Association between body mass index and osteoporosis in women from northwestern Rio Grande do Sul / Associação entre o índice de massa corporal e osteoporose em mulheres da região noroeste do Rio Grande do Sul

ABSTRACT Objective: To investigate the association between body mass index (BMI) and bone mineral density (BMD) in postmenopausal women. Methods: Observational study with postmenopausal women who underwent bone densitometry in Palmeira das Missões - RS. Sociodemographic data, risk for osteoporosis and food intake were assessed through a specific form. BMI was calculated according to WHO criteria. The assessment of BMD was performed by dual-energy X-ray absorptiometry (DXA) and classified according to WHO. Statistical analysis was performed using prevalence ratios (PR) and their respective 95% confidence intervals for the factors studied. Variables associated with p < 0.20 with the different outcomes (osteopenia and osteoporosis) were included in a Poisson regression model with robust variance to adjust for potential confounding factors. A 5% significance level was considered. Results: 393 postmenopausal women with a mean age of 59.6 ± 8.2 years participated.After the adjustments, the normal weight women had 1.2 times the prevalence of osteopenia of obese women (PR = 1.2; CI 95% 1.3-1.5). Considering osteoporosis, the PR of euthophic women was twice the PR of obese women (PR = 2; CI 95% 1.4-2.9) and was 1.7 times greater for overweight group compared to obese category (PR = 1.7; CI 95% 1.2-2.5). Conclusion: Obese women had lower prevalence of osteopenia compared with normal weight subjects and also with lower prevalence of osteoporosis as compared to normal- and overweight women.

RESUMO Objetivo: Verificar a associação entre o índice de massa corporal (IMC) e a densidade mineral óssea (DMO) em mulheres pós-menopáusicas. Métodos: Estudo observacional, com mulheres pós-menopáusicas submetidas à densitometria óssea em Palmeira das Missões (RS). Dados sociodemográficos, de risco para a osteoporose e do consumo alimentar foram avaliados por meio de formulário específico. O IMC foi calculado de acordo com a Organização Mundial de Saúde (OMS). A avaliação da DMO foi feita por meio de absorciometria por dupla emissão de raios-X (DXA) e classificada de acordo com a OMS. A análise estatística foi feita por meio de razões de prevalência (RP) e os seus respectivos intervalos de 95% de confiança para os fatores em estudo. Variáveis que se associaram com p < 0,20 com os diferentes desfechos (osteopenia e osteoporose) foram incluídas em um modelo de regressão de Poisson com variância robusta para ajuste para potenciais fatores de confusão. Foi considerado um nível de significância de 5%. Resultados: Participaram 393 mulheres pós-menopáusicas, com média de 59,6 ± 8,2 anos.Após os ajustes, as mulheres eutróficas apresentaram 1,2 vez a prevalência de osteopenia das mulheres obesas (RP = 1,2; IC 95% 1,3-1,5). E em relação à osteoporose, no grupo das eutróficas a RP foi duas vezes a RP das obesas (RP = 2; IC 95% 1,4-2,9) e 1,7 no grupo com sobrepeso em relação à categoria obesidade (RP = 1,7; IC 95% 1,2-2,5). Conclusões: As mulheres obesas apresentaram menor prevalência de osteopenia em comparação com as eutróficas, bem como tiveram menor prevalência de osteoporose em comparação com as mulheres eutróficas e com sobrepeso.

Association between self-reported oral health, tooth loss and atherosclerotic burden

Previous studies have suggested that oral diseases may influence the development of atherosclerosis. The aim of this study was to test the hypothesis that poor self-reported oral health (SROH) and tooth loss are positively associated with coronary atherosclerotic burden (CAB). 382 consecutive subjects undergoing coronary angiography were included. Socio-demographic characteristics, cardiovascular risk factors and oral health status were collected using a standardized questionnaire, including data on SROH and use of dental prosthesis. Number of teeth and anthropometric measures were collected through clinical examinations. CAB at coronary angiography was quantified using the Friesinger score (FS). Prevalence ratios (PR) were calculated with Poisson regression analyses. Mean age was 60.3 ± 10.8 years, with 63.2% males. In the bivariate analysis, there was a significant association (p < 0.05) between CAB and age (> 60y) (PR = 1.01, 95%CI = 1.02-1.16), male gender (PR = 1.11, 95%CI = 1.03-1.19), smoking (PR = 1.08, 95%CI = 1.01- 1.16), hypertension (PR = 1.12, 95%CI = 1.03-1.22), diabetes (PR = 1.17, 95%CI = 1.05-1.21), poor SROH (PR = 1.22, 95%CI = 1.02-1.46) and tooth loss (< 20teeth present) (PR = 1.10, 95%CI = 1.02-1.19). The use of dental prosthesis was not associated with CAB. The multivariate models, adjusted for age, gender, smoking, hypertension, diabetes and dyslipidemia showed that poor SROH (p = 0.03) and tooth loss (p = 0.02) were independently associated with CAB, confirming the study hypothesis.

