Avaliação da densidade óssea, composição corporal e fraturas por fragilidade óssea em pacientes com anemia falciforme: estudo observacional
Data
2023-03-01
Autores
Pedro, Pedro Paulo de Alcantara 
Orientadores
Szejnfeld, Vera Lucia
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A doença falciforme (DF) é a hemoglobinopatia mais comum no
mundo, e geralmente é associada a desfechos musculoesqueticos adversos e
baixa massa óssea. Objetivo: Avaliar a densidade mineral óssea (DMO),
parâmetros da composição corporal e taxa de fratura por fragilidade em homens
com DF, e investigar a potencial associação com os parâmetros clínicos.
Metodologia: Um total de 44 pacientes com DF (29,5 ± 12) e 88 controles
saudáveis (27.7 ± 6) foram pareados por idade. Foram avaliadas fraturas
vertebrais morfométricas de baixo impacto utilizando raios X de coluna
convencional, enquanto DMO e parâmetros da composição corporal foram
mensurados pela absorciometria por dupla emissão de raios X (DXA).
Resultados: Homens com DF tiveram significativamente maiores taxas de baixa
massa óssea (31,7% vs 5.7%; p<0,001), baixa massa magra (36,6% vs 14,8%;
p=0,010) e baixa massa gorda (51,2% vs 3,4%; p<0,001) quando comparado
com os controles saudáveis. 15 fraturas vertebrais morfometricas foram
observadas em 21% dos pacientes com DF. Nem parâmetros densitometricos e
nem características clínicas foram significativamente associadas a fratura
vertebral. Conclusão: Homens com DF apresentam altas taxas de fratura
vertebral, baixa massa óssea, baixa massa magra e baixa massa gorda
comparado a controles saudáveis pareados por idade. Nenhuma característica
clínica ou variável densitometrica foi significativamente associada com fratura
vertebral.
Introduction: The most common hemoglobinopathy around the world, Sickle cell disease (SCD) is often associated with adverse musculoskeletal outcomes and low bone mass. Objective: To evaluate bone mineral density (BMD), body composition parameters and fragility fractures rate in men with SCD and investigate its potential association clinical parameters. Methodology: A total of 44 men with SCD (29.5± 12) and 88 healthy controls (27.7 ± 6) matched for age were evaluated. Morphometric low-impact vertebral fractures were assessed using conventional spine X-rays, while bone mineral density (BMD) and body composition parameters were measured by dual X-ray absorptiometry (DXA). Results: Men with SCD had significantly higher rates of low bone mass (31.7% vs 5.7%; P<0.001), low lean mass (36.6% vs 14.78%; p=0.010) and low fat mass (51.2% vs 3.4%; p<0.001) when compared to their healthy controls. Morphometric grades 15 vertebral fractures were observed in 21% of the SCD patients. Neither densitometric parameters nor clinical characteristics were significantly associated with vertebral fracture. Conclusion: Men with SCD present high rates of vertebral fractures, low bone, low lean and low fat mass as compared to age-matched healthy controls. No clinical characteristic or densitometric variable was significantly associated with vertebral fracture.
Introduction: The most common hemoglobinopathy around the world, Sickle cell disease (SCD) is often associated with adverse musculoskeletal outcomes and low bone mass. Objective: To evaluate bone mineral density (BMD), body composition parameters and fragility fractures rate in men with SCD and investigate its potential association clinical parameters. Methodology: A total of 44 men with SCD (29.5± 12) and 88 healthy controls (27.7 ± 6) matched for age were evaluated. Morphometric low-impact vertebral fractures were assessed using conventional spine X-rays, while bone mineral density (BMD) and body composition parameters were measured by dual X-ray absorptiometry (DXA). Results: Men with SCD had significantly higher rates of low bone mass (31.7% vs 5.7%; P<0.001), low lean mass (36.6% vs 14.78%; p=0.010) and low fat mass (51.2% vs 3.4%; p<0.001) when compared to their healthy controls. Morphometric grades 15 vertebral fractures were observed in 21% of the SCD patients. Neither densitometric parameters nor clinical characteristics were significantly associated with vertebral fracture. Conclusion: Men with SCD present high rates of vertebral fractures, low bone, low lean and low fat mass as compared to age-matched healthy controls. No clinical characteristic or densitometric variable was significantly associated with vertebral fracture.
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Citação
PEDRO, Pedro Paulo de Alcantara. Avaliação da densidade óssea, composição corporal e fraturas por fragilidade óssea em pacientes com anemia falciforme: estudo observacional. 2023. 54 f. Dissertação (Mestrado em Reumatologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2023.