Fraturas ósseas em mulheres na pós-menopausa: um estudo de coorte em Santa Maria/RS

Detalhes bibliográficos
Autor(a) principal: Leal, Rafaela Martinez Copês
Data de Publicação: 2021
Tipo de documento: Tese
Idioma: por
Título da fonte: Manancial - Repositório Digital da UFSM
Texto Completo: http://repositorio.ufsm.br/handle/1/24306
Resumo: Osteoporosis is characterized by low bone mass associated with abnormalities in bone microarchitecture, increasing the risk of fragility fractures. Although there are guidelines for the diagnosis and treatment of osteoporosis, which could reduce the incidence of fractures by more than 70%, this disease continues to be underdiagnosed and undertreated. Knowledge of the epidemiology of fractures is essential for planning preventive actions and treatment strategies. Body mass index (IMC) is a major determinant of bone mineral density (BMD) and obesity is widely believed to protect against fracture. However, studies have challenged this assumption and have shown that fractures in obese people contribute substantially to the total number of fractures. Therefore, the aims of this study were to establish the incidence of bone fractures in the population of postmenopausal women attending the primary care in the municipality of Santa Maria, to evaluate their epidemiological characteristics, to access the FRAX algorithm utility is this population, and to evaluate the association between obesity and fractures. A cohort study was carried out in the municipality of Santa Maria, in women aged 55 years or older, in the post-menopause and who attended the basic health unit. The recruitment period was from March 1 to August 31, 2013. Participants were followed from September 1, 2013 until July 31, 2018. In the initial contact, a questionnaire was carried out and weight and height were measured. The follow-up was carried out on 854 women who contributed to 2732 people/year. It was done by annual telephone contact for 5 years. Information that included occurrence of bone fractures, diagnosis or treatment of osteoporosis, new comorbidities and use of medications was collected. In the fifth year of the study, visits were made to the basic heath unit to review the fracture incidence of the study participants. The average follow-up time was 3.2 years (SD 1.05; minimum follow-up 1.1 years and maximum 5.6 years). During this period, 62 fractures occurred in 58 women. The incidences of total fractures and major fractures in our study were 22.3 and 15.0 fractures per 1000 people/year, respectively. The most frequent fracture sites were 1) wrist, 2) shoulder, 3) ribs and, 4) hip. Hip fractures were the fourth most frequent site with an incidence of 3.3 fractures per 1000 people / year. Rheumatoid arthritis, previous fracture and use of glucocorticoids were risk factors for fractures in our study. Women who fractured had absolute 10-year fracture risk scores calculated by the higher FRAX algorithm than women who did not fracture. The incidence of fractures was similar among obese and non-obese women (24.2 per 1000 person/year vs. 22.9 per 1000 person/year, respectively; p=0.864 – Kaplan Meier). It is concluded that the incidence of fractures in postmenopausal women in Santa Maria was high and similar to other studies of Brazilian and Latin American populations and obesity is not a protective factor to bone fractures.
