Impacto da obesidade nas fraturas ósseas em mulheres na pós-menopausa: um estudo de base populacional em Santa Maria

• Autor(a) principal: Copês, Rafaela Martinez
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Manancial - Repositório Digital da UFSM
• dARK ID: ark:/26339/0013000012jvm
• Texto Completo: http://repositorio.ufsm.br/handle/1/5836
• topic: Obesidade; Fraturas ósseas; Mulheres pós-menopausa; Obesity; Fractures; Postmenopausal women; CNPQ::CIENCIAS DA SAUDE

Body mass index (IMC) is a major determinant of bone mineral density (BMD) and obesity is widely believed to protect against fracture. Nevertheless, the higher BMD associated with obesity may just reflect the adaptation related to the increased mechanical demands on the skeleton in these subjects. The protection that it confers against fracture may not be greater than the protection that lower BMD confers in leaner individuals, particularly in view of the greater prevalence of trauma related to falls in the obese population. Therefore, the aim of this work was to evaluate the association between obesity and bone fractures in postmenopausal women in the city of Santa Maria/RS. This was a cross-sectional study carried out in the city of Santa Maria, parallel 29°, Southern Brazil, from 1st March to 31 August 2013. Were included to this survey post-menopausal women age, 55 years or over, who attend a General Practice Surgery (UBS) of its territory. Women with cognitive impairment, communication disabilities and in the menacme were excluded. Data were collected using a standardized questionnaire that covered domains about patients characteristics, fracture history, risk factors for fractures and medication use. Overall, one thousand and fifty seven women were eligible for analysis. BMI was assessed in 973 women, in which 39.6% had a BMI of 30 kg/m2 or more. A history of prevalent fracture was present in 17.4% obese women and 16.2% of non-obese women (P = 0.622). There was no difference between the BMI of the postmenopausal women with fractures and postmenopausal women without prevalent fractures. In addition, obesity has not shown to be a protective factor of bone fractures, given its odds ratio was 1.09 (95% CI 0.74 to 1.54). No association between the sites of fracture and BMI were detected. Age and mobility impairment were associated with bone fractures in obese women. On the other hand, hospital stay (at least one day overnight in the last year), disability in activities of daily living, ischemic heart disease, rheumatoid arthritis, and family history of fracture, and age were associated with prevalent fractures in nonobese women. In conclusion, our study has not identified a protective impact of obesity to the occurrence of bone fractures in postmenopausal women, although different factors associated with fractures were observed between obese and nonobese women.