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A osteoporose no doente diabético
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Em Portugal, no ano 2013, estimou-se que a Diabetes Mellitus (DM) afetasse cerca de 13% da população portuguesa, com idades entre os 20 e os 79 anos. A DM é uma doença metabólica crónica caracterizada não só, por hiperglicemia como também por alterações no metabolismo de alguns nutrientes. Tendo em conta diversos estudos já publicados, torna-se evidente que tanto a DM1 como a DM2 estão associadas a um aumento do risco de fratura, comprovando que esta patologia também tem impacto no tecido ósseo.
A osteoporose (OP) caracteriza-se por um aumento do risco de fratura devido a uma diminuição da massa óssea e/ou a deterioração da microarquitetura óssea. Um dos métodos usado na avaliação do risco de fratura e na decisão de instituir terapêutica osteoporótica é a ferramenta de avaliação do risco de fratura (FRAX); este algoritmo tem em conta inúmeros fatores de risco: idade, fratura prévia, história familiar, baixo peso e índice de massa corporal (IMC), terapêutica contínua com glucocorticóides, artrite reumatóide, tabagismo e consumo excessivo de álcool. No entanto, não tem em conta fatores de risco para quedas nem a presença de complicações relacionadas com a diabetes que, por si só, aumentam o risco de queda nos doentes diabéticos.
Daqui se constrói o estudo apresentado cujo objetivo é comparar o valor de FRAX obtido a partir dos dados da população estudada no EpiReumaPt de diabéticos e não diabéticos, de ambos os sexos, e avaliar a sua relevância para estimativa do risco de fratura nos doentes diabéticos em Portugal.
In Portugal, in 2013, it was estimated that diabetes mellitus (DM) would affect about 13% of the Portuguese population aged between 20 and 79 years. DM is a chronic metabolic disorder characterized not only by hyperglycemia, but also by changes in the metabolism of certain nutrients. Taking into account several published studies, it is evident that both DM1 and DM2 are associated with an increased risk of fracture, indicating that this condition also has an impact on the bone. Osteoporosis (OP) is characterized by an increased risk of fracture due to decreased bone mass and / or deterioration of bone micro architecture. One of the methods used in assessing the risk of fracture and help in the decision to establish osteoporotic therapy is the fracture risk assessment tool (FRAX); this algorithm takes into account many risk factors as age, sex, body mass index, use of glucocorticoids, current smoking, alcohol intake of three or more units per day, secondary osteoporosis, rheumatoid arthritis and prior fragility fracture. However, it doesn’t take in account risk factors for falls or the presence of diabetic complications that, by itself, increase the risk of fall in diabetic patients. The aim of the presented study is to compare the FRAX value obtained from the population data EpiReumaPt studied in diabetic and non-diabetic patients, of both genders, and assess their relevance to estimate fracture risk in diabetic patients in Portugal.
In Portugal, in 2013, it was estimated that diabetes mellitus (DM) would affect about 13% of the Portuguese population aged between 20 and 79 years. DM is a chronic metabolic disorder characterized not only by hyperglycemia, but also by changes in the metabolism of certain nutrients. Taking into account several published studies, it is evident that both DM1 and DM2 are associated with an increased risk of fracture, indicating that this condition also has an impact on the bone. Osteoporosis (OP) is characterized by an increased risk of fracture due to decreased bone mass and / or deterioration of bone micro architecture. One of the methods used in assessing the risk of fracture and help in the decision to establish osteoporotic therapy is the fracture risk assessment tool (FRAX); this algorithm takes into account many risk factors as age, sex, body mass index, use of glucocorticoids, current smoking, alcohol intake of three or more units per day, secondary osteoporosis, rheumatoid arthritis and prior fragility fracture. However, it doesn’t take in account risk factors for falls or the presence of diabetic complications that, by itself, increase the risk of fall in diabetic patients. The aim of the presented study is to compare the FRAX value obtained from the population data EpiReumaPt studied in diabetic and non-diabetic patients, of both genders, and assess their relevance to estimate fracture risk in diabetic patients in Portugal.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2016
Palavras-chave
Diabetes mellitus (DM) Osteoporose (OP) Ferramenta de avaliação do risco de fratura (FRAX) Fraturas e densidade mineral óssea (DMO) Mestrado Integrado - 2016