Buttros Davi de Araújo Brito, Nahas-Neto Jorge, Nahas Eliana Aguiar Petri, Cangussu Luciana Mendes, Barral Ana Beatriz Cesar Rodrigues, Kawakami Márcia Suemy
Programa 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.
Rev Bras Ginecol Obstet. 2011 Jun;33(6):295-302. doi: 10.1590/s0100-72032011000600006.
To evaluate bone mineral density (BMD) and their risk factors associated with postmenopausal osteoporosis.
A cross-sectional clinical study was performed on 431 women (aged 40-75 years).
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.
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).
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.
评估骨矿物质密度（BMD）及其与绝经后骨质疏松症相关的危险因素。
对431名年龄在40 - 75岁的女性进行了一项横断面临床研究。
闭经超过12个月且年龄大于45岁，或40岁后双侧卵巢切除术且过去12个月通过双能X线吸收法（DXA）测得的BMD值（腰椎/股骨颈T值）。评估的危险因素：年龄、绝经年龄和时间、吸烟、体育活动（每周5次，每次30分钟）、类风湿关节炎（RA）、皮质激素治疗和激素治疗（HT）的使用、既往骨折史、母亲髋部骨折史以及体重指数（BMI = 体重/身高²）。采用χ²检验和逻辑回归方法（比值比 - OR）来确定骨质疏松症风险。
根据世界卫生组织标准，106名（24.6%）女性患有骨质疏松症（T值 < -2.5 DP），188名（43.6%）患有骨质减少症（-1.0 / -2.4 DP），137名（31.8%）正常（> -1.0 DP）。40 - 49岁女性中12%被检测出患有骨质疏松症，50 - 59岁女性中21.8%，60岁以上女性中45.7%（p < 0.001）。绝经时间小于5年的女性中11.8%发生骨质疏松症，绝经时间为6至10年的女性中29.4%，绝经时间大于10年的女性中41%（p < 0.001）。在绝经早的女性中，80%表现为骨质减少/骨质疏松（p = 0.03），在BMI < 20 kg/m²的女性中，50%患有骨质疏松症（p < 0.001）。骨质疏松症检测风险随年龄（OR = 1.1；95%置信区间 = 1.0 - 1.1）、绝经时间（OR = 1.1；95%置信区间 = 1.0 - 1.1）、吸烟（OR = 1.9；95%置信区间 = 1.2 - 3.2）、类风湿关节炎（OR = 3.6；95%置信区间 = 1.3 - 9.6）和母亲骨折史（OR = 2.1；95%置信区间 = 1.1 - 3.0）增加（p < 0.05）。相比之下，使用HT（OR = 0.3；95%置信区间 = 0.2 - 0.6）和高BMI（OR = 0.9；95%置信区间 = 0.8 - 0.9）可降低风险（p < 0.05）。
在绝经后女性中，年龄、绝经时间、吸烟和母亲骨折史是骨质疏松症风险的临床指标，而使用HT和高BMI被证明是保护因素。
