Consumo de calcio en mujeres jóvenes y factores de riesgo que favorecen la osteoporosis en la postmenopausia / Calcium consumption in young women and risk factors that favor osteoporosis in postmenopause

Fundamentos: La osteoporosis es una enfermedad crónica ósea considerada un problema de salud pública, cuya prevalencia es mayor en mujeres que en hombres. Debido a ello el objetivo fue evaluar el consumo de calcio diario en 138 mujeres jóvenes de la localidad de Makallé, Chaco, teniendo en cuenta sus requerimientos y señalar los factores de riesgo. Métodos: Estudio descriptivo de corte transversal, una vez obtenido el consentimiento de los encuestados, se aplicó una encuesta online estructurada con preguntas cerradas y abiertas dividida en dos secciones, para determinar elnivel de conocimiento de calcio y su frecuencia de consumo. Se analizó la distribución de frecuencias y se realizaron análisis de varianza para ver las diferencias entre grupos. Resultados: Se obtuvieron 136 respuestas, que evidenciaron que el 60% de las mujeres conoce la importancia del consumo de calcio y el momento fundamental de su consumo; el 82% conoce los alimentos fuentes del mineral y sus factores inhibidores como el alcohol el 42% y las bebidas cola el 39%. Por otra parte, demostraron desconocer cómo prevenir pérdidas del mineral un 40% siendo solo el 28% de respuestas correctas. El 50% conocía la enfermedad de osteoporosis y el 49% cómo prevenirla. Conclusiones: Se pudo determinar en las encuestadas que muchas mujeres no cubren el requerimiento diario promedio de calcio a través de la alimentación, teniendo en cuenta los factores que inhiben su absorción lo cual predispone a mayor riesgo de osteoporosis a edad avanzada. Esto señala la necesidad de establecer un programa de prevención sobre la osteoporosis. (AU)

Background: Osteoporosis is a chronic bone disease considered a public health problem and being more prevalent in women than in men. Therefore, the importance of studying young women in the age range in which they are closeto the maximum bone peak since it is a preventable disease. Due to this problem, the main objective is to evaluate the daily calcium consumption in 138 young women from the town of Makallé, Chaco, taking into account their requirements and pointing out the risk factors. Methods: Descriptive cross-sectional study, once the consent of the respondents was obtained, a structured online survey with closed and open questions was applied, divided into two sections, to determine the level of knowledge of calcium and its frequency of consumption. The results are presented in tables and graphs of frequency distribution and being significant when the value of p was less than 0.05. Results: 136 responses were obtained, which showed that 60% of the women know the importance of calciumconsumption and the fundamental moment of its consumption; 82% know the food sources of the mineral and its inhibitory factors such as alcohol 42% and cola drinks 39%. In addition, they demonstrated not knowing how to prevent mineral losses by 40%, with only 28% being correct. 50% know about osteoporosis disease and 49% know how to prevent it. Conclusions: It was determined that the surveyed women do not meet their average daily calcium requirementthrough food, taking into account the factors that inhibit its absorption, which predisposes them to a higher risk of osteoporosis in advanced age. This point to the need to establish a prevention program on osteoporosis since it iscurrently considered a public health problem. (AU)

Closing the gap in osteoporosis management: the critical role of primary care in bone health.

OBJECTIVE: The World Health Organization issued a call to action for primary care to lead efforts in managing noncommunicable diseases, including osteoporosis. Although common, osteoporosis remains underdiagnosed and undertreated. Primary care practitioners (PCPs) are critical in identifying individuals at risk for osteoporosis and osteoporotic fractures; however, recent advances in assessment, diagnosis, and treatment of osteoporosis have not been incorporated into clinical practice in primary care due to numerous reasons including time constraints and insufficient knowledge. To close this gap in clinical practice, we believe PCPs need a practical strategy to facilitate osteoporosis assessment and management that is easy to implement. METHODS: In this article, we consolidate information from various global guidelines and highlight areas of agreement to create a streamlined osteoporosis management strategy for a global audience of PCPs. RESULTS: We present a systematic approach to facilitate osteoporosis assessment and management that includes four steps: (1) identifying patients at risk through proactive screening strategies, (2) investigating and diagnosing patients, (3) intervening with personalized treatment plans, and (4) implementing patient-centered strategies for long-term management and monitoring of patients. CONCLUSION: Primary care has a central role in ensuring the incorporation of key elements of holistic care as outlined by the World Health Organization in managing noncommunicable diseases including osteoporosis; namely, a people-centered approach, incorporation of specialist services, and multidisciplinary care. This approach is designed to strengthen the health system's response to the growing osteoporosis epidemic.

