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患有和未患乳腺癌的绝经后女性的骨矿物质密度

Bone mineral density in postmenopausal women with and without breast cancer.

作者信息

Conde Délio Marques, Costa-Paiva Lúcia, Martinez Edson Zangiacomi, Pinto-Neto Aarão Mendes

机构信息

Medical Residency Training Program in Breast Disorders, Breast Service, Hospital Materno Infantil, Goiânia, GO, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2012 Nov-Dec;58(6):673-8.

Abstract

OBJECTIVE

The values of bone mineral density (BMD) were compared in postmenopausal women with and without breast cancer.

METHODS

A cross-sectional study was conducted, including 51 breast cancer survivors (BCS) and 71 women without breast cancer, who were non-users of hormone therapy, tamoxifen, or aromatase inhibitors. BMD T-scores and measurements in grams per centimeter squared (g/cm²) were obtained at the femoral neck, trochanter, Ward's triangle, and lumbar spine. Osteopenia and osteoporosis were grouped and categorized as abnormal BMD. Unconditional logistic regression analysis was used to estimate the odds ratios (OR) of abnormal BMD values as measures of association, with 95% confidence intervals (CIs), adjusting for age, years since menopause, parity, and body mass index (BMI).

RESULTS

The mean age of the women with and without breast cancer was 54.7 ± 5.8 years and 58.2 ± 4.8 years (p < 0.01), respectively. After adjusting for age, parity and BMI, abnormal BMD at the femoral neck (adjusted OR: 4.8; 95% CI: 1.5-15.4), trochanter (adjusted OR: 4.6; 95% CI: 1.4-15.5), and Ward's triangle (adjusted OR: 4.5; 95% CI: 1.5-12.9) were significantly more frequent in postmenopausal BCS than in women without breast cancer. Postmenopausal BCS had a significantly lower mean BMD at the trochanter (0.719 vs. 0.809 g/cm², p < 0.01) and at the Ward's triangle (0.751 vs. 0.805 g/cm², p = 0.03).

CONCLUSION

The prevalence of abnormal BMD was higher in postmenopausal BCS than in postmenopausal women without breast cancer. Bone health requires special vigilance and the adoption of interventions should be instituted early to minimize bone loss in BCS.

摘要

目的

比较患有和未患有乳腺癌的绝经后女性的骨密度(BMD)值。

方法

开展了一项横断面研究,纳入51名乳腺癌幸存者(BCS)和71名未患乳腺癌的女性,这些女性均未使用激素疗法、他莫昔芬或芳香化酶抑制剂。在股骨颈、大转子、沃德三角区和腰椎处获取BMD T值以及以克每平方厘米(g/cm²)为单位的测量值。骨质减少和骨质疏松被归为骨密度异常。采用无条件逻辑回归分析来估计骨密度异常值的比值比(OR)作为关联度量,并给出95%置信区间(CI),同时对年龄、绝经年限、产次和体重指数(BMI)进行校正。

结果

患有和未患有乳腺癌的女性的平均年龄分别为54.7±5.8岁和58.2±4.8岁(p<0.01)。在对年龄、产次和BMI进行校正后,绝经后BCS在股骨颈(校正OR:4.8;95%CI:1.5 - 15.4)、大转子(校正OR:4.6;95%CI:1.4 - 15.5)和沃德三角区(校正OR:4.5;95%CI:1.5 - 12.9)出现骨密度异常的情况显著多于未患乳腺癌的女性。绝经后BCS在大转子处的平均骨密度(0.719 vs. 0.809 g/cm²,p<0.01)和沃德三角区(0.751 vs. 0.805 g/cm²,p = 0.03)显著更低。

结论

绝经后BCS中骨密度异常的患病率高于未患乳腺癌的绝经后女性。骨骼健康需要特别警惕,应尽早采取干预措施以尽量减少BCS的骨质流失。

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