Disciplina de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Rev Saude Publica. 2010 Jun;44(3):479-85. doi: 10.1590/s0034-89102010000300011.
To estimate the prevalence and analyze risk factors associated to osteoporosis and low-trauma fracture in women.
Cross-sectional study including a total of 4,332 women older than 40 attending primary care services in the Greater São Paulo, Southeastern Brazil, between 2004 and 2007. Anthropometrical and gynecological data and information about lifestyle habits, previous fracture, medical history, food intake and physical activity were obtained through individual quantitative interviews. Low-trauma fracture was defined as that resulting from a fall from standing height or less in individuals 50 years or older. Multiple logistic regression models were designed having osteoporotic fracture and bone mineral density (BMD) as the dependent variables and all other parameters as the independent ones. The significance level was set at p<0.05.
The prevalence of osteoporosis and osteoporotic fractures was 33% and 11.5%, respectively. The main risk factors associated with low bone mass were age (OR=1.07; 95% CI: 1.06;1.08), time since menopause (OR=2.16; 95% CI: 1.49;3.14), previous fracture (OR=2.62; 95% CI: 2.08;3.29) and current smoking (OR=1.45; 95% CI: 1.13;1.85). BMI (OR=0.88; 95% CI: 0.86;0.89), regular physical activity (OR=0.78; 95% CI: 0.65;0.94) and hormone replacement therapy (OR=0.43; 95% CI: 0.33;0.56) had a protective effect on bone mass. Risk factors significantly associated with osteoporotic fractures were age (OR=1.05; 95% CI: 1.04;1.06), time since menopause (OR=4.12; 95% CI: 1.79;9.48), familial history of hip fracture (OR=3.59; 95% CI: 2.88;4.47) and low BMD (OR=2.28; 95% CI: 1.85;2.82).
Advanced age, menopause, low-trauma fracture and current smoking are major risk factors associated with low BMD and osteoporotic fracture. The clinical use of these parameters to identify women at higher risk for fractures might be a reasonable strategy to improve the management of osteoporosis.
评估骨质疏松症和低创伤性骨折在女性中的流行率，并分析其相关的危险因素。
这是一项横断面研究，共纳入 2004 年至 2007 年期间巴西东南部大圣保罗地区 4332 名 40 岁以上的女性。通过个人定量访谈获得了人体测量学和妇科数据以及生活方式习惯、既往骨折、病史、饮食和身体活动信息。50 岁及以上人群因站立高度或更低高度的跌倒而导致的骨折被定义为低创伤性骨折。设计了多个逻辑回归模型，将骨质疏松性骨折和骨密度（BMD）作为因变量，将所有其他参数作为自变量。显著性水平设为 p<0.05。
骨质疏松症和骨质疏松性骨折的患病率分别为 33%和 11.5%。与低骨量相关的主要危险因素包括年龄（OR=1.07；95%CI：1.06；1.08）、绝经时间（OR=2.16；95%CI：1.49；3.14）、既往骨折（OR=2.62；95%CI：2.08；3.29）和当前吸烟（OR=1.45；95%CI：1.13；1.85）。BMI（OR=0.88；95%CI：0.86；0.89）、规律的身体活动（OR=0.78；95%CI：0.65；0.94）和激素替代疗法（OR=0.43；95%CI：0.33；0.56）对骨量有保护作用。与骨质疏松性骨折显著相关的危险因素包括年龄（OR=1.05；95%CI：1.04；1.06）、绝经时间（OR=4.12；95%CI：1.79；9.48）、家族性髋部骨折史（OR=3.59；95%CI：2.88；4.47）和低 BMD（OR=2.28；95%CI：1.85；2.82）。
高龄、绝经、低创伤性骨折和当前吸烟是与低 BMD 和骨质疏松性骨折相关的主要危险因素。这些参数在临床上用于识别骨折风险较高的女性可能是改善骨质疏松症管理的合理策略。
