Navegando por Palavras-chave "bone density"
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- ItemSomente MetadadadosThe association between coronary artery calcification progression and loss of bone density in non-dialyzed CKD patients(Dustri-verlag Dr Karl Feistle, 2012-12-01) Watanabe, Renato [UNIFESP]; Lemos, Marcelo Montebello [UNIFESP]; Carvalho, Aluizio Barbosa de [UNIFESP]; Rochitte, Carlos Eduardo; Santos, Raul D.; Draibe, Sergio A. [UNIFESP]; Canziani, Maria Eugenia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Background: Coronary artery calcification (CAC) and low bone density are coexisting deleterious conditions commonly shared by chronic kidney disease (CKD) patients. in the present study, we aimed to investigate whether the progression of CAC was associated with overtime reduction in bone density in non-dialyzed CKD patients. Methods: This is a prospective study of 24 months including 72 non-dialyzed CKD patients Stages 2 - 4 (age 57.6 +/- 10.3 years, 62% male, 22% diabetics). CAC and vertebral bone density (VBD) were measured by computed tomography. Results: At baseline, 46% of the patients had CAC (calcified group) and calcification was not identified in 54% of the patients (non-calcified group). the calcified group was older, predominantly male, and had lower VBD in comparison to non-calcified group. CAC progression was observed only in the calcified group (91% of the patients increased calcium score). the multiple regression analysis revealed loss of VBD as the independent determinant of CAC progression in these patients. Conclusion: CAC progression was associated with loss of VBD in non-dialyzed CKD patients.
- ItemAcesso aberto (Open Access)Densidade mineral óssea de adolescentes com sobrepeso e obesidade(Sociedade Brasileira de Pediatria, 2005-08-01) Cobayashi, Fernanda [UNIFESP]; Lopes, Luiz A. [UNIFESP]; Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Santo AmaroOBJECTIVE: to study bone density as a concomitant factor for obesity in post-pubertal adolescents, controlling for other variables that may interfere in such a relation. METHODS: Study comprising 83 overweight and obese adolescents (BMI > P85) and 89 non obese ones (P5 < BMI < P85). Cases and controls were selected out of 1,420 students (aged 14-19) from a public school in the city of São Paulo. The bone mineral density of the lumbar spine (L2-L4 in g/cm²) was assessed by dual-energy x-ray absorptiometry (LUNAR DPX-L). The variable bone density was dichotomized using 1.194 g/cm² as cutoff point. Bivariate analyses were conducted considering the prevalence of overweight and obesity followed by multivariate analysis (logistic regression) according to a hierarchical conceptual model. RESULTS: The prevalence of bone density above the median was twice more frequent among cases (69.3%) than among controls (32.1%). In the bivariate analysis such prevalence resulted in an odds ratio (OR) of 4.78. The logistic regression model showed that the association between obesity and mineral density is yet more intense with an OR of 6.65 after the control of variables related to sedentary lifestyle and intake of milk and dairy products. CONCLUSION: Obese and overweight adolescents in the final stages of sexual maturity presented higher bone mineral density in relation to their normal-weight counterparts; however, cohort studies will be necessary to evaluate the influence of such characteristic on bone resistance in adulthood and, consequently, on the incidence of osteopenia and osteoporosis at older ages.
- ItemAcesso aberto (Open Access)Doença celíaca em tratamento: avaliação da densidade mineral óssea(Sociedade Brasileira de Pediatria, 2003-08-01) Carvalho, Cecília Noronha De Miranda; Sdepanian, Vera Lucia [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Fagundes Neto, Ulysses [UNIFESP]; Universidade Estadual do Rio de Janeiro; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: the present study was designed to compare the bone mineral density of children and adolescents with celiac disease to the bone mineral density of controls, and to evaluate laboratory analysis of calcium metabolism of celiac disease patients. METHODS: thirty celiac disease patients (17 children, 13 adolescents), on a gluten-free diet, and 23 healthy subjects were studied. Tests of bone mineral density of the lumbar spine (DEXA, Lunar) were performed in all patients and controls. Laboratory analysis of calcium metabolism was performed in all patients. RESULTS: mean weight and height of adolescents with celiac disease were lower than mean weight and height of controls (p<0.05). Bone mineral density in adolescents with celiac disease was significantly reduced if compared to controls (p=0.015), whereas no significant difference was found among children with celiac disease and controls. The number of adolescents who had started a gluten-free diet after the age of 2 years was higher than in children (p=0.003). Serum levels of ionized calcium, total calcium and parathormone were normal. CONCLUSIONS: the one mineral density of adolescents with celiac disease was lower than controls; whereas, no difference was found between the bone mineral density of children with celiac disease and controls.
- ItemAcesso aberto (Open Access)FRAX TM: construindo uma ideia para o Brasil(Sociedade Brasileira de Endocrinologia e Metabologia, 2009-08-01) Pinheiro, Marcelo de Medeiros [UNIFESP]; Camargos, Bruno Muzzi; Borba, Victoria Zeghbi Cochenski [UNIFESP]; Lazaretti-Castro, Marise [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Minas Gerais Centro de Pós-Graduação; Universidade Federal do Paraná Hospital de Clínicas; Sociedade Brasileira para o Estudo do Metabolismo Ósseo e Mineral; Sociedade Brasileira de Endocrinologia e MetabologiaGenetic and racial background, body composition, bone mineral density (BMD), diet, physical activity and life style help to explain the wide difference observed in the world prevalence and incidence of osteoporosis. Recently, a fracture assessment tool, named FRAX TM, was developed to integrate clinical risk factors (genetic and environmental conditions) and BMD, in order to quantify the ten-year probability of an osteoporotic fracture. Shortly, it will be used to indicate treatment for high risk patients. However, this tool is now available only to those populations with known reliable and prospective epidemiologic data of the osteoporotic fractures - fact that does not include the Brazilian population. The aim of this paper was to review the main national and international epidemiologic studies to better understand the differences between the clinical risk factors, BMD and fracture probability of these populations. The authors concluded that, to use the FRAX TM tool, it is necessary more epidemiological data that could characterize the Brazilian population. The future studies should be prospective, evaluate the quality of life, mortality and morbidity after a fracture, as well the life expectancy of the population and the cost-effectiveness and utility related to the osteoporotic fracture. In fact, it is not recommended to use any of the populations available in the FRAX TM tool, as a substitute for the Brazilian population.
