Enfrentamiento de la osteoporosis post menopáusica en la consulta ginecológica / Coping with postmenopausal osteoporosis in the gynecological consultation

La osteoporosis es un desorden esquelético que afecta aproximadamente al 21% de las mujeres entre 50 y 84 años. Su importancia radica en que se asocia a un aumento en el riesgo de fractura, y por lo tanto, a un incremento en la morbimortalidad. El diagnóstico puede ser realizado mediante historia clínica o densitometría mineral ósea. Teniendo en cuenta que el sobrediagnóstico y sobretratamiento de osteoporosis en la práctica ginecológica es frecuente, es esencial conocer tanto las indicaciones para realizar densitometría como los criterios diagnósticos de la patología. El primer pilar para la prevención y tratamiento de osteoporosis es el ejercicio y el aporte adecuado de calcio y vitamina D. Los bifosfonatos son la terapia médica de primera línea, sin embargo, existen otras alternativas que han ha demostrado disminuir el riesgo de fractura osteoporótica como la terapia hormonal de la menopausia y el denosumab.

Osteoporosis is a skeletal disorder that affects approximately 21% of women between 50 and 84 years. It's an important public health issue because low bone mass leads to an increased risk of fracture, having negative consequences in morbidity and mortality in this population. Diagnosis is based in clinical history and bone densitometry. Over diagnosis and over treatment of osteoporosis is common in gynecologic practice. The knowledge of diagnostic criteria and indications to perform bone densitometry is relevant. Treatment of osteoporosis consists in lifestyle measures like exercise and adequate consumption of calcium and vitamin D. Bisphosphonates are first-line medical therapy, but alternative treatments including hormone replacement therapy and denosumab have also shown to decrease risk of fracture.

Oxidative stress is associated with the number of components of metabolic syndrome: LIPGENE study

Previous evidence supports the important role that oxidative stress (OxS) plays in metabolic syndrome (MetS)-related manifestations. We determined the relationship between the number of MetS components and the degree of OxS in MetS patients. In this comparative cross-sectional study from the LIPGENE cohort, a total of 91 MetS patients (43 men and 48 women; aged between 45 and 68 years) were divided into four groups based on the number of MetS components: subjects with 2, 3, 4 and 5 MetS components (n=20, 31, 28 and 12, respectively). We measured ischemic reactive hyperemia (IRH), plasma levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), total nitrite, lipid peroxidation products (LPO), hydrogen peroxide (H2O2), superoxide dismutase (SOD) and glutathione peroxidase (GPx) plasma activities. sVCAM-1, H2O2 and LPO levels were lower in subjects with 2 or 3 MetS components than subjects with 4 or 5 MetS components. IRH and total nitrite levels were higher in subjects with 2 or 3 MetS components than subjects with 4 or 5 MetS components. SOD and GPx activities were lower in subjects with 2 MetS components than subjects with 4 or 5 MetS components. Waist circumference, weight, age, homeostatic model assessment-beta, triglycerides (TGs), high-density lipoprotein and sVCAM-1 levels were significantly correlated with SOD activity. MetS subjects with more MetS components may have a higher OxS level. Furthermore, association between SOD activity and MetS components may indicate that this variable could be the most relevant OxS biomarker in patients suffering from MetS and could be used as a predictive tool to determine the degree of the underlying OxS in MetS.