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spelling Fraturas ósseas em mulheres na pós-menopausa: um estudo de coorte em Santa Maria/RSObesity and bone fractures in women in the post menopause: a cohort study in Santa Maria/RSFraturasFraturas de quadrilFRAXOsteoporoseObesidadeFractureHip fractureOsteoporosisObesityCNPQ::CIENCIAS BIOLOGICAS::FARMACOLOGIAOsteoporosis is characterized by low bone mass associated with abnormalities in bone microarchitecture, increasing the risk of fragility fractures. Although there are guidelines for the diagnosis and treatment of osteoporosis, which could reduce the incidence of fractures by more than 70%, this disease continues to be underdiagnosed and undertreated. Knowledge of the epidemiology of fractures is essential for planning preventive actions and treatment strategies. Body mass index (IMC) is a major determinant of bone mineral density (BMD) and obesity is widely believed to protect against fracture. However, studies have challenged this assumption and have shown that fractures in obese people contribute substantially to the total number of fractures. Therefore, the aims of this study were to establish the incidence of bone fractures in the population of postmenopausal women attending the primary care in the municipality of Santa Maria, to evaluate their epidemiological characteristics, to access the FRAX algorithm utility is this population, and to evaluate the association between obesity and fractures. A cohort study was carried out in the municipality of Santa Maria, in women aged 55 years or older, in the post-menopause and who attended the basic health unit. The recruitment period was from March 1 to August 31, 2013. Participants were followed from September 1, 2013 until July 31, 2018. In the initial contact, a questionnaire was carried out and weight and height were measured. The follow-up was carried out on 854 women who contributed to 2732 people/year. It was done by annual telephone contact for 5 years. Information that included occurrence of bone fractures, diagnosis or treatment of osteoporosis, new comorbidities and use of medications was collected. In the fifth year of the study, visits were made to the basic heath unit to review the fracture incidence of the study participants. The average follow-up time was 3.2 years (SD 1.05; minimum follow-up 1.1 years and maximum 5.6 years). During this period, 62 fractures occurred in 58 women. The incidences of total fractures and major fractures in our study were 22.3 and 15.0 fractures per 1000 people/year, respectively. The most frequent fracture sites were 1) wrist, 2) shoulder, 3) ribs and, 4) hip. Hip fractures were the fourth most frequent site with an incidence of 3.3 fractures per 1000 people / year. Rheumatoid arthritis, previous fracture and use of glucocorticoids were risk factors for fractures in our study. Women who fractured had absolute 10-year fracture risk scores calculated by the higher FRAX algorithm than women who did not fracture. The incidence of fractures was similar among obese and non-obese women (24.2 per 1000 person/year vs. 22.9 per 1000 person/year, respectively; p=0.864 – Kaplan Meier). It is concluded that the incidence of fractures in postmenopausal women in Santa Maria was high and similar to other studies of Brazilian and Latin American populations and obesity is not a protective factor to bone fractures.A osteoporose é caracterizada por baixa massa óssea associada a anormalidades na microarquitetura do osso aumentando o risco de fraturas de fragilidade. Apesar de existirem diretrizes para o diagnóstico e tratamento da osteoporose, que poderia reduzir a incidência de fraturas em mais de 70%, esta enfermidade continua sendo subdiagnosticada e subtratada. O conhecimento da epidemiologia das fraturas e seus fatores de risco é fundamental para o planejamento de ações preventivas e estratégias de tratamento. O índice de massa corporal (IMC) é um importante determinante da densidade mineral óssea (DMO) e acreditava-se que a obesidade fosse fator protetor contra fraturas. Entretanto, estudos tem desafiado essa suposição e evidenciado que fraturas em pessoas obesas contribuem substancialmente para o número total de fraturas. Portanto, os objetivos deste estudo foram estabelecer a incidência de fraturas ósseas na população de mulheres na pós-menopausa frequentadoras da atenção primaria do