis more than 15 years ago were excluded. The clinical variables analyzed were gender, age, menopause, smoking, alcohol consumption, duration of disease, age at diagnosis, immunosuppression/use of oral corticosteroids, current treatment, diagnosis of other autoimmune diseases, abdominal circumference, weight, height, and body mass index. Through bone densitometry and body composition examinations, the mineral density in the femur and lumbar spine, trabecular bone score, android to gynoid ratio, body fat index, and appendicular muscle mass index were measured. The sample contains 17 patients, nine female and eight male, aged between 24 and 70 years, with a diagnosis of severe psoriasis. The median time of illness in the analyzed group was 10 years. One patient had degraded microarchitecture, six patients were diagnosed with osteopenia, and one patient had osteoporosis. There was a statistically significant difference in the prevalence of altered bone mass for the patients over 50 years old in the sample when compared to the general population of the same age group. The data suggest that there may need to be several years of bone exposure to psoriatic skin disease before significant bone loss emerges. The densitometric evaluation associated with the trabecular bone score is of great value, as patients with psoriasis without joint disease may also show signs of bone loss, even without a significant decrease in bone mass when compared to healthy controls. In addition, psoriasis has a high psychosocial burden and, in its severe form, can predispose patients to obesity. There is also evidence of benefit in earlier screening for bone changes in patients with severe psoriasis over the age of 50 years, with the inclusion of bone assessment in the management of the disease to screen for potential fractures and consequent reduction in overall morbidity associated with psoriatic disease. |
publishDate |
2022 |
dc.date.accessioned.fl_str_mv |
2022-08-16T12:42:27Z |
dc.date.available.fl_str_mv |
2022-08-16T12:42:27Z |
dc.date.issued.fl_str_mv |
2022-07-19 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
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masterThesis |
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http://repositorio.ufsm.br/handle/1/25894 |
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http://repositorio.ufsm.br/handle/1/25894 |
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por |
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por |
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400000000001 |
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600 600 600 600 600 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Ciências da Saúde |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Ciências da Saúde |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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