- ItemSomente MetadadadosHigh sodium chloride intake is associated with low bone density in calcium stone-forming patients(Dustri-verlag Dr Karl Feistle, 2000-08-01) Martini, Lígia Araújo [UNIFESP]; Cuppari, Lilian [UNIFESP]; Colugnati, Fernando Antonio Basile [UNIFESP]; Sigulem, Dirce Maria [UNIFESP]; Szejnfeld, Vera Lucia [UNIFESP]; Schor, Nestor [UNIFESP]; Heilberg, Ita Pfeferman [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Although renal stone disease has been associated with reduced bone mass, the impact of nutrient intake on bone loss is unknown. Subjects and methods: The present study was undertaken to investigate the influence of nutrient intake on bone density of 85 calcium stone-forming (CSF) patients (47 male and 38 premenopausal females) aged 41 +/- 11 years (X +/- SD). Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry at the lumbar spine (L-2 - L-4) and femoral neck sites: and low BMD was defined as a T score < -1 (WHO criteria). A 4-day dietary record and a 24-hour urine sample were obtained from each patient for the assessment of nutrient intake and urinary calcium (Uc,), sodium (U-Na), phosphate and creatinine excretion. Results: Forty-eight patients (56%) presented normal BMD and 37 (44%) low BMD. There were no statistical differences regarding age, weight, height, body mass index, protein, calcium and phosphorus intakes between both groups. The mean Uc,, phosphorus and nitrogen appearance also did not differ between groups. However, there was a higher percentage of hypercalciuria among low vs normal BMD patients (62 vs 33%, p < 0.05). Low BMD patients presented a higher mean sodium chloride (NaCl) intake and excretion (UNa) than normal BMD (14 +/- 5 vs 12 +/- 4 g/day and 246 +/- 85 vs 204 +/- 68 mEq/day, respectively p < 0.05). The percentage of patients presenting NaCl intake greater than or equal to 16 g/day was also higher among low vs normal BMD patients (35 vs 12%, p < 0.05). After adjustment for calcium and protein intakes, age, weight, body mass index, urinary calcium, citrate and uric acid excretion, and duration of stone disease, multiple-regression analysis showed that a high NaCl intake (2 16 g/day) was the single variable that was predictive of risk of low bone density in CSF patients (odds ratio = 3.8). Conclusion: These data suggest that reducing salt intake should be recommended for CSF patients presenting hypercalciuria and osteopenia.
- ItemAcesso aberto (Open Access)Linhas escleróticas metafisárias em crianças e adolescentes em uso de alendronato(Sociedade Brasileira de Reumatologia, 2010-06-01) Silva, Érika Cristina Carneiro da [UNIFESP]; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Castro, Tania Caroline Monteiro de [UNIFESP]; Barbosa, Cassia Maria Passarelli Lupoli [UNIFESP]; Fernandes, Artur da Rocha Correa [UNIFESP]; Hilário, Maria Odete Esteves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: Bisphosphonates inhibit bone resorption by interfering with the action of osteoclasts. Among the adverse effects, sclerotic lines observed in the metaphysis of long bones have been described as the main imaging finding in pediatric patients. OBJECTIVE: To evaluate the frequency of radiographic changes caused by alendronate in children and adolescents with low bone density or calcinosis. PATIENTS AND METHODS: We conducted a cross-sectional study with 21 patients who were treated with once-weekly alendronate for at least 10 months. Patients underwent x-rays of long bones before the start of alendronate and approximately one year after its use. RESULTS: Eleven patients (52.3%) had sclerotic lines in the metaphysis of long bones. The most frequent site was the tibia (8/11 patients), followed by the femur (7/11), humerus (6/11), radius (4/11), ulna (3/11), and fibula (2/11). Regression of radiographic changes during the study period (up to 1.1 years after discontinuation of alendronate) was not observed. CONCLUSION: If used carefully, alendronate is safe and radiographic changes have not been shown to be clinically relevant.
- ItemAcesso aberto (Open Access)Physical approach for prevention and treatment of osteoporosis(Sociedade Brasileira de Endocrinologia e Metabologia, 2010-03-01) Lirani-Galvão, Ana Paula Rebucci [UNIFESP]; Lazaretti-Castro, Marise [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Osteoporosis and its consequent fractures are a major problem in public health. To complement the conventional pharmacological treatment for this metabolic disease, non-pharmacological treatment options have been developed in the last decades. Several studies demonstrate that physical exercise programs including impact exercises, specific strength training, balance and coordination training may maintain or increase spine and hip bone mineral density as well as decrease the frequency of falls among osteoporotic and osteopenic patients. Furthermore, some physical agents such as vibratory platforms, low intensity electrical stimulation, laser therapy and ultrasound show positive effects on osteoporotic tissue as well. Consequently, while planning treatment for an osteoporotic patient, non-pharmacological management options should be considered and integrated to the conventional treatment in order to maximize its effects and improve the quality of life of these patients.