Objetivo: Avaliar a prevalência de sarcopenia em pacientes idosos portadores de diabetes mellitus (DM), verificando sua associação com histórico de fraturas e quedas. Modelo do estudo: Observacional, transversal e analítico. Metodologia: Estudo realizado em hospital universitário de Campina Grande, Paraíba. Envolveu pacientes idosos (≥60 anos) com DM. Foram excluídos aqueles com diagnóstico de osteoporose. O critério preditor de sarcopenia foi a circunferência da panturrilha (CP): <33 cm para mulheres e <34 cm para homens. Resultados: A amostra válida foi de 44 pacientes, todos com diabetes mellitus tipo 2 (DM2). A prevalência de sarcopenia foi de 20,4%. Houve relação estatisticamente significativa entre sarcopenia e história de fraturas em traumas de baixa energia (p = 0,022). Não houve diferença entre os grupos com e sem sarcopenia em relação à história de quedas no último ano (p = 0,589). Houve associação entre uso de psicotrópicos e ocorrência de quedas (p = 0,001). A maioria dos achados convergiram para aqueles já presentes na literatura. Conclusão: Apesar da CP não ser, de forma isolada, um método estabelecido para o diagnóstico de sarcopenia, a perda muscular apontada por tal medida mostrou-se associada a histórico de fraturas em idosos com DM2, de forma que essa acessível mensuração pode alertar para iniciar intervenções que possam melhorar a qualidade de vida dos idosos.

Primary hyperparathyroidism (PHPT) is an endocrine disorder resulting from the hyperfunction of one or more parathyroid glands, with hypersecretion of parathyroid hormone (PTH). It can be managed by parathyroidectomy (PTX) or non-surgically. Medical therapy with pharmacological agents is an alternative for those patients with asymptomatic PHPT who meet guidelines for surgery but are unable or unwilling to undergo PTX. In this review, we focus upon these non-surgical aspects of PHPT management. We emphasize the most studied and widely used pharmacological alternatives: bisphosphonates, denosumab, cinacalcet and hormone therapy, in addition to combined therapy. We also address the relevant aspects of perioperative management.

Heart failure (HF) is a prevalent clinical syndrome that causes significant physical limitations. Osteoporosis is also an important cause of loss of functionality, and it mainly affects women. There are several reports linking HF and osteoporosis, and both share risk factors. Most of the data available so far point to bone fragility as a consequence of HF, and several mechanisms have been identified to explain this relationship. Among the proposed pathophysiological mechanisms are the hyperactivation of the renin–angiotensin–aldosterone system and the increase in parathyroid hormone, functional limitation, production of inflammatory mediators and the use of drugs for HF. The role of osteoprotegerin has gained attention owing to its cardiovascular and skeletal effects, its observed deficiency during the postmenopausal period along with its compensatory increases in HF and severe osteoporosis. The objective of this review was to perform a literature search for the main evidence on skeletal impairment in HF, with emphasis on women. As for epidemiological studies, we selected data from 3 meta-analyses and 20 individual observational studies, which together showed the interrelationship between the two clinical conditions in terms of both decreased bone density and increased fracture risk. In conclusion, HF and osteoporosis are interrelated conditions mediated by complex pathophysiological mechanisms which may be more relevant for postmenopausal women, considered to be a vulnerable population for both cardiovascular diseases and bone fragility.

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