Epidemiología de las fracturas osteoporóticas en Andalucía en el período 2000-2010 / Epidemiology of osteoporotic fractures in Andalusia, Spain, from 2000-2010

Fundamento y objetivo: El objetivo de este estudio es conocer diferentes datos epidemiológicos de las fracturas osteoporóticas en Andalucía en el período 2000-2010. Ante la falta de estudios epidemiológicos de fracturas en Andalucía nos propusimos conocer el número y tasas de incidencia de las fracturas osteoporóticas, su distribución por sexo y edad, localización, estacionalidad y tendencia secular. Métodos: Estudio de cohorte observada durante un periodo de 11 años analizando los datos suministrados por el registro del Conjunto Mínimo Básico de Datos durante el período 2000-2010. Resultados: El total de fracturas osteoporóticas fueron 96.458 con una tasa de incidencia bruta de 374,18 fracturas por 100.000 habitantes. Las fracturas aumentaron en este período un 27% (p<0,01, IC 95%, 0,71; 0,73). Hemos encontrado un cambio de tendencia en la relación mujer/hombre pasando de 3,4 a 3,2 y en la disminución de fracturas en los dos últimos años, sobre todo en el último, con una disminución del 11,2% en las fracturas de cadera (p<0,001, IC 95%, 0,88; 0,895). Conclusiones: En este periodo se ha producido un aumento de fracturas por el envejecimiento de la población pero también un cambio de tendencia con la disminución de fracturas en algunos grupos de edad. La tasa de incidencia de fracturas es variable entre los diferentes países y regiones de España y entre las diferentes provincias de Andalucía

Background and objective: The aim of this study was to examine the epidemiological data on osteoporotic fractures in Andalusia in the period 2000-2010. In view of the lack of epidemiological studies of fractures in Andalusia, we set out to ascertain the number and incidence rates of osteoporotic fractures and their distribution by gender and age, location, comorbidity, seasonality and secular trend. Methods: Cohort study observed over a period of 11 years analysing the data provided by the Minimum Basic Data Set register for the period 2000-2010. Results: There were a total of 96,458 osteoporotic fractures, with a crude incidence rate of 374.18 fractures per 100,000 population. Fractures increased in this period by 27% (p<.01, IC 95%, 0.71; 0.73). We found a trend change in female/male ratio, from 3.4 to 3.2, and in the reduction in fractures in the last two years, especially in the past year, with a decrease of 11.2% in hip fractures (p<.001, IC 95%, 0.88; 0.895). Conclusions: In this period, there has been an increase in fractures as a consequence of the ageing of the population, but also a change in trend, with fractures decreasing in some age groups. The incidence rate of fractures varies between different countries and regions of Spain, and between different provinces of Andalusia

Epidemiology of osteoporotic fractures in Andalusia, Spain, from 2000-2010. / Epidemiología de las fracturas osteoporóticas en Andalucía en el período 2000-2010.

BACKGROUND AND OBJECTIVE: The aim of this study was to examine the epidemiological data on osteoporotic fractures in Andalusia in the period 2000-2010. In view of the lack of epidemiological studies of fractures in Andalusia, we set out to ascertain the number and incidence rates of osteoporotic fractures and their distribution by gender and age, location, comorbidity, seasonality and secular trend. METHODS: Cohort study observed over a period of 11 years analysing the data provided by the Minimum Basic Data Set register for the period 2000-2010. RESULTS: There were a total of 96,458 osteoporotic fractures, with a crude incidence rate of 374.18 fractures per 100,000 population. Fractures increased in this period by 27% (p<.01, IC 95%, 0.71; 0.73). We found a trend change in female/male ratio, from 3.4 to 3.2, and in the reduction in fractures in the last two years, especially in the past year, with a decrease of 11.2% in hip fractures (p<.001, IC 95%, 0.88; 0.895). CONCLUSIONS: In this period, there has been an increase in fractures as a consequence of the ageing of the population, but also a change in trend, with fractures decreasing in some age groups. The incidence rate of fractures varies between different countries and regions of Spain, and between different provinces of Andalusia.