Osteoporosis is a chronic condition associated with aging in which bones become "porous" and weak, and are more likely to break (i.e., fracture) even with minimal trauma such as tripping or falling from a standing height. A broken bone is a serious condition that not only affects daily activities, but can also lead to reduced quality of life, need for caregiver support, work loss, hospital and rehabilitation costs, nursing home costs, and increased mortality. Although osteoporosis is common, it is often undiagnosed or untreated, leaving many people at risk for experiencing broken bones. A broken bone increases the risk of more broken bones. Given the growing size of the aging global population, osteoporosis and the risk of broken bones represent an urgent problem and growing burden. We need ways to make it easier for primary care practitioners (PCPs), such as family physicians, internists, physician assistants, nurse practitioners, and nurses, to include osteoporosis care as part of routine clinical visits. In this article, we discuss the critical role of PCPs in early detection, diagnosis, and treatment of osteoporosis as they are often the first point of contact for at-risk patients. We present a simple, four-step approach to help PCPs and patients navigate the journey from osteoporosis diagnosis to a treatment plan. The four steps are to: (1) identify at-risk patients by screening for weak bones or osteoporosis, (2) perform necessary tests to diagnose patients, (3) develop a personalized treatment plan, and (4) determine long-term strategies for managing and monitoring bone health.

The prevalence and risk factors for osteoporosis among 18- to 49-year-old Turkish women.

The aim of this study was to determine the prevalence of osteoporosis and associated risk factors in Turkish women aged 18-49 years. A population-based, cross-sectional study was conducted between January and April 2014. The sample (n = 1,792) was comprised of women aged 18-49 years, who resided in Cubuk, Ankara, Turkey, and were selected by simple random sampling. The data were collected in face-to-face interviews using an Individual Information Form and an Osteoporosis Risk Estimation Scale. Bone mineral density was assessed using standard dual-energy X-ray absorptiometry. Multiple logistic regression and chi-square analyses were used for analyses. Most participants (80.1%) were at low risk of developing osteoporosis, while 6.9% were at medium to high risk of developing the disease. From bone mineral density levels, 33.3% were osteopenic; 4.0% were osteoporotic; 33.3% were osteopenic at the femoral neck; and 6.7% were osteoporotic at the lumbar vertebra L1-L4. Further, results of multiple logistic regression analyses showed that osteoporosis risk was significantly associated with smoking, having light skin, multiparity, and having a family history of osteoporosis (p < .05). These results indicated that public health screening strategies for protecting women's bone health at earlier ages than previously thought might be beneficial.

Combined effects of collagen type I alpha1 (COL1A1) Sp1 polymorphism and osteoporosis risk factors on bone mineral density in Turkish postmenopausal women.

Identification of risk factors for osteoporosis has been essential for understanding the development of osteoporosis. The collagen type I alpha1 (COL1A1) gene is suggested to be implicated in reduced bone mineral density (BMD) in osteoporosis. In the present study, the investigation of the effects of Sp1 polymorphic variants of COL1A1 gene on BMD values, and the determination of the association between COL1A1 Sp1 gene variants and osteoporosis risk factors in the context of gene-environment interaction in Turkish postmenopausal women were aimed. For the detection of COL1A1 Sp1 polymorphism, PCR-RFLP techniques have been used. BMD for lumbar spine (L1-L4) and hip (femoral neck and total hip) was measured by DXA. This study was carried out using a sample of 254 postmenopausal women. We observed a trend decrease in BMD values in the subjects with "ss" genotype having lower BMD of lumbar spine, femoral neck and total hip than those with "SS" and "Ss" genotype, however the differences did not reach statistical significance (P>0.05). We also found that the frequencies of the BMD under mean values at the femoral neck (57.5%) and total hip (76.2%) increased considerably in the subjects carrying "Ss/ss" genotypes in combination of having family history of osteoporosis (61.5% for femoral neck) and smoking history (90.0% for total hip). This population-based study indicates that COL1A1 Sp1 polymorphism may contribute to the development of osteoporosis in combination of osteoporosis risk factors in Turkish postmenopausal women.

