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ISSN 0188-9796 (Impreso)

2000, Número 2

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Rev Endocrinol Nutr 2000; 8 (2)


Pérdida de masa ósea durante el climaterio (Estudio de 490 casos en el cuello de fémur)

Barreira ME, Delezé HM, Morales TJ

Idioma: Español
Referencias bibliográficas: 70
Paginas: 43-47
Archivo PDF: 210.03 Kb.


RESUMEN

El objetivo del estudio fue evaluar la densidad mineral ósea del cuello del fémur en pacientes del sexo femenino cuya edad quedara comprendida en el periodo del climaterio; es decir, entre los 40 y 55 años. En seis meses se registró aleatoriamente un total de 490 casos referidos a los centro de densitometría de tres ciudades del país, los cuales fueron divididos en tres grupos; el primero con un rango de edad de 40-45 años, el segundo de los 46-50 años y el tercero de los 51 a 55 años. En ningún caso se investigó la presencia o ausencia de factores de riesgo a fin de detectar la prevalencia de osteopenia y/o osteoporosis en el cuello de fémur de las pacientes que habitualmente son referidas para estudio. Los resultados revelaron que en el grupo de 40-45 años hubo osteopenia en el 29.91% y osteoporosis en el 2.56%, en el grupo de 46 a 50 años la prevalencia de osteopenia se incrementó a 42% y de osteoporosis 6.8%; mientras que entre los 51 a 55 años la osteopenia fue 48.7% y la osteoporosis alcanzó el 16.75%. Consideramos de gran importancia la valoración de la masa ósea en la cadera durante los años de la menopausia; ya que en la tercera edad, la fractura de cadera se presenta en una de cada seis mujeres y constituye la complicación más grave y devastadora de la enfermedad.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Consensus Development Conference: Diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 1993; 94: 646-650.

  2. Anonymous. Osteoporosis: review of the evidence for prevention, diagnosis and treatment and cost-effectiveness analysis: status report. Osteoporosis Int 1998: 8 (suppl 4)S1-S88.

  3. Poor G et al. Determinants of Reduced Survival Following Hip Fractures in Men. Clin Orthop 1995; 319: 260-65.

  4. Kanis JA, Johnell O. The burden of osteoporosis. J Endocrinol Invest 1999; 22: 583-588.

  5. Riggs BL, Wahner WH, Dunn WL, Mazess RB, Offord KP, Melton U III. Differencial changes in bone mineral density of the appendicular and axial skeleton with aging.

  6. Relationship with to spinal osteoporosis. J Clin Invest 1981; 67: 328-335.

  7. Hansen MA, Overgaard K, Riis BJ, Christiansen C. Role of peak bone mass and bone loss in postmenopausal osteoporosis: 12 year study. Br Med J 1991; 303: 961-964.

  8. Delmas PD. Hormone replacement therapy in the prevention and treatment of osteoporosis. Osteoporosis Int 1997; Suppl 1: 5357.

  9. Riggs BL, Wahner WH, Seeman E, Offord KP, Dunn WL, Mazess RB, Johnson KA, Melton U III. Changes in bone mineral density of the proximal femur and spine whith aging. J Clin Invest 1982; 70: 716-723.

  10. Riggs BL, Wahner WH, Melton U III, Richelson LS, Judd L, Offord KP. Rates of bone loss in the appendicular and axial skeletons of women: Evidence of substantial vertebral bone loss before menopause. J Clin Invest 1986; 77: 1487-1491.

  11. Hui SL, Slemenda CW, Johnston CC, Appledorm CR. Effects of age and menopause on vertebral bone density. Bone Miner 1987; 2: 141-146 .

  12. Saambrook PN, Eisman JA, Furler SM, Pocock NA. Computer modeling and analysis of cross-sectional bone density studies with respect to age and the menopause. J Bone Miner Res 1987; 2: 119-114.

  13. Nilas L, Gotfresen A, Hadberg A, Christiansen C. Age related bone loss in women evaluated by single and dual photon technique. Bone Miner 1988; 4: 95-103.

  14. Hedlund LR, Gallagher JC. The effect of age and menopause on bone mineral density of the proximal femur. J Bone Miner Res 1989; 4: 639-642.

  15. Rodin A, Murby B, Smith MA, Caleffi M, Fentiman I, Chapman MG, Fogelman I. Premenopausal bone loss in the lumbar spine and neck of femur: A study of 225 caucasian women. Bone 1990; 11: 1-5.

  16. Sowers MB, Clark MK, Hollis B, Wallace RB, Jannausch M. Radial bone mineral density in pre and perimenopausal women. A prospective study of rates and risk factors for loss. J Bone Miner Res 1992; 7: 647-657.

  17. Hansen MA. Assessment of age and risk factors on bone density and bone turnover in healthy premenopausal women. Osteoporosis Int 1994; 4: 123-128.

  18. Christiansen C. Postmenopausal bone loss and the risk of osteoporosis. Osteoporosis Int 1994; 4(Suppl 1): S47-S51.

  19. Recker R, Lappe J, Kimmel D, Davies K. Longitudinal studies of perimenopausal bone loss. J Bone Miner Res 1995; 10: S147.