Editorial: Deficiencia de vitamina D. Consecuencias para la salud / No disponible

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Introducción: Deficiencia de vitamina D. Consecuencias para la salud / No disponible

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Utilización de la vitamina D en la práctica clínica / No disponible

No disponible

Efecto del bloqueo del factor de necrosis tumoral α sobre el metabolismo óseo en las enfermedades inflamatorias articulares crónicas / Effect of tumour necrosis factor α blockade on bone metabolism in chronic inflammatory joint diseases

Fundamento y objetivo: Evaluar el efecto de los tratamientos anti-TNF sobre la densidad mineral ósea (DMO), los marcadores de remodelado óseo (MRO) y la ratio receptor activator for nuclear factor κB ligand (RANKL, «ligando del receptor activador del factor nuclear κB»)/osteoprotegerina (OPG) en los pacientes con enfermedades inflamatorias articulares crónicas. Métodos: Estudio longitudinal prospectivo en condiciones de práctica clínica sobre 31 pacientes diagnosticados de artritis reumatoide, artropatía psoriásica y espondilitis anquilosante que estuvieron durante un año en tratamiento con fármacos anti-TNF alfa. Al inicio y al final del estudio se evaluaron la DMO, la OPG y la forma soluble de RANKL (sRANKL), y durante el estudio (0, 3, 6, 9 y 12 meses), la actividad de la enfermedad (SDAI, BASDAI y PCR), la capacidad funcional (HAQ, BASFI), los MRO y la vitamina D. Resultados: La DMO no se modificó después de un año de tratamiento. Los pacientes que consumieron corticoides tuvieron una pérdida media de masa ósea del 3% en el raquis lumbar (± 1,6, p = 0,02). En cuanto a los MRO, no experimentaron cambios significativos a lo largo del estudio. Disminuyó la actividad de la enfermedad, tanto SDAI (p = 0,002) como BASDAI (p = 0,002). La OPG se mantuvo sin cambios durante el año de tratamiento, mientras que disminuyeron significativamente tanto el sRANKL (0,28 ± 0,22, p = 0,013) como la ratio sRANKL/OPG (0,04 ± 0,03, p = 0,031). Conclusión: Los pacientes en tratamiento con anti-TNF no presentaron una pérdida de DMO significativa durante el seguimiento (un año), a la vez que experimentaron una mejora de la actividad de la enfermedad. Estos resultados han sido más evidentes en los pacientes respondedores (AU)

Background and objective: To evaluate the effect of anti-TNF treatments on bone mineral density (BMD), bone remodelling markers (BRM) and receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) in patients with chronic inflammatory joint diseases. Methods: A longitudinal prospective study was performed under clinical practice conditions on 31 patients diagnosed of rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis who had received treatment with anti-TNF alpha drugs for one year. BMD, OPG and RANKL soluble form (sRANKL) were studied at the onset and end of the study. During the study (0, 3, 6, 9 and 12 month), disease activity (SDAI, BASDAI and CRP), functional capacity (HAQ, BASFI), BRM and vitamin D were studied. Results: BMD was not modified after one year of treatment. The patients who took corticosteroids had a mean bone mass loss of 3% in the lumbar spine (± 1.6, P = .02). In regards to the BRM, did not experience significant changes over the course of the study. Disease activity, both SDAI (P = .002) and BASDAI (P = .002), decreased. OPG was maintained without changes during the year of treatment while both the sRANKL (0.28 ± 0.22, P = .013) and sRANKL/OPG ratio significantly decreased (0.04 ± 0.03,P = .031). Conclusion: The patients being treated with anti-TNF did not present with a significant loss of DMO during the study (one year), at the same time experiencing an improvement in disease activity. This protection has been clearer in the responding patients (AU)

[Effect of tumour necrosis factor α blockade on bone metabolism in chronic inflammatory joint diseases]. / Efecto del bloqueo del factor de necrosis tumoral α sobre el metabolismo óseo en las enfermedades inflamatorias articulares crónicas.

BACKGROUND AND OBJECTIVE: To evaluate the effect of anti-TNF treatments on bone mineral density (BMD), bone remodelling markers (BRM) and receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) in patients with chronic inflammatory joint diseases. METHODS: A longitudinal prospective study was performed under clinical practice conditions on 31 patients diagnosed of rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis who had received treatment with anti-TNF alpha drugs for one year. BMD, OPG and RANKL soluble form (sRANKL) were studied at the onset and end of the study. During the study (0, 3, 6, 9 and 12 month), disease activity (SDAI, BASDAI and CRP), functional capacity (HAQ, BASFI), BRM and vitamin D were studied. RESULTS: BMD was not modified after one year of treatment. The patients who took corticosteroids had a mean bone mass loss of 3% in the lumbar spine (±1.6, P=.02). In regards to the BRM, did not experience significant changes over the course of the study. Disease activity, both SDAI (P=.002) and BASDAI (P=.002), decreased. OPG was maintained without changes during the year of treatment while both the sRANKL (0.28±0.22, P=.013) and sRANKL/OPG ratio significantly decreased (0.04±0.03, P=.031). CONCLUSION: The patients being treated with anti-TNF did not present with a significant loss of DMO during the study (one year), at the same time experiencing an improvement in disease activity. This protection has been clearer in the responding patients.

Protocolo de tratamiento de la deficiencia de vitamina D / Protocol of treatment of vitamin D deficiency

No disponible