Zonana-Nacacha A, Armenta-Rivera OT

Language: Spanish
References: 25
Page: 291-296
PDF size: 60.31 Kb.

ABSTRACT

Objective To know the frequency and factors associated with the intake of calcium (Ca), vitamin D supplements and use of hormone replacement therapy (HRT) among postmenopausal (PM) health professionals women.
Methods. During January to June 2004, health workers women of IMSS General Hospitals in Tijuana and Ensenada, Baja California, Mexico, were invited to participate. An interview and measurement of calcaneous bone mineral density (BMD) were performed. The following variables were assessed: sociodemographic, clinic and gynecologic features. We defined preventive osteoporosis (OP) treatment as the use of HRT, intake of Ca supplements (≥1000 mg/ day) and supplements of vitamin D for a least six months.
Results: Among 739 women interviewed, 312 were PM, and 31%, 25% and 31% have been taking Ca supplements, vitamin D, and HRT respectively. Calcium, vitamin D supplements intake and use of HTR was similar during the menopause evolution. The variables significantly associated with the use of preventive OP treatment were older age, low weight, previous ooferectomy and use of corticosteroids. In the multivariate analysis, age and underweight were significantly associated with a low bone mass density, independently of the use of preventive OP treatment
Conclusions. The frequency and length of time of Ca, vitamin D supplements intake and use of HRT was low, and 50% of PM health professional women are not under preventive OP therapy.

REFERENCES

1. Heaney RP. Pathophysiology of osteoporosis. Endocrinol Metab Clin North Am 1998;27:255-265.

2. Reid IR, Ames RW, Evans MC, Gamble GD, Sharpe SJ. Effect of calcium supplementation on bone loss in postmenopausal women. N Engl J Med 1993; 328:460-464.

3. Di Daniele N, Carbonelli MG, N, lacopino L, De Lorenzo A, Andreoli A. Effect of supplementation of calcium and D on bone mineral density and bone mineralcontent in peri- and post-menopause; women; a double-blind, randomized, controlled trial. Pharmacol Res 2004;50:637-641.

4. Suzuki Y, Whiting SJ, Davison KS, Chilibeck PD. Total calcium intake is associated with cortical bone mineral density in a cohort of postmenopausal women not taking estrogen. J Nutr Health Aging 2003;7:296-299.

5. Dawson-Hughes B, Harris SS; Krall EA, Dallal GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. New Engl J Med 1997;337:670-676.

6. Anderson GL, Limacher M, Assaf AR, Bassford T, Beresford SA, Black H, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA.2004;291:1701-1712.

7. Barrett-Connor E. Hormone replacement therapy: BMJ 1998;317:457-461.

8. Cauley JA, Seeley GD, Ensrud K, Ettinger B, Black D, Cummings SR. Estrogen replacement therapy and fractures in older women: Study oF Osteoporotic Fractures Research Group. Ann Intern Med 1995:122:9-116.

9. NIH Consensus conference. Optimal calcium intake. NIH Consensus Development Panel on Optimal Calcium Intake. JAMA 1994;272:1942-1948.

10. Arab L, Carriquiry A, Steck-Scott S, Gaudet MM. Ethnic differences in the nutrient intake adequacy of premenopausal US women: results from the Third National Health Examination Survey. J Am Diet Assoc 2003;103:1008-1014.

11. Masse PG, Dosy J, Tranchant CC, Dallaire R. Dietary macro- and micronutrient intakes of nonsupplemented pre- and postmenopausal women with a perspective on menopause-associated diseases. J Hum Nutr Diet 2004;17:121-132.

12. Greer FR, Krebs NF. American Academy of Pediatrics Committee on Nutrition. Optimizing bone health and calcium intakes of infants, children, and adolescents. Pediatrics 2006;117:578-585.

13. Flores M, Melgar H, Cortes C, Rivera M, Rivera J, Sepulveda J. Consumo de energía y nutrimentos en mujeres mexicanas en la edad reproductiva. Salud Pub Mex 1998;40:161-171.

14. Manson JE, Martin KA. Postmenopausal hormone replacement therapy. New Engl J Med 2001;345:34-40.

15. Shea B, Wells G, Cranney A, Zytaruk N, Robinson V, Griffith L et al. VII. Meta- Analysis of Calcium Supplementation for the Prevention of Postmenopausal Osteoporosis. Endocr Rev 2002; 23: 552-559.

16. Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ 3rd. Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985-1989. J Bone Miner Res 1992;7:221-227.

17. Eisman J, Clapham S, Kehoe L. Australian Bone Care Study. Osteoporosis prevalence and levels of treatment in primary care: the Australian Bone Care Study. J Bone Miner Res 2004;19:1969-1975.

18. Ip TP, Lam CL, Kung AW. Awareness of osteoporosis among physicians in China. Osteoporos Int 2004;15:329-334.

19. Simonelli C, Killeen K, Mehle S, Swanson L. Barriers to osteoporosis identification and treatment among primary care physicians and orthopedic surgeons. Mayo Clin Proc 2002;77:334-338.

20. Geller SE, Derman R. Knowledge, beliefs, and risk factors for osteoporosis among African-American and Hispanic women. J Natl Med Assoc 2001;93:13-21.

21. Deleze M, Cons-Molina F, Villa AR, Morales-Torres J, Gonzalez-Gonzalez JG, Calva JJ, et al. Geographic differences in bone mineral density of Mexican women. Osteoporos Int 2000;11:562-569.

22. Riedt CS, Cifuentes M, Stahl T, Chowdhury HA, Schlussel Y, Shapses SA. Overweight postmenopausal women lose bone with moderate weight reduction and 1 g/day calcium intake. J Bone Miner Res 2005;20:455-463.

23. Lopez-Caudana AE, Tellez-Rojo Solis MM, Hernandez-Avila M, Clark P, Juarez-Marquez SA, et al. Predictors of bone mineral density in female workers in Morelos State, Mexico. Arch Med Res 2004;35:172-180.

24. Ravn P, Cizza G, Bjarnason NH, Thompson D, Daley M, Wasnich RD, et. al. Low body mass index is an important risk factor for low bone mass and increased bone loss in early postmenopausal women. Early Postmenopausal Intervention Cohort (EPIC) study group. J Bone Miner Res 1999,14:622-627.

25. Deleze M. Osteoporosis. Una area dinamica de la medicina. Recomendaciones internacionales en el año 2000 para diagnostico y trtamiento. Rev Mex Reumatt 200116:209-214.