  20. Hansen MA, Overgaard K, Christiansen C. Spontaneous postmenopausal bone loss in different skeletal areas: Followed up for 15 years. J Bone Miner Res 1995; 10: 205-210.

  21. Garnero P, Sornay-Rendu E, Chapuy MC, Delmas PD. Increased bone turnover in late postmenopausal women is a major determinant of osteoporosis. J Bone Miner Res

  22. 1996; 11: 337-349.

  23. Kanis JA, Melton U, Christiansen C, Johnston C. The diagnosis of osteoporosis. J Bone Min Res 1994; 9: 1137-1141.

  24. World Health Organization. Assessment of fracture risk and its application to screening of postmenopausal osteoporosis. WHO Technical Report Series 843, WHO Geneva, 1994.

  25. Genant HK, Gramp SG, Glüer CC, Faulker KG, Jergas M et al. Universal Standarization for Dual X-ray absorciometry: Patient and Phantom Cross-Calibration Results. J Bone Min Res 1994; 9(10): 1503-1514.

  26. Reid DM, Lanham SA, McDonald AG et al. Speed and comparability of three dual-energy X-ray absorpciometer (DXA) models. In: Overgaard K, Christiansen C (eds). Osteoporosis 1990; 2: 575-577.

  27. Lauritzen JB, Schwarz P, Lund B, McNair P. Changing incidence and residual lifetime risk of common osteoporosis-related fractures. Osteoporosis Int 1993; 3: 127-132.

  28. Cooper C. The crippling consequences of fractures and their impact on quality of life. Am J Med 1997; 103: 125-195.

  29. Meunier PJ. Evidence-based medicine and osteoporosis. A comparison of fracture risk reduction data from osteoporosis randomized trials. Int J Clin Pract 1999; 53: 122-129.

  30. Hoerger TJ et al. Healthcare use among US women aged 45 and older. Total costs and costs selected postmenopausal health risk. J Womens Health 1998; 8: 1077-1089.

  31. Kanis JA, Delmas P, Burckhardt et al. Guidelines for diagnosis and management for osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporosis Int 1997; 7: 390-406.

  32. Jalovaara P, Virkkunen H. Quality of life after primary hemiarthroplasty for femoral neck fracture: 6-year followup of 185 patients. Acta Orthop Scand 1991; 62: 208-217.

  33. Allander E et al. Falls and hip fracture. A reasonable basis for prevention? Scand J Rheumatol 1996; 25(suppl 103): 49-52.

  34. Delezé M, Aguirre E, Villa A, Calva J, Cons F et al. The Prevalence of Osteoporosis and Osteopenia by DEXA in an Apparently Healthy Mexican population. A Multicenter Study. Arthritis Rheum 1997; (suppl)40: 9: S41.

  35. Delezé M, Aguirre E, Villa A, Calva J, Cons F et al. Prevalencia de osteopenia y osteoporosis en México. Estudio Multicéntrico. Rev Med Intern Mex 1997; 13: (suppl): 4.

  36. Arlot ME, Sonray-Rendu E, Garnero P, Vey-Marty B, Delmas PD. Apparent Pre and Postmenopausal bone loss evaluated by DXA at different skeletal sites in women: The OFELY cohort. J Bone Miner Res 1997; 12(4): 683-690.

  37. Consensus Development Conference: Diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 1993; 94: 646-650.

  38. Anonymous. Osteoporosis: review of the evidence for prevention, diagnosis and treatment and cost-effectiveness analysis: status report. Osteoporosis Int 1998: 8 (suppl 4)S1-S88.

  39. Poor G et al. Determinants of Reduced Survival Following Hip Fractures in Men. Clin Orthop 1995; 319: 260-65.

  40. Kanis JA, Johnell O. The burden of osteoporosis. J Endocrinol Invest 1999; 22: 583-588.

  41. Riggs BL, Wahner WH, Dunn WL, Mazess RB, Offord KP, Melton U III. Differencial changes in bone mineral density of the appendicular and axial skeleton with aging. Relationship with to spinal osteoporosis. J Clin Invest 1981; 67: 328-335.

  42. Hansen MA, Overgaard K, Riis BJ, Christiansen C. Role of peak bone mass and bone loss in postmenopausal osteoporosis: 12 year study. Br Med J 1991; 303: 961-964.

  43. Delmas PD. Hormone replacement therapy in the prevention and treatment of osteoporosis. Osteoporosis Int 1997; Suppl 1: 5357.

  44. Riggs BL, Wahner WH, Seeman E, Offord KP, Dunn WL, Mazess RB, Johnson KA, Melton U III. Changes in bone mineral density of the proximal femur and spine whith aging. J Clin Invest 1982; 70: 716-723.

  45. Riggs BL, Wahner WH, Melton U III, Richelson LS, Judd L, Offord KP. Rates of bone loss in the appendicular and axial skeletons of women: Evidence of substantial vertebral bone loss before menopause. J Clin Invest 1986; 77: 1487-1491.