Decreased bone mineral density and associated risk factors in hospital visiting people of Islamabad.

OBJECTIVE: TBesides aging there are multiple factors involved in decreasing Bone Mineral Density. Knowing the burden of the diseaseand its related factors in our population can help better treat this. Therefore, our objective was to identify subjects with low Bone Mineral Density (BMD) and its risk factors in hospital visiting people in Islamabad. METHODS: Descriptive cross sectional study was conducted atRawal Institute of Health Sciences, Islamabad in 3rd week of June, 2014. Total 300 persons including patients, attendants and hospital staff were selected.Calcaneus BMD was measured usingultrasound bone densitometer. T-score was calculated.Specific questionnaire form was filled to identify risk factors. Prevalence and prevalence ratio was calculated. RESULTS: Out of 300 study sample, 178 (59.3%) are females. Mean age of the study population is 37.34 (SD=12.93). Overall, prevalence of osteopaenia and osteoporosis in the study population is 107 (35.7%) and 5 (1.7%) respectively. Prevalence of osteopaenia is seen more in elderly subjects, females, people with low Body Mass Index (BMI), people who are usually not exposed to sunlight and who are mostly bound to houses. CONCLUSIONS: Decreased BMD is associated with increasing age, female gender, low BMI, little exposure to sun light and being restrained to homes. It is not affected by daily milk intake, parity of females, cola drinking and smoking in our part of the world.

Indications of DXA in women younger than 65 yr and men younger than 70 yr: the 2013 Official Positions.

Dual-energy X-ray absorptiometry (DXA) is the method of choice to assess fracture risk for women 65 yr and older and men 70 yr and older. The 2007 International Society for Clinical Densitometry Official Positions had developed guidelines for assessing bone density in younger women during and after the menopausal transition and in men 50-69 yr and the 2008 National Osteoporosis Foundation (NOF) guidelines recommended testing in postmenopausal women younger than 65 yr and men 50-69 yr only in the presence of clinical risk factors. The purpose of the 2013 DXA Task Force was to reassess the NOF guidelines for ordering DXA in postmenopausal women younger than 65 yr and men 50-69 yr. The Task Force reviewed the literature published since the 2007 Position Development Conference and 2008 NOF, reviewing clinical decision rules such as the Osteoporosis Screening Tool and FRAX and sought to keep recommendations simple to remember and implement. Based on this assessment, the NOF guidelines were endorsed; DXA was recommended in those postmenopausal women younger than 65 yr and men 50-69 yr only in the presence of clinical risk factors for low bone mass, such as low body weight, prior fracture, high-risk medication use, or a disease or condition associated with bone loss.

Risk factors for spinal osteoporosis as compared with femoral osteoporosis in urban Iranian women.

BACKGROUND: We aimed to define and compare the risk factors of spinal and femoral osteoporosis in postmenopausal Iranian women. METHOD: It was a multicentre based study carried out in two stages during 2002 to 2005 among post menopausal women in Tehran. In first stage case group included 140 women with diagnosed spinal osteoporosis using DEXA method as definition of WHO and Controls were 167 women with normal spinal BMD. In second stage, among the same study population case groups were 72 women with total femoral neck osteoporosis. The controls included 191 women with normal femoral BMD.' Odds Ratio was used for estimation the association of risk factors with spinal and femoral osteoporosis. RESULTS: PLUS COMMON WELL KNOWN OSTEOPOROSIS RISK FACTORS, SIGNIFICANT RISK FACTORS FOR EACH REGION WITH THEIR ODDS RATIOS INCLUDED: Steroid use (2.4) and low activity (3.6) for femoral osteoporosis and parity>3 (2) and lactation duration > 2 yr (1.9) for spinal osteoporosis. CONCLUSIONS: There are some common and different protective and risk factors for spinal and femoral osteoporosis in this population.

The value of calcaneal bone mass measurement using a dual X-ray laser Calscan device in risk screening for osteoporosis.

