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[Risk factors for osteoporosis in postmenopausal women from southeast Brazilian]
Davi de Araújo Brito Buttros1, Jorge Nahas-Neto, Eliana Aguiar Petri Nahas
1Programa de Pós-Graduação em Ginecologia, Obstetrícia e Mastologia da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista Júlio de Mesquita Filho–UNESP– Botucatu (SP), Brasil.
Purpose:
To evaluate bone mineral density (BMD) and their risk factors associated with postmenopausal osteoporosis.
Methods:
A cross-sectional clinical study was performed on 431 women (aged 40-75 years).
Inclusion Criteria:
amenorrhea > 12 months and age > 45 years or, bilateral oophorectomy > 40 years with BMD values (T-score of lumbar spine/femur neck) by DXA of the last 12 months. Risk factors evaluated: age, age and time of menopause, smoking, physical activity (30 min/5 times/week), rheumatoid arthritis (RA), use of corticotherapy and hormone therapy (HT), previous fracture, maternal hip fracture and body mass index (BMI = weight/height²). The χ2 test and the logistic regression method (Odds Ratio--OR) were used to determine osteoporosis risk.
Results:
According to WHO criteria, 106 (24.6%) women showed osteoporosis (T-score < -2.5 DP), 188 (43.6%) osteopenia (-1.0/-2.4 DP), and 137 (31.8%) were normal (> -1.0 DP). Osteoporosis was detected in 12% of women aged 40-49 years, in 21.8% of women aged 50-59 years and in 45.7% of women aged > 60 years (p < 0.001). Osteoporosis occurred in 11.8% of women with a menopause period < 5 years, in 29.4% with a menopause period from 6 to 10 years, and in 41% of women with a menopause period > 10 years (p < 0.001). Of the women with early menopause, 80% showed osteopenia/osteoporosis (p = 0.03), and of those with BMI < 20 kg/m², 50% were osteoporotic (p < 0.001). The risk for osteoporosis detection increased with age (OR = 1.1; CI 95% = 1.0-1.1), time of menopause (OR = 1.1; CI 95% = 1.0-1.1), smoking (OR = 1.9; CI 95% = 1.2-3.2), RA (OR = 3.6; CI 95% = 1.3-9.6) and maternal fracture history (OR = 2.1; CI 95% = 1.1-3.0) (p < 0.05). In contrast, HT use (OR = 0.3; 95% CI = 0.2-0.6) and high BMI (OR = 0.9; 95% CI = 0.8-0.9) reduced the risk (p < 0.05).
Conclusion:
In postmenopausal women, age, time of menopause, smoking and maternal history of fracture were clinical indicators of risk for osteoporosis, whereas HT use and high BMI proved to be protective factors.
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