município de Santa Maria, avaliar suas características epidemiológicas, a utilidade do algoritmo FRAX nessa população e avaliar a associação entre obesidade e fraturas ósseas. Foi realizado um estudo de coorte no município de Santa Maria, em mulheres com idade igual ou maior a 55 anos, na pós-menopausa e que frequentassem a unidade básica de saúde. O período de recrutamento foi de 01 março a 31 agosto de 2013. As participantes foram seguidas a partir de 01 de setembro de 2013 ate 31 de julho de 2018. No contato inicial foi realizado um questionário e mensurados peso e altura. O seguimento foi realizado em 854 mulheres que contribuíram para 2732 pessoas/ano, foi feito contato telefônico anual durante 5 anos com as participantes coletando informações que incluíam ocorrência de fraturas ósseas, diagnóstico ou tratamento de osteoporose, comorbidades novas e uso de medicamentos. No quinto ano do estudo foram realizadas visitas nas unidades básicas de saúde para revisão da incidência de fratura das participantes do estudo. O tempo médio de seguimento foi 3,2 anos (DP 1,05; seguimento mínimo 1.1 anos e máximo 5.6 anos). Durante esse período ocorreram 62 fraturas em 58 mulheres. As incidências de fraturas totais e fraturas maiores em nosso estudo foram 22,3 e 15,0 fraturas por 1000 pessoas/ano, respectivamente. Os sítios mais frequentes de fraturas foram 1) punho, 2) ombro, 3) costelas e 4) quadril. Artrite reumatoide, fratura previa e uso de glicocorticoides foram fatores de risco para fraturas no nosso estudo. As mulheres que fraturaram apresentaram escores de risco absoluto de fraturas em 10 anos calculados pelo algoritmo FRAX mais alto que as mulheres que não fraturaram. A Incidência de fraturas foi similar em mulheres obesas e não obesas (24.2 per 1000 pessoas/ano vs. 22.9 per 1000 pessoas/ano, respectivamente; p=0.864 – Kaplan Meier). Conclui-se que a incidência de fraturas nas mulheres pós-menopausa de Santa Maria foi alta e similar a outros estudos de populações brasileiras e da América Latina e que a obesidade não constitui fator de proteção para fraturas ósseas.Universidade Federal de Santa MariaBrasilFarmacologiaUFSMPrograma de Pós-Graduação em FarmacologiaCentro de Ciências da SaúdePremaor, Melissa Orlandinhttp://lattes.cnpq.br/1919693261808995Moresco, Rafael NoalBochi, Guilherme VargasSchuch, Natielen JacquesFerrari, Teresa Cristina de AbreuLeal, Rafaela Martinez Copês2022-05-06T13:52:24Z2022-05-06T13:52:24Z2021-03-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisapplication/pdfhttp://repositorio.ufsm.br/handle/1/24306porAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSM2022-05-06T13:56:53Zoai:repositorio.ufsm.br:1/24306Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2022-05-06T13:56:53Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false
dc.title.none.fl_str_mv Fraturas ósseas em mulheres na pós-menopausa: um estudo de coorte em Santa Maria/RS
Obesity and bone fractures in women in the post menopause: a cohort study in Santa Maria/RS
title Fraturas ósseas em mulheres na pós-menopausa: um estudo de coorte em Santa Maria/RS
spellingShingle Fraturas ósseas em mulheres na pós-menopausa: um estudo de coorte em Santa Maria/RS
Leal, Rafaela Martinez Copês
Fraturas
Fraturas de quadril
FRAX
Osteoporose
Obesidade
Fracture
Hip fracture
Osteoporosis
Obesity
CNPQ::CIENCIAS BIOLOGICAS::FARMACOLOGIA
title_short Fraturas ósseas em mulheres na pós-menopausa: um estudo de coorte em Santa Maria/RS
title_full Fraturas ósseas em mulheres na pós-menopausa: um estudo de coorte em Santa Maria/RS
title_fullStr Fraturas ósseas em mulheres na pós-menopausa: um estudo de coorte em Santa Maria/RS
title_full_unstemmed Fraturas ósseas em mulheres na pós-menopausa: um estudo de coorte em Santa Maria/RS
title_sort Fraturas ósseas em mulheres na pós-menopausa: um estudo de coorte em Santa Maria/RS
author Leal, Rafaela Martinez Copês
author_facet Leal, Rafaela Martinez Copês
author_role author
dc.contributor.none.fl_str_mv Premaor, Melissa Orlandin
http://lattes.cnpq.br/1919693261808995
Moresco, Rafael Noal
Bochi, Guilherme Vargas
Schuch, Natielen Jacques
Ferrari, Teresa Cristina de Abreu
dc.contributor.author.fl_str_mv Leal, Rafaela Martinez Copês
dc.subject.por.fl_str_mv Fraturas
Fraturas de quadril
FRAX
Osteoporose
Obesidade
Fracture
Hip fracture
Osteoporosis
Obesity
CNPQ::CIENCIAS BIOLOGICAS::FARMACOLOGIA
topic Fraturas
