Study of Risk Factors for Low Bone Mass in Postmenopausal Women from Argentina

BRANCE ML; LARROUDÉ MS; BRUN LR

Congreso; 20th PANLAR Meeting 2018; 2018

Osteoporosiscauses more than 8.9 million fractures annually in the world.  Fractures have high morbidity and mortalityin the population. Multiples factors can negatively contribute on bone massleading to osteopenia and osteoporosis. Moreover, the risks factor could affecttreatment efficacy. Objectives: Theaim of this study was study the risk factors for low bone mass in postmenopausalwomen. Methods: Aretrospective and observationalstudy were carried out. The clinical records of postmenopausalwomen (n=232) derived to our center for the study of bone mass were analyzed. Exclusioncriteria: autoimmune disease, chronic renal disease, diabetes mellitus, cancer,AIDS, chronic hepatic failure. 167 patients were excluded because autoimmunedisease (n=80), diabetes mellitus (n=50), cancer (n=35) and chronic renaldisease (n=2) and 65 postmenopausal women were included in this study. Theresults are expressed as mean±SD. Results:The main characteristic of this population were= age: 66.7±9.4 [range 46-91];menarche: 12.0±1.2; years of menopause: 19.2±9.4; body mass index (BMI):27.3±5.9 (BMI<18.5=1.5%; 18.5-24.9=41.6%; 25-29.9=32.3%; >30=24.6);calcium intake >500 mg/day: 26.1%; current smoking: 18.5%; alcohol 3 or moreunits/day: 12.3%; parent fractured hip: 9.2%. The 41.5% was treated to bonemass, 70.4% with one drug (mainly ibandronate and alendronate) and 29.6% hadbeen switched to a second drug (mainly denosumab). The 31% received vitamin Dsupplement The basal lumbar spine (LS) bone mineral density (BMD) [Lunar Prodigy]was 0.902±0.150 g/cm2, T-score -2.2±1.3 and the basal femoral neck(FN) BMD was 0.729±0.115, T-score -2.1±1.0. According to densitometryevaluation, 52.3% had osteoporosis, 43.0% osteopenia and 4.6% normal bone mass.However, 18.5% (n=12) showed vertebral fracture (VF) and 36.9% (n=24) nonvertebral fractures. Only 1 VF was symptomatic and the others were findings inthe dorsal and lumbar spine Rx. The VF distribution were: 8.3% lumbar, 58.4%dorsal, 33.3% dorsal and lumbar. Seven patients showed only 1 VF and 5 had 2 ormore VF. The non VF were mainly in radio and femoral neck. The basalbiochemical parameters were= calcium: 9.3±0.7 mg/dl; phosphate: 3.3±0.5 mg/dl;total alkaline phosphate: 129.9±259.9 U/l [range 27-2002]; parathormone:99.0±203.0 pg/ml [range 30-1424]; Dpd: 8.7±3.5 nm/mM Cr; 25(OH)vitamin D:22.4±10.2 ng/ml. Finally, 35.4% had secondary hyperparathyroidism, 4.6% primaryhyperparathyroidism (2 case of adenoma and 1 carcinoma) and 15.4%hipercalciuria. Conclusions:High percentage of hyperparathyroidism, vitamin D deficiency,low calcium intake and vertebral and non vertebral fractures were found. Inaddition to the BMD evaluation, a comprehensive evaluation of the patients is requiredincluding anamnesis of the risk factors and bone laboratory.