OBJECTIVE: To evaluate how bone mineral density in the calcaneus measured by a dual energy X-ray laser (DXL) correlates with bone mineral density in the spine and hip in Turkish women over 40 years of age and to determine whether calcaneal dual energy X-ray laser variables are associated with clinical risk factors to the same extent as axial bone mineral density measurements obtained using dual energy x-ray absorbtiometry (DXA). MATERIALS AND METHODS: A total of 2,884 Turkish women, aged 40-90 years, living in Ankara were randomly selected. Calcaneal bone mineral density was evaluated using a dual energy X-ray laser Calscan device. Subjects exhibiting a calcaneal dual energy X-ray laser T- score < or = -2.5 received a referral for DXA of the spine and hip. Besides dual energy X-ray laser measurements, all subjects were questioned about their medical history and the most relevant risk factors for osteoporosis. RESULTS: Using a T-score threshold of -2.5, which is recommended by the World Health Organization (WHO), dual energy X-ray laser calcaneal measurements showed that 13% of the subjects had osteoporosis, while another 56% had osteopenia. The mean calcaneal dual energy X-ray laser T-score of postmenopausal subjects who were smokers with a positive history of fracture, hormone replacement therapy (HRT), covered dressing style, lower educational level, no regular exercise habits, and low tea consumption was significantly lower than that obtained for the other group (p<0.05). A significant correlation was observed between the calcaneal dual energy X-ray laser T-score and age (r= -0.465, p=0.001), body mass index (BMI) (r=0.223, p=0.001), number of live births (r= -0.229, p=0.001), breast feeding time (r= -0.064, p=0.001), and age at menarche (r= -0.050, p=0.008). The correlations between calcaneal DXL and DXA T-scores (r=0.340, p=0.001) and calcaneal DXL and DXA Z-scores (r=0.360, p=0.001) at the spine, and calcaneal DXL and DXA T- scores (r=0.28, p=0.001) and calcaneal DXL and DXA Z-scores (r=0.33, p=0.001) at the femoral neck were statistically significant. CONCLUSION: Bone mineral density measurements in the calcaneus using a dual energy X-ray laser are valuable for screening Turkish women over 40 years of age for the risk of osteoporosis.

The value of calcaneal bone mass measurement using a dual X-ray laser calscan device in risk screening for osteoporosis

OBJECTIVE: To evaluate how bone mineral density in the calcaneus measured by a dual energy X-ray laser (DXL) correlates with bone mineral density in the spine and hip in Turkish women over 40 years of age and to determine whether calcaneal dual energy X-ray laser variables are associated with clinical risk factors to the same extent as axial bone mineral density measurements obtained using dual energy x-ray absorbtiometry (DXA). MATERIALS AND METHODS: A total of 2,884 Turkish women, aged 40-90 years, living in Ankara were randomly selected. Calcaneal bone mineral density was evaluated using a dual energy X-ray laser Calscan device. Subjects exhibiting a calcaneal dual energy X-ray laser T- score <-2.5 received a referral for DXA of the spine and hip. Besides dual energy X-ray laser measurements, all subjects were questioned about their medical history and the most relevant risk factors for osteoporosis. RESULTS: Using a T-score threshold of -2.5, which is recommended by the World Health Organization (WHO), dual energy X-ray laser calcaneal measurements showed that 13 percent of the subjects had osteoporosis, while another 56 percent had osteopenia. The mean calcaneal dual energy X-ray laser T-score of postmenopausal subjects who were smokers with a positive history of fracture, hormone replacement therapy (HRT), covered dressing style, lower educational level, no regular exercise habits, and low tea consumption was significantly lower than that obtained for the other group (p<0.05). A significant correlation was observed between the calcaneal dual energy X-ray laser T-score and age (r=-0.465, p=0.001), body mass index (BMI) (r=0.223, p=0.001), number of live births (r=-0.229, p=0.001), breast feeding time (r=-0.064, p=0.001), and age at menarche (r=-0.050, p=0.008). The correlations between calcaneal DXL and DXA T-scores (r=0.340, p=0.001) and calcaneal DXL and DXA Z-scores (r=0.360, p=0.001) at the spine, and calcaneal DXL and DXA T- ...