Fraturas de quadril
FRAX
Osteoporose
Obesidade
Fracture
Hip fracture
Osteoporosis
Obesity
CNPQ::CIENCIAS BIOLOGICAS::FARMACOLOGIA
description Osteoporosis is characterized by low bone mass associated with abnormalities in bone microarchitecture, increasing the risk of fragility fractures. Although there are guidelines for the diagnosis and treatment of osteoporosis, which could reduce the incidence of fractures by more than 70%, this disease continues to be underdiagnosed and undertreated. Knowledge of the epidemiology of fractures is essential for planning preventive actions and treatment strategies. Body mass index (IMC) is a major determinant of bone mineral density (BMD) and obesity is widely believed to protect against fracture. However, studies have challenged this assumption and have shown that fractures in obese people contribute substantially to the total number of fractures. Therefore, the aims of this study were to establish the incidence of bone fractures in the population of postmenopausal women attending the primary care in the municipality of Santa Maria, to evaluate their epidemiological characteristics, to access the FRAX algorithm utility is this population, and to evaluate the association between obesity and fractures. A cohort study was carried out in the municipality of Santa Maria, in women aged 55 years or older, in the post-menopause and who attended the basic health unit. The recruitment period was from March 1 to August 31, 2013. Participants were followed from September 1, 2013 until July 31, 2018. In the initial contact, a questionnaire was carried out and weight and height were measured. The follow-up was carried out on 854 women who contributed to 2732 people/year. It was done by annual telephone contact for 5 years. Information that included occurrence of bone fractures, diagnosis or treatment of osteoporosis, new comorbidities and use of medications was collected. In the fifth year of the study, visits were made to the basic heath unit to review the fracture incidence of the study participants. The average follow-up time was 3.2 years (SD 1.05; minimum follow-up 1.1 years and maximum 5.6 years). During this period, 62 fractures occurred in 58 women. The incidences of total fractures and major fractures in our study were 22.3 and 15.0 fractures per 1000 people/year, respectively. The most frequent fracture sites were 1) wrist, 2) shoulder, 3) ribs and, 4) hip. Hip fractures were the fourth most frequent site with an incidence of 3.3 fractures per 1000 people / year. Rheumatoid arthritis, previous fracture and use of glucocorticoids were risk factors for fractures in our study. Women who fractured had absolute 10-year fracture risk scores calculated by the higher FRAX algorithm than women who did not fracture. The incidence of fractures was similar among obese and non-obese women (24.2 per 1000 person/year vs. 22.9 per 1000 person/year, respectively; p=0.864 – Kaplan Meier). It is concluded that the incidence of fractures in postmenopausal women in Santa Maria was high and similar to other studies of Brazilian and Latin American populations and obesity is not a protective factor to bone fractures.
publishDate 2021
dc.date.none.fl_str_mv 2021-03-31
2022-05-06T13:52:24Z
2022-05-06T13:52:24Z
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format doctoralThesis
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dc.identifier.uri.fl_str_mv http://repositorio.ufsm.br/handle/1/24306
url http://repositorio.ufsm.br/handle/1/24306
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv 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.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade Federal de Santa Maria
Brasil
Farmacologia
UFSM
Programa de Pós-Graduação em Farmacologia
Centro de Ciências da Saúde
publisher.none.fl_str_mv Universidade Federal de Santa Maria
Brasil
Farmacologia
UFSM
Programa de Pós-Graduação em Farmacologia
Centro de Ciências da Saúde
dc.source.none.fl_str_mv reponame:Manancial - Repositório Digital da UFSM
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institution UFSM
reponame_str Manancial - Repositório Digital da UFSM
collection Manancial - Repositório Digital da UFSM
repository.name.fl_str_mv Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)
repository.mail.fl_str_mv atendimento.sib@ufsm.br||tedebc@gmail.com
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