Relação do perfil da ingestão alimentar com densidade mineral e marcadores ósseos em mulheres idosas
Data
2017-02-20
Autores
Destefani, Silvia Andréa [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A osteoporose representa um problema de saúde pública em todo o mundo, acometendo particularmente a população feminina acima dos 50 anos de idade. A perda óssea que ocorre com o processo de envelhecimento é devida a várias causas, mas pode ser agravada pelo fornecimento inadequado de nutrientes essenciais para a formação e manutenção do tecido ósseo. Todavia, pouco se sabe sobre o perfil nutricional dos grupos populacionais de risco para a osteoporose, bem como sobre a relação entre esse perfil e parâmetros relacionados à saúde óssea. Objetivos: Avaliar a associação entre dieta recente e saúde óssea, especificamente densidade mineral e marcadores de remodelação ósseos, em um grupo de pacientes do sexo feminino, com mais de 60 anos de idade. Métodos: Foi realizado estudo observacional e transversal, com um grupo de 105 mulheres idosas quanto a características dietéticas, densitométricas e quanto a marcadores de remodelação óssea, investigando a presença de relação entre esses parâmetros. As características dietéticas avaliadas foram: a ingestão de macronutrientes e energia, dos minerais cálcio (Ca) e fósforo (P), das vitaminas A, D, E e K, de alimentos, por grupos alimentares, bem como a qualidade da dieta. A densidade mineral óssea (DMO) foi avaliada em colo de fêmur, fêmur total e coluna lombar, sendo considerados a DMO, em g/cm2, e o desvio padrão em relação ao adulto jovem (T-escore). Foram avaliadas as concentrações séricas dos marcadores de remodelação fosfatase alcalina – fração óssea (FAo) e C-telopeptídeo (CTX). Resultados: Com relação à qualidade da dieta, 58 pacientes (55,2%) apresentaram má qualidade e 47 (44,8%) necessitaram de melhorias, não tendo sido observado pessoas com dieta de boa qualidade. O grupo necessitando de melhorias apresentou concentrações menores de CTX [0,35 (0,05;1,09) vs 0,52 (0,10;1,45); p= 0,03)] e FAo (38,7 ± 12,9 U/L vs 46,10 ± 15,2 U/L; p< 0,01) do que o com dieta de má qualidade. Não foram observadas diferenças entre os grupos com relação à DMO (p> 0,05). Na análise univariada, foram observadas correlações, negativa entre o consumo de leite/derivados e as concentrações de FAo (r= -0,20, p= 0,04), e positiva entre o de legumes/verduras e as de CTX (r= 0,21, p= 0,03), que não se mantiveram na multivariada. Não foram encontradas outras associações significantes entre os demais parâmetros avaliados. Conclusões: Observou-se relação entre a dieta recente e saúde óssea. As pacientes com pior qualidade da dieta apresentaram maiores concentrações de marcadores de remodelação óssea, com a ingestão de leite/derivados tendo apresentado associação negativa com FAo e a de legumes/verduras positiva com CTX, na análise univariada, associações que não se mantiveram na análise multivariada. Não foram observadas associações da DMO ou dos marcadores de remodelação com a ingestão de macronutrientes, minerais Ca e P ou vitaminas A, D, E e K.
Introduction: Osteoporosis is a global health problem that affects mostly women aged more than 50 years. Age-related bone loss is multifactorial, but it can be worsened by inadequate intake of essential nutrients for bone formation and maintenance. Nonetheless, little is known about the nutritional profile of population groups at risk of osteoporosis or about the relationships between such profile and bone health parameters. Objectives: To assess the association between recent diet and bone health, especially bone mineral density and remodeling markers, in a group of females aged more than 60 years. Methods: This cross-sectional study investigated the dietary and bone density characteristics, and the bone remodeling markers of 105 older women, and whether those parameters were interrelated. The study dietary characteristics were: dietary intakes (by food groups) of macronutrients, energy, calcium (Ca), phosphorus (P), and vitamins A, D, E, and K, and quality diet. The bone mineral density (BMD) in g/cm2 of the femoral neck, total femur, and lumbar spine were determined, along with their standard deviation from those of young adults (Tscore). Serum levels of the remodeling markers bone-specific alkaline phosphatase (BSAP) and C-terminal telopeptide (CTx) were measured. Results: Fifty-eight patients (55.2%) had poor diet quality, and the diets of 47 (44.8%) patients needed improvement. No patient had good quality diet. The group that required improvement had lower levels of CTx [0.35 (0.05;1.09) vs 0.52 (0.10;1.45); p= 0.03)] and BSAP (38.7 ± 12.9 U/L vs 46.10 ± 15.2 U/L; p< 0.01) than the group with low quality diet. The DMO of the two groups did not differ (p> 0.05). According to univariate analysis, the intake of milk and dairy products was negatively correlated with BSAP level (r= -0.20, p= 0.04), and the intake of vegetables was positively correlated with CTx level (r= 0.21, p= 0.03), but these correlations disappeared in multivariate analysis. Significant associations between the other study parameters were not found. Conclusions: Recent diet was related to bone health. Patients with worse quality diet had higher levels of bone remodeling markers. In univariate analysis, milk and dairy product intake was negatively associated with BSAP, and vegetable intake was positively associated with CTx. However, these associations disappeared in multivariate analysis. BMD and bone remodeling markers were not associated with the intake of macronutrients, Ca, P, or vitamins A, D, E, and K.
Introduction: Osteoporosis is a global health problem that affects mostly women aged more than 50 years. Age-related bone loss is multifactorial, but it can be worsened by inadequate intake of essential nutrients for bone formation and maintenance. Nonetheless, little is known about the nutritional profile of population groups at risk of osteoporosis or about the relationships between such profile and bone health parameters. Objectives: To assess the association between recent diet and bone health, especially bone mineral density and remodeling markers, in a group of females aged more than 60 years. Methods: This cross-sectional study investigated the dietary and bone density characteristics, and the bone remodeling markers of 105 older women, and whether those parameters were interrelated. The study dietary characteristics were: dietary intakes (by food groups) of macronutrients, energy, calcium (Ca), phosphorus (P), and vitamins A, D, E, and K, and quality diet. The bone mineral density (BMD) in g/cm2 of the femoral neck, total femur, and lumbar spine were determined, along with their standard deviation from those of young adults (Tscore). Serum levels of the remodeling markers bone-specific alkaline phosphatase (BSAP) and C-terminal telopeptide (CTx) were measured. Results: Fifty-eight patients (55.2%) had poor diet quality, and the diets of 47 (44.8%) patients needed improvement. No patient had good quality diet. The group that required improvement had lower levels of CTx [0.35 (0.05;1.09) vs 0.52 (0.10;1.45); p= 0.03)] and BSAP (38.7 ± 12.9 U/L vs 46.10 ± 15.2 U/L; p< 0.01) than the group with low quality diet. The DMO of the two groups did not differ (p> 0.05). According to univariate analysis, the intake of milk and dairy products was negatively correlated with BSAP level (r= -0.20, p= 0.04), and the intake of vegetables was positively correlated with CTx level (r= 0.21, p= 0.03), but these correlations disappeared in multivariate analysis. Significant associations between the other study parameters were not found. Conclusions: Recent diet was related to bone health. Patients with worse quality diet had higher levels of bone remodeling markers. In univariate analysis, milk and dairy product intake was negatively associated with BSAP, and vegetable intake was positively associated with CTx. However, these associations disappeared in multivariate analysis. BMD and bone remodeling markers were not associated with the intake of macronutrients, Ca, P, or vitamins A, D, E, and K.
Descrição
Palavras-chave
Alimentos, Densidade óssea, Remodelação óssea, Osteoporose, Nutrientes, Dieta