Estudo da perda e dos fatores associados à densidade mineral óssea de idosos
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2021-03-16
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Universidade Federal de Goiás
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The decrease in bone mineral density (BMD) is associated with complex outcomes such as fractures, which compromise the functionality and quality of life of the elderly The role of some factors such as vitamins D and B12, and bio-chemical tests is not conclusive between genders in the elderly aged 70 years or ol-der, whose decline in BMD may be even greater. Still, in Brazil, there is no evidence from longitudinal studies on the loss of BMD over time. OBJECTIVE: The objecti-ves of this study were: (i) to analyze the profile and factors associated with BMD in elderly over 70 years old, according to sex; (ii) to analyze the loss of BMD in the el-derly in ten years, and the factors that increase its reduction. METHODOLOGY: Prospective cut epidemiological study, with a ten-year follow-up period, carried out in central Brazil. The baseline started in 2008 was composed of 418 elderly people. In 2009, 132 baseline participants were invited to review the DMO. In 2018/2019, all the elderly in the sample being followed up underwent BMD analysis. Thus, for the analysis of the first objective, 175 elderly people were included and for the second objective 79 elderly people with BMD results in two evaluations (2009 and 2018/2019). A home interview was conducted, using a standardized questionnaire by trained researchers. The dependent variable was the BMD analyzed from the dual energy X-ray absorptiometry (DXA) exam, estimated in the spine and femur in g / cm2. The exposure variables were sociodemographic and health conditions. The data were analyzed using the STATA program, version 15.0. To analyze the factors asso-ciated with BMD and loss of BMD, bivariate and multiple analyzes stratified by sex were performed. In the bivariate analysis, a generalized linear model (MLG) of the linear family was used to verify the association between the dependent variable and each independent variable. Variables with p-value <0.20 were included in a final MLG to adjust for potential confounding variables. The magnitude of the association was presented as a regression coefficient (beta) and a 95% confidence interval (95% CI). Variables with p-value <0.05 were considered statistically significant. RE-SULTS: Of the 175 elderly people in the cross-sectional study, 65% were female and 59.4% were between 70 and 79 years old (mean 78.8 years). The overall mean BMD of the spine was 1.064 g / cm2 (± 0.01), with 0.998 g / cm2 in women and 1.186 g / cm2 in men (p <0.001). The general mean BMD of the femur was 0.825 g / cm2 (± 0.12), with 0.774 g / cm2 in women and 0.916 g / cm2 in men (p <0.001). In men, factors associated with appendicular muscle mass, education level, handgrip strength, triglycerides, vitamin D, vitamin B12 and creatinine. In women, appendicular muscle mass, glycated hemoglobin, vitamin B12 were associated with BMD. Of the 79 parti-cipants eligible for BMD loss analysis (cohort study), the overall mean BMD at base-line was 1.147 g / cm2 and after 10 years of follow-up was 0.815 g / cm2. The ave-rage loss of BMD between 2009 and 2019 was -0.341 g / cm2, reflecting a loss of around -29.38%. The loss of BMD was greater in men with a statistically significant difference (p <0.001). CONCLUSION: The present study confirmed that there is a difference in BMD between the sexes and that the factors associated with BMD in the spine and femur may be different. The components of sarcopenia have been positi-vely associated with BMD. Positive association between BMD and glycated hemo-globin, triglycerides and creatinine were controversial with the current literature. The loss of BMD in 10 years was more expressive in men, which suggests that it can oc-cur in this group in later periods. To study the factors related to BMD and how bone mass loss can be prevented by assisting public health policies to avoid outcomes such as fractures, loss of functionality, increased demands for care and costs for the health system.
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LIMA, B. R. Estudo da perda e dos fatores associados à densidade mineral óssea de idosos. 2021. 165 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2021.