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Master's Dissertation
DOI
10.11606/D.5.2007.tde-31052007-165929
Document
Author
Full name
Raissa Gomes da Silva
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2007
Supervisor
Committee
Zerbini, Cristiano Augusto de Freitas (President)
Castro, Charles Heldan de Moura
Pereira, Rosa Maria Rodrigues
Title in Portuguese
Avaliação da composição corporal e densidade mineral ósseo em mulheres com artrite reumatóide
Keywords in Portuguese
Artrite reumatóide
Composição corporal
Densidade mineral óssea
Osteoporose e mulheres
Abstract in Portuguese
INTRODUÇÃO: A diminuição da massa óssea e mudanças na composição corporal são comuns em pacientes com artrite reumatóide, particularmente nos usuários de glicocorticóide (GC). OBJETIVO: Analisar o comprometimento dos componentes da composição corporal e densidade mineral óssea (DMO) na artrite reumatóide (AR) e seus aspectos clínicos. MÉTODOS: 83 mulheres com AR realizaram densitometria óssea para análise de massa óssea total e regional e estudo da composição corporal (CC). Além disso, foram submetidas à realização laboratorial de provas inflamatórias, dosagem de fator reumatóide e aplicados questionários para avaliação da atividade da doença, classe funcional, atividade física, e inquérito alimentar. RESULTADOS: A prevalência de osteoporose nas pacientes menopausadas foi de 21,4%, 46,4% com osteopenia e 32,1% com valores normais e ocorreu de forma semelhante em coluna lombar e colo do fêmur. As mulheres na pré-menopausa apresentaram maiores valores nas médias de DMO. A idade teve efeito negativo nas medidas DMO e de CC enquanto que o índice de massa corpórea (IMC) mostrou efeito positivo nestas variáveis. A atividade física apresentou efeito positivo na DMO de fêmur total. A duração da AR teve efeito negativo na DMO de coluna lombar. O GC foi o determinante negativo na massa magra total e aumentou o percentual de gordura. CONCLUSÕES: O achado de valores reduzidos de DMO sugere que devam ser aplicadas medidas para a prevenção e tratamento de osteoporose. A doença (AR) também influenciou negativamente a DMO nestas pacientes e a utilização de GC modificou a CC, reduzindo a massa muscular e aumentando o percentual de gordura. A preservação da massa muscular é importante ao equilíbrio das pacientes, com conseqüente diminuição de quedas e futuras fraturas.
Title in English
Evaluation of body composition and body mineral density in women with rheumatoid arthritis
Keywords in English
Body composition
Bone mineral density
Osteoporosis and women
Rheumatoid arthritis
Abstract in English
INTRODUCTION: The reduction of bone mass and changes in body compositions are usual in patients with rheumatoid arthritis specialty in users of glucocorticoid (GC). OBJECTIVE: To evaluate the bone mineral density (BMD) and body composition (BC) including its correlation to factors of rheumatoid arthritis (RA) and clinics concerns. METHODS: BMD and body composition (total and regional) were measured by densitometry in 83 patients with RA. Furthermore, it was performed laboratory exams (rheumatoid factor, inflammatory exams) and activity of disease, functional class, physical activity and alimentary data were colleted by specific questionnaires. RESULTS: The prevalence of osteoporosis in menopausal patients was 21,4%, 46,4% of osteopenia and 32,1% were normal and osteoporosis was similar in lumbar spine and femoral neck. Premenopausal women had the biggest values of BMD medias. Dose of GC was negative determinant of total lean mass and made positive effect in total fat percentual. Age made negative effect in BMD and body composition. BMI showed positive effect in all CC variables. The physical activity made positive effect in BMD in total femur. The RA duration had negative effect in BMD in lumbar spine. CONCLUSIONS: The finding of low BMD suggests a better approach to prevention and treatment. The disease (RA) also made a negative influence in BMD in these patients and the use of GC cause changes in body composition, with reduction in lean mass and improvement of total fat percentual. Recommendations to preservation of lean mass are important to reduction of falls and consequent diminution of fractures.
 
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RaissaGomesSilva.pdf (2.44 Mbytes)
Publishing Date
2007-07-02
 
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