artigo dE rEvisão rEviEw articlE RESUMO A prevalência de incapacidade e dependência funcional é maior em idosos e está intimamente associada à redução da massa muscular, que ocorre, até mesmo, em indivíduos saudáveis. A sarcopenia parece decorrer da interação complexa de distúrbios da inervação, diminuição de hormônios, aumento de mediadores inflamatórios e alterações da ingestão protéico-calórica que ocorrem durante o envelhecimento. A perda de massa e força muscular é responsável pela redução de mobilidade e aumento da incapacidade funcional e dependência. Quando associada à fragilidade, esta perda gera custos econômicos e sociais. Neste artigo, pretende-se avaliar aspectos relacionados à gênese da sarcopenia, bem como analisar possíveis opções terapêuticas e de prevenção.
OBJECTIVE: To estimate the prevalence and analyze risk factors associated to osteoporosis and low-trauma fracture in women. METHODS: Cross-sectional study including a total of 4,332 women older than 40 attending primary care services in the Greater São Paulo, Southeastern Brazil, between 2004 and 2007. Anthropometrical and gynecological data and information about lifestyle habits, previous fracture, medical history, food intake and physical activity were obtained through individual quantitative interviews. Low-trauma fracture was defined as that resulting from a fall from standing height or less in individuals 50 years or older. Multiple logistic regression models were designed having osteoporotic fracture and bone mineral density (BMD) as the dependent variables and all other parameters as the independent ones. The significance level was set at p<0.05. RESULTS: The prevalence of osteoporosis and osteoporotic fractures was 33% and 11.5%, respectively. The main risk factors associated with low bone mass were age (OR=1.07; 95% CI: 1.06;1.08), time since menopause (OR=2.16; 95% CI: 1.49;3.14), previous fracture (OR=2.62; 95% CI: 2.08;3.29) and current smoking (OR=1.45; 95% CI: 1.13;1.85). BMI (OR=0.88; 95% CI: 0.86;0.89), regular physical activity (OR=0.78; 95% CI: 0.65;0.94) and hormone replacement therapy (OR=0.43; 95% CI: 0.33;0.56) had a protective effect on bone mass. Risk factors significantly associated with osteoporotic fractures were age (OR=1.05; 95% CI: 1.04;1.06), time since menopause (OR=4.12; 95% CI: 1.79;9.48), familial history of hip fracture (OR=3.59; 95% CI: 2.88;4.47) and low BMD (OR=2.28; 95% CI: 1.85;2.82). CONCLUSIONS: Advanced age, menopause, low-trauma fracture and current smoking are major risk factors associated with low BMD and osteoporotic fracture. The clinical use of these parameters to identify women at higher risk for fractures might be a reasonable strategy to improve the management of osteoporosis.
The epidemiology of osteoporotic fractures varies widely among countries and is primarily related to differences in the population and utilization of public healthcare services. Since 1994, over 200 studies about osteoporosis and fractures have been conducted in Brazil, among which 60 have described the current epidemiological status. This work is a compilation of studies published in scientific journals (PubMed, MedLine, Lilacs, SciELO Database) with the respective highlights. Overall, these studies show moderate incidence of hip fracture in subjects over 50 years old. However, the prevalence of all types of bone fragility fracture is higher, ranging from 11% to 23.8%. In addition, there is a high incidence of recurrent falls, which are the main extra-skeletal factor associated with these fractures. According to the national studies, 12 months after femoral fractures, the mortality rate ranged between 21.5% and 30%, and there was also a high rate of physical impairment, deterioration of the quality of life and excessive burden to the healthcare system. Considering its high prevalence and associated mortality and physical impairment, osteoporosis and its main consequence, bone fragility fractures, must be considered a major public health problem in our country.
OBJECTIVE:To estimate the prevalence of self-reported osteoporosis (with previous medical diagnosis) and the associated risk and protection factors. METHODS:A cross-sectional study was carried out, based on data from the system Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL -telephone-based surveillance of risk and protective factors for chronic diseases). A total of 54,369 individuals aged ≥ 18 years living in homes served by at least one fi xed telephone line in Brazilian state capitals and the federal district in 2006 were interviewed. Estimates of osteoporosis in relation to socioeconomic and behavioral factors and the body mass index were stratifi ed according to sex. The risk of occurrence of osteoporosis was calculated for each variable separately and through a multivariate model, taking the odds ratio to be a proxy for the prevalence ratio. RESULTS:The reported prevalence of osteoporosis was 4.4%, predominantly among women (7.0%) ≥ 45 years of age whose marital status was not single and who were former smokers. Among men, age > 65 years, married or widowed status and sedentarism were positively associated with this outcome. CONCLUSIONS:Among the factors associated with osteoporosis, modifi able characteristics relating to disease prevention were highlighted, such as physical activity and smoking habits. The aging of the Brazilian population is refl ected in the current total of more than 16 million individuals over the age of 60 years. This number is projected to exceed 50 million in 2050. DESCRIPTORS:a Consequently, the chances of occurrences of age-related diseases among the population, such as osteoporosis, are increasing.Racial and genetic, anthropometric, sociocultural, economic, nutritional and lifestyle differences, along with the way in which public healthcare resources are used in different countries around the world, contribute towards explaining the divergences in the incidence and prevalence of osteoporosis.A survey conducted in Latin America estimated that the prevalence of osteoporosis in the vertebrae was between 12% and 18% and in the proximal femur, between 8% and 22%, among women over the age of 50 years.9 Clark et al 6 estimated a prevalence of vertebral fractures of 11.2% in a random sample of 1,922 women over the age of 50 years, in fi ve Latin American countries, including Brazil.In São Paulo, in a study on 301 individuals over the age of 70 years, the prevalence of osteoporosis was found to be between 22% and 33% among women and between 6% and 16% among men.3 Among the risk factors most associated with low bone density, advanced age, low consumption of dairy products and daily consumption of alcoholic drinks have been highlighted. On the other hand, high body mass index (BMI ≥ 30 kg/m 2 ) and daily physical activity lasting more than 30 minutes perform a protective role. b However, the prevalence of osteoporosis and factors associated with it among the Brazilian population have not been fully clarifi ed.The aim of the pres...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.