Associação de diferentes medidas e índices antropométricos com a carga aterosclerótica coronariana / Association of different anthropometric measures and indices with coronary atherosclerotic burden

FUNDAMENTO: A associação entre parâmetros antropométricos e carga aterosclerótica ainda não está bem estabelecida e poucos estudos na literatura abordam esse tema. OBJETIVO: Avaliar a associação de diferentes parâmetros antropométricos com a carga aterosclerótica coronariana. MÉTODOS: Participaram do estudo pacientes adultos submetidos à cineangiocoronariografia. Dados sociodemográficos e fatores de risco cardiovasculares foram coletados em um questionário padronizado. Foram medidos peso, altura, circunferência da cintura (CC), circunferência abdominal (CABD), circunferência do quadril (CQ) e circunferência do pescoço (CP), com o cálculo do índice de massa corporal (IMC) e das relações cintura-quadril (RCQ), circunferência abdominal-quadril (RCABDQ) e cintura-altura (RCALT). A carga aterosclerótica coronariana na cineangiocoronariografia foi medida pelo Escore de Friesinger (EF). Aterosclerose significativa foi considerada quando o EF > 5. RESULTADOS: A amostra foi constituída por 337 pacientes, dos quais 213 eram homens (63,2 por cento). A idade média foi de 60,1 ± 10 anos. Somente a RCQ (r = 0,159 e p = 0,003) apresentou correlação linear significativa com a carga aterosclerótica coronariana medida pelo EF. Quando separamos a amostra por gênero, nas mulheres encontramos correlação significativa da RCABDQ (r = 0,238 e p = 0,008) e da RCQ (r = 0,198 e p = 0,028) com o EF. Não se encontrou nos homens correlação entre parâmetros antropométricos e EF. Após os ajustes para as variáveis sexo, idade, HAS, tabagismo e DM, nenhum parâmetro antropométrico foi associado com a carga aterosclerótica coronariana medida pelo EF na amostra total ou separada por gênero. CONCLUSÃO: Nenhum parâmetro antropométrico foi fator de risco independente para a carga aterosclerótica coronariana.

BACKGROUND: The association between anthropometric parameters and atherosclerotic burden is not well established and few studies have addressed this issue. OBJECTIVE: To evaluate the association of different anthropometric parameters with the coronary atherosclerotic burden. METHODS: Adult patients undergoing coronary angiography were enrolled in the study. Sociodemographic characteristics and cardiovascular risk factors were collected through a standardized questionnaire. Weight, height, waist circumference (WC), abdominal circumference (AbC), hip circumference (HC) and neck circumference (NC) were measured and body mass index (BMI), waist-hip ratio (WHR), abdominal circumference-hip ratio (AbCHR) and waist-height ratio (WHtR) were calculated. The atherosclerotic burden at the coronary angiography was measured through Friesinger score (FS). Significant atherosclerosis was considered when FS > 5. RESULTS: The sample consisted of 337 patients, of whom 213 were men (63.2 percent). The mean age was 60.1 ± 10 years. Only WHR (r = 0.159 and p = 0.003) showed a significant linear correlation with the coronary atherosclerotic burden as measured by FS. When the sample was stratified by gender, we found a significant correlation between women's AbCHR (r = 0.238 and p = 0.008) and WHR (r = 0.198 and p = 0.028) with FS. Men showed no correlation between anthropometric parameters and FS. After adjusting for gender, age, hypertension, smoking and DM, no anthropometric parameter was associated with coronary atherosclerotic burden as measured by FS in the total sample or when separated by gender. CONCLUSION: No anthropometric parameter was an independent risk factor for coronary atherosclerotic burden.