OLIVERI Maria Beatriz
congresos y reuniones científicas
How frequent is premenopausal osteoporosis in Clinical Practice?
BAGUR A; MASTAGLIA SR; GONZALEZ D; FERNANDEZ C; OLIVERI B; MAUTALEN C
Congreso; Anual Meeting ASBMR; 2011
How Frequent Is Premenopausal Osteoporosis In Clinical Practice? Bagur A, Mastaglia S, Gonzalez D, Fernandez C, Oliveri B, Mautalen C Centro de Osteopatías Médicas, Buenos Aires, Argentina Premenopausal (preMP) osteoporosis (OP) may be idiopathic or due to diseases or treatments that affect bone mineral density (BMD). Aim: To identify the frequency and clinical characteristics of women with preMP OP in clinical practice. We reviewed the clinical records of 61 preMP women who were referred during the last 3 years for evaluation of OP or low BMD to an Institute of Metabolic Bone Diseases. Patients were either self-referred due to concern for the disease or referred from other physician mainly on the basis of a previous BMD measurement. The preMP OP represents ~0.3% of the total number of consultations for OP seen during that period. We analyzed the clinical relevant information such as personal and familiar history of fractures (Fx), BMD, biochemical bone markers, the final diagnosis and their treatments. BMD was considered normal as a Z score above -2.0 in the lumbar spine and/or total femur. Results: 23 out 61 (38%) were in the BMD osteoporotic values. In 9 out of 23 (39%) a diagnosis of idiopathic or primary (1º) OP was made. Fourteen patients (61%) had secondary (2º) OP due to the following diseases: pregnancy (3), celiac disease (2), hypercalciuria (2), 1º hyperparathyroidism (1), anorexia nervosa (1), hypothalamic amenorrhea (1), glucocorticoid (1), osteogenesis imperfecta (1), excess of T4 (1), and congenital adrenal hyperplasia (1). None of the women with 1º OP had Fx. Four out 14 women (29%) with 2º OP had Fx at the following site: wrist (2), vertebrae (1), and metatarsal (1). Five (55%) of the 1º OP women and 3 (21%) with 2º OP had a familiar history of Fx. The only differences between 1º and 2º OP were: Age was lower in 2º vs 1º OP (29.2±9 vs. 42.0±6, p<0.0001 respectively) and serum calcium was lower in 1º vs. 2º OP (9.1±0.3 vs. 9.5±0.3, p<0.03 respectively). PTH, 25OHD, CTX and BAP were similar en both groups. The 1º OP patients received the following treatments: Calcium and vitamin D (Ca+D) (6), bisphosphonate (B) (2), without treatment (1). Secondary OP patients received: Ca+D and treatment according to the underlying disease. The PreMP visits represent ~0.3% of the total number of consultations for OP in our Center. Less than a half of preMP women who consult to evaluate their BMD have OP and ~40% of them are idiopathic. In the remaining 60% 2º OP was recognized. It is therefore important to rule out diseases and drugs that can affect BMD in these young women.