  46. Hui SL, Slemenda CW, Johnston CC, Appledorm CR. Effects of age and menopause on vertebral bone density. Bone Miner 1987; 2: 141-146 .

  47. Saambrook PN, Eisman JA, Furler SM, Pocock NA. Computer modeling and analysis of cross-sectional bone density studies with respect to age and the menopause. J Bone Miner Res 1987; 2: 119-114.

  48. Nilas L, Gotfresen A, Hadberg A, Christiansen C. Age related bone loss in women evaluated by single and dual photon technique. Bone Miner 1988; 4: 95-103.

  49. Hedlund LR, Gallagher JC. The effect of age and menopause on bone mineral density of the proximal femur. J Bone Miner Res 1989; 4: 639-642.

  50. Rodin A, Murby B, Smith MA, Caleffi M, Fentiman I, Chapman MG, Fogelman I. Premenopausal bone loss in the lumbar spine and neck of femur: A study of 225 caucasian women. Bone 1990; 11: 1-5.

  51. Sowers MB, Clark MK, Hollis B, Wallace RB, Jannausch M. Radial bone mineral density in pre and perimenopausal women. A prospective study of rates and risk factors for loss. J Bone Miner Res 1992; 7: 647-657.

  52. Hansen MA. Assessment of age and risk factors on bone density and bone turnover in healthy premenopausal women. Osteoporosis Int 1994; 4: 123-128.

  53. Christiansen C. Postmenopausal bone loss and the risk of osteoporosis. Osteoporosis Int 1994; 4(Suppl 1): S47-S51.

  54. Recker R, Lappe J, Kimmel D, Davies K. Longitudinal studies of perimenopausal bone loss. J Bone Miner Res 1995; 10: S147.

  55. Hansen MA, Overgaard K, Christiansen C. Spontaneous postmenopausal bone loss in different skeletal areas: Followed up for 15 years. J Bone Miner Res 1995; 10: 205-210.

  56. Garnero P, Sornay-Rendu E, Chapuy MC, Delmas PD. Increased bone turnover in late postmenopausal women is a major determinant of osteoporosis. J Bone Miner Res 1996; 11: 337-349.

  57. Kanis JA, Melton U, Christiansen C, Johnston C. The diagnosis of osteoporosis. J Bone Min Res 1994; 9: 1137-1141.

  58. World Health Organization. Assessment of fracture risk and its application to screening of postmenopausal osteoporosis. WHO Technical Report Series 843, WHO Geneva, 1994.

  59. Genant HK, Gramp SG, Glüer CC, Faulker KG, Jergas M et al. Universal Standarization for Dual X-ray absorciometry: Patient and Phantom Cross-Calibration Results. J Bone Min Res 1994; 9(10): 1503-1514.

  60. Reid DM, Lanham SA, McDonald AG et al. Speed and comparability of three dual-energy X-ray absorpciometer (DXA) models. In: Overgaard K, Christiansen C (eds). Osteoporosis 1990; 2: 575-577.

  61. Lauritzen JB, Schwarz P, Lund B, McNair P. Changing incidence and residual lifetime risk of common osteoporosis-related fractures. Osteoporosis Int 1993; 3: 127-132.

  62. Cooper C. The crippling consequences of fractures and their impact on quality of life. Am J Med 1997; 103: 125-195.

  63. Meunier PJ. Evidence-based medicine and osteoporosis. A comparison of fracture risk reduction data from osteoporosis randomized trials. Int J Clin Pract 1999; 53: 122-129.

  64. Hoerger TJ et al. Healthcare use among US women aged 45 and older. Total costs and costs selected postmenopausal health risk. J Womens Health 1998; 8: 1077-1089.

  65. Kanis JA, Delmas P, Burckhardt et al. Guidelines for diagnosis and management for osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporosis Int 1997; 7: 390-406.

  66. Jalovaara P, Virkkunen H. Quality of life after primary hemiarthroplasty for femoral neck fracture: 6-year followup of 185 patients. Acta Orthop Scand 1991; 62: 208-217.

  67. Allander E et al. Falls and hip fracture. A reasonable basis for prevention? Scand J Rheumatol 1996; 25(suppl 103): 49-52.

  68. Delezé M, Aguirre E, Villa A, Calva J, Cons F et al. The Prevalence of Osteoporosis and Osteopenia by DEXA in an Apparently Healthy Mexican population. A Multicenter Study. Arthritis Rheum 1997; (suppl)40: 9: S41.

  69. Delezé M, Aguirre E, Villa A, Calva J, Cons F et al. Prevalencia de osteopenia y osteoporosis en México. Estudio Multicéntrico. Rev Med Intern Mex 1997; 13: (suppl): 4.

  70. Arlot ME, Sonray-Rendu E, Garnero P, Vey-Marty B, Delmas PD. Apparent Pre and Postmenopausal bone loss evaluated by DXA at different skeletal sites in women: The OFELY cohort. J Bone Miner Res 1997; 12(4): 683-690.




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