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Vol. 7. Issue 1.
Pages 13-19 (January - February 2011)
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Vol. 7. Issue 1.
Pages 13-19 (January - February 2011)
Original article
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Rheumatology and osteoporosis (RETOSS): a vision of postmenopausal osteoporosis in rheumatology departments throughout Spain
Reumatología y osteoporosis (RETOSS): osteoporosis posmenopáusica en la consulta de reumatología
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Miguel Bernad Pinedaa,
Corresponding author
mbernadp@hotmail.com

Corresponding author.
, Carlos Manuel González Fernándezb, Manuel Fernández Pradac, Jaime Fernández Campillod, Rosaura Maeso Martíne, María Victoria Garcés Puentesf
a Reumatología, Hospital Universitario La Paz, Madrid, Spain
b Reumatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
c Reumatología, Hospital de Guadalajara, Guadalajara, Spain
d Reumatología, Hospital de Torrevieja, Torrevieja, Alicante, Spain
e Departamento Médico, Laboratorios Fcos. ROVI, Madrid, Spain
f Servicios Integrales de Gestión Médica, Madrid, Spain
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Article information
Abstract
Objective

To know the characteristics of the postmenopausal women with osteoporosis consulting Rheumatology Hospital Divisions in Spain.

Methods

An epidemiologic, observational, transverse and multicentric study was performed from June to September 2008 in 63 rheumatology divisions in Spain. Six hundred and twenty nine osteoporotic postmenopausal women were studied using a questionnaire designed to get demographic, clinical, radiological, bone density, and functional information. Every physician had to choose only one patient per day, usually the first woman to come in and fulfill the inclusion and exclusion criteria.

Results

Mean age of included women was 66,6 [9,2) years, weight: 64,6 [10,1] kg and body mass index: 26,1 [4,1] kg/m2. They were 3,1 [2,8] cm shorter than the maximal historical height. 35,7% of them had a family history of fracture and 40,7% had a past history of fracture, of which 54,8% were vertebral fractures. Patients who received calcidiol <20ng/ml sustained more falls (P=.033) and fractures (P=.006) than women receiving calcidiol >20ng/ml. Risk of falls and fractures increased with advancing age and 51,5% of women who fell, had a fracture. 75% of women had poor calcium intake (≤400mg/day). The Get up & go test showed a linear trend to an increased probability of >20 s in relationship with the age as well as with an increased incidence of fractures. 71,8% of patients had back pain and in 85,3% it went from moderate to severe.

Conclusion

Most osteoporotic postmenopausal Spanish women have a low calcium intake, one out of three has a family history of fractures that increases fracture incidence and this shows a relationship with age and functional capacity; four out of ten have had any type of fractures, one out of three have fallen during the past year and half of these present back pain. Calcidiol levels have been evaluated in a small group of patients.

Keywords:
Postmenopausal osteoporosis
Fractures
Calcidiol
Get up & go test
Resumen
Objetivo

Conocer las características de las mujeres posmenopáusicas con osteoporosis que acuden a las consultas hospitalarias de reumatología en España.

Métodos

Desde junio a septiembre de 2008 se realizó un estudio epidemiológico, observacional, transversal y multicéntrico en 63 consultas de reumatología en toda España. Se evaluaron 629 mujeres posmenopáusicas con osteoporosis utilizando un cuestionario diseñado para recoger datos demográficos, clínicos, radiológicos, de densidad ósea y de función física. Cada médico participante escogió una paciente por día; la primera que cumplía los criterios de inclusión y exclusión.

Resultados

La media de la edad fue de 66,6 (9,2) años, del peso fue de 64,6 (10,1) kg y del índice de masa corporal (IMC): 26,1 (4,1) kg/m2. La pérdida de talla media fue de 3,1 (2,8) cm en relación con la media de la talla histórica. El 35,7% tenía antecedentes familiares de fractura, el 40,7% había tenido alguna fractura, de las cuales el 54,8% eran fracturas vertebrales. En las pacientes que presentaban calcidiol < 20ng/ml se observó una mayor frecuencia de caídas (p = 0,033) y de fracturas (p=0,006), respecto al grupo con valores de calcidiol > 20ng/ml. Se encontró un aumento significativo de la probabilidad de caídas asociadas a la edad, y el 51,5% de las mujeres que se había caído había sufrido algún tipo de fractura por fragilidad. El 75% de las mujeres tenía una ingesta baja de calcio (400mg/d). El test Get up & go mostró un incremento significativo de la probabilidad de test > 20 segundos en relación con la edad, de forma lineal, y con un aumento de la incidencia de fracturas. El 71,8% de las pacientes tenía dolor de espalda y entre estas, el 85,3% presentaba dolor de moderado a severo.

Conclusiones

La mayoría de las mujeres españolas posmenopáusicas con osteoporosis que acuden a las consultas de reumatología tiene una ingesta baja de calcio y un tercio de ellas tiene antecedentes familiares de fractura. La incidencia de fracturas muestra una clara relación con la edad, la capacidad funcional y el dolor de espalda. La determinación de la concentración de calcidiol sérico se realiza en un bajo porcentaje de pacientes.

Palabras clave:
Osteoporosis posmenopáusica
Fracturas
Calcidiol
Test Get up & go
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