Non-alcoholic fatty liver disease and its associated risk factors in Brazilian postmenopausal women.

OBJECTIVE: To evaluate the prevalence and risk factors of non-alcoholic fatty liver disease (NAFLD) in postmenopausal women. METHODS: A cross-sectional study was carried involving 188 women (age ≥ 45 years and amenorrhea ≥ 12 months) attending the outpatient unit in south-eastern Brazil. Exclusion criteria were liver disease (hepatitis B and C, cholestatic disease, liver insufficiency), use of drugs that affect liver metabolism; alcoholics; AIDS or cancer history; and morbid obesity. NAFLD was diagnosed by abdominal ultrasound. Clinical, anthropometric (body mass index, waist circumference) and biochemical variables were measured. RESULTS: Of the 188 women, 73 (38.8%) had NAFLD. Blood pressure, waist circumference, body mass index, LDL cholesterol, triglycerides and glucose were significantly higher in NAFLD patients when compared with women without NAFLD (control group) (p < 0.05). HOMA-IR values indicated insulin resistance only in the NAFLD group (6.1 ± 4.6 vs. 2.4 ± 1.4 in control group, p < 0.05). Metabolic syndrome was detected in 93.1% of the women affected by NAFLD, and 46.1% of the control group (p < 0.05). In multivariate analysis, adjusted for age and weight, the variables considered at risk for the development of NAFLD, were: high waist circumference (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.01-1.13), insulin resistance (OR 3.81, 95% CI 2.01-7.13), and presence of metabolic syndrome (OR 8.68, 95% CI 3.3-24.1). CONCLUSION: NAFLD showed a high prevalence among postmenopausal women. The presence of metabolic syndrome, abdominal obesity and IR were indicators of risk for the development of NAFLD.

Assessment of risk factors for low bone mineral density in Brazilian postmenopausal women.

OBJECTIVE: To assess risk factors associated with low bone mineral density (BMD) in postmenopausal women. METHODS: In this cross-sectional study, a total of 412 Brazilian postmenopausal women, aged 40-75 years, with BMD measured using central dual-energy X-ray absorptiometry, were included. The clinical risk factors assessed were: age, time since menopause, smoking, physical activity, use of hormone therapy (HT) or corticosteroids, personal fracture history, maternal history of fracture, and body mass index (BMI, weight/height(2)). Low BMD was considered when total spine and/or femoral neck T-score values were ≤ -2.0 standard deviations. Logistic regression was used to determine the odds ratio (OR) for low BMD in the presence of the influential variables analyzed. RESULTS: Low BMD, which occurred in 36.6% (151/412) of the participants, was observed in 22.4% of women aged 40-49 years, in 34.2% of those aged 50-59 years, and in 60.5% of those > 60 years (p < 0.001). Similarly, low BMD was observed in 21.9% of women with menopause duration ≤ 5 years, in 39.5% with a duration of 6-10 years, and in 57.7% with menopause duration of > 10 years (p < 0.001). Seventy percent of women with BMI < 20 kg/m(2) were osteopenic/osteoporotic (p < 0.001). The percentage of HT users was 37.4%; 27.7% took regular physical activity and 24.5% were smokers. The risk for low BMD detection increased significantly with age (OR 1.08; 95% confidence interval (CI) 1.02-1.14), time since menopause (OR 1.12; 95% CI 1.04-1.20), smoking (OR 3.43; 95% CI 1.67-6.96), fracture history (OR 2.05; 95% CI 1.11-3.78), and maternal history of fracture (OR 2.16; 95% CI 1.14-4.09). Physical activity, diet, corticotherapy and thyropathies did not influence risk. Contrarily, use of HT (OR 0.38; 95% CI 0.24-0.60) and high BMI (OR 0.89; 95% CI 0.84-0.96) reduced risk (p < 0.05). CONCLUSION: In postmenopausal women, age, time since menopause, smoking, and personal or maternal history of fracture were strong clinical indicators of risk for low BMD, whereas the use of hormone therapy and high BMI were shown to be protective factors.