Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(6):295-302
DOI 10.1590/S0100-72032011000600006
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; CI95%=1.0-1.1), time of menopause (OR=1.1; CI95%=1.0-1.1), smoking (OR=1.9; CI95%=1.2-3.2), RA (OR=3.6; CI95%=1.3-9.6) and maternal fracture history (OR=2.1; CI95%=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.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):467-472
DOI 10.1590/S0100-72032005000800006
PURPOSE: to evaluate the prevalence of subclinical hypothyroidism and its effects on lipidic profile and bone mineral density (BMD) in postmenopausal women. METHODS: a cross-sectional study with survey of data from medical records of patients attended at a climacteric outpatient clinic. Inclusion criteria: postmenopausal women with measured thyroid-stimulating hormone (TSH) and free thyroxin (T4-L). Exclusion criteria: hyperthyroidism and thyroid cancer. Values of TSH >5.0 mIU/ml and normal T4-L were considered to be subclinical hypothyroidism. The 329 selected women (55.2±6.4 years) were divided into three groups: normal thyroid function (control) (n=208), subclinical hypothyroidism (n=53) and clinical hypothyroidism under treatment (n=59). Clinical data, hormonal therapy use, body mass index (BMI=kg/m²), lipid profile (total cholesterol, HDL, LDL, triglycerides) and BMD of lumbar column and femur were obtained. RESULTS: subclinical hypothyroidism was diagnosed in 16.1% of the cases. The groups were homogeneous regarding clinical features, BMI or lipidic profile. BMD in lumbar column and femur was lower in subclinical and clinical hypothyroidism than in euthyroidism (p<0.001). There was a negative correlation between values of TSH and BMD of lumbar column and femur (p<0.001). There was no correlation between TSH values and age, menopause time, BMI, and lipid profile. The total of hormonal therapy users was 65.1%, mean duration of 3.43±2.42 years, not differing between the groups. CONCLUSION: subclinical hypothyroidism with prevalence of 16.1% in postmenopausal women was associated with lower BMD, with no effects on lipid profile.