Bone mineral density in Jamaican black women after hysterectomy and bilateral oophorectomy: an observational study / Densidad mineral osea en mujeres negras jamaicanas después de histerectomía y ooforectomía bilateral: un estudio observacional

OBJECTIVE: To see if black Jamaican postmenopausal women who had hysterectomy were at increased risk of osteoporosis. To assess the risk of osteoporosis in hysterectomized Jamaican postmenopausal patients. METHOD: We reviewed 809 women (403 hysterectomized and 406 controls) for cardiovascular disease risk. We did a demographic history and examination looking at blood pressure, waist hip ratio and body mass index and investigations done included fasting blood glucose and total and high density lipoprotein (HDL) cholesterol. We also measured bone density at the heel in all women using the Achilles ultrasound bone densitometer looking at T-score and Z-score. RESULTS: There was a significant association of hysterectomy status and bone mineral density (BMD) status with a smaller than expected proportion of women with osteoporosis in the hysterectomy group (χ2 = 18.4; p = 0.001). The mean T-score was significantly higher in the hysterectomized women, adjusting for age, waist circumference and sociodemographic factors. The relationship between the various predictors and BMD was explored by stepwise regression modelling. The factors that were significantly related to low BMD were hysterectomy status, age, waist circumference and being employed. CONCLUSION: Hysterectomy was not found to be a significant risk factor for osteoporosis. The osteoporosis risk among menopausal women in Jamaica appears to be due to other risk factors which probably existed prior to the operation.

OBJETIVO: Determinar si mujeres negras jamaicanas postmenopáusicas sometidas a histerectomía corrían mayor riesgo de osteoporosis. Evaluar el riesgo de osteoporosis en pacientes jamaicanas postmenopáusicas histerectomizadas. MÉTODO: Se examinaron 809 mujeres (403 histerectomizadas y 406 controles) para evaluar el riesgo de enfermedad cardiovascular. Hicimos una historia demográfica y un examen para obtener información sobre la presión arterial, el índice cintura/cadera ratio, y el índice de masa corporal. Asimismo, realizamos investigaciones que incluyeron pruebas de glucemia en ayunas, colesterol total, y colesterol de lipoproteínas de alta densidad (HDL). También medimos la densidad ósea en el talón de todas las mujeres, usando el densitómetro óseo ultrasónico modelo Achilles para obtener el T-score y el Z-score. RESULTADOS: Hubo una asociación significativa entre el estado de histerectomía y el estado de la densidad mineral ósea (DMO) con una proporción de mujeres con osteoporosis en el grupo de histerectomía (χ2 = 18.4; p = 0,001) más pequeña de lo esperada. El T-score promedio fue significativamente mayor en las mujeres histerectomizadas, ajustando por edad, circunferencia de la cintura y factores sociodemográficos. La relación entre los distintos factores predictivos y DMO fue explorada mediante regresión gradual stepwise modelado. Los factores que estuvieron significativamente relacionados con baja DMO fueron estado histerectomía, edad, circunferencia de la cintura y siendo empleado. CONCLUSIÓN: Se halló que la histerectomía no es un factor de riesgo significativo para la osteoporosis. El riesgo de osteoporosis entre las mujeres menopáusicas de Jamaica parece deberse a otros factores de riesgo que probablemente existían antes de la operación.

Doença periodontal e osteoporose em mulheres na pós-menopausa / Periodontal disease and osteoporosis in pososteoporosis womem

O presente estudo teve como objetivo avaliar a possível relação entre perda óssea alveolar e osteoporose relacionada à menopausa por meio da revisão da literatura. A doença periodontal é caracterizada pela reabsorção do osso alveolar e pela perda dos tecidos de inserção dental. A etiologia da doença periodontal como infecção bacteriana é bem aceita, entretanto, a perda de osso bucal como resultado da osteopenia provavelmente seja importante na criação de um hospedeiro suscetível. Além disso, a osteoporose e a periodontite apresentam fatores tiológicos comuns que podem influenciar diretamente ou modular ambas as doenças. Muitos dos estudos sugerem que há relação entre essas doenças, mas devemos avaliar todos os fatores que podem influenciar os resultados. Fatores que devem ser considerados incluem gênero, idade, reposição hormonal, fumo, raça, tempo da menopausa, tipo de estudo, tamanho da amostra, e outros. O entendimento claro dessa relação pode melhorar os cuidados de saúde e a detecção de ambas as doenças, além de possibilitar o desenvolvimento de estratégias preventivas a fim de limitar a incidência dessas doenças em mulheres na pós-menopausa. O aumento do diálogo entre médicos e dentistas será muito importante na manutenção da ótima saúde dessas pacientes...

Alta prevalencia de osteoporosis en mujeres mapuches postmenopáusicas asintomáticas / High prevalence of osteoporosis in asymptomatic postmenopausal Mapuche women

BACKGROUND: Genetic and environmental factors are responsible for variations in the frequency of osteoporosis. Prevalence of osteoporosis in Mapuche women (native Chileans) is unknown. AIM: To assess the prevalence and risk factors for osteoporosis in Mapuche women. MATERIAL AND METHOD: A random sample of 95 asymptomatic postmenopausal Mapuche females, stratified by age, was studied. Women with diseases or medications that could interfere with calcium metabolism were excluded. Spine and femoral neck bone mass density was determined using a Lunar DPX Alpha densitometer. RESULTS: Seventeen percent of women had normal bone mineral density in both spine and femoral neck. In the spine, 25.3 per cent had a normal bone mineral density, 17.9 per cent had osteopenia and 56.8 per cent had osteoporosis. In the femoral neck, 34.7 per cent had a normal bone mineral density, 57.9 per cent had osteopenia, and 7.4 per cent had osteoporosis. There was a positive correlation between bone mineral density and body mass index. Women with more than one hour per day of physical activity, had a significantly lower proportion of osteopenia or osteoporosis. No association between bone mineral density and parity or calcium intake, was observed. CONCLUSIONS: There is a high prevalence of osteopenia and osteoporosis among Mapuche women. Osteoporosis was associated with low body mass index.