Gratis Densitometría Ósea (Exámen Osteoporosis). Public. · Hosted by Dr. Luis Miguel Pérez Guadiana. Interested. clock. Tuesday, May 16, at AM. Exámen de Densitometría ósea. Public. · Hosted by Farmacia San Nicolas ONLINE. Interested. clock. Thursday, April 24, at AM – PM UTC- Se compararon los casos de densidad mineral ósea anormal de acuerdo a los Palabras clave: densitometría ósea, valores normales referencia, etnicidad;.
|Published (Last):||5 November 2005|
|PDF File Size:||2.42 Mb|
|ePub File Size:||3.24 Mb|
|Price:||Free* [*Free Regsitration Required]|
Reference values for areal bone mineral density among a healthy Mexican population. Compare the influence of ethnicity in the prevalence of osteopenia and osteoporosis in various Mexican populations using two normal dual X-ray absorptiometry DXA reference databases: MMP included 9 subjects participating in an ongoing long-term cohort study focusing on lifestyle and chronic diseases, of which 6 MMP males and females aged 7 to 80 years were the normal subjects used to determine bone density T- and Z-scores, following WHO criteria, and peak bone mass values.
Abnormal bone mass density values estimated by the manufacturer’s and peak bone mass reference values were compared. Our results show that by using the manufacturer’s T-score values in the mestizo Mexican population we are underestimating the number of abnormal bone mass BMD populations.
Osteoporosis and its most common complication, fragility fractures, are well recognized internationally as public health problems.
Hiperparatiroidismo primario. Papel actual de la densitometría ósea | Radiología
Inthe World Health Organization WHO developed criteria to classify bone mineral density BMD values as an estimation of lifelong relative fracture risk 14 and to classify people as osteopenic or osteoporotic based on the low energy dual x-ray absorptiometry DXA T-score values of healthy young adults 20 to 40 years old.
BMD is influenced by genetic and lifestyle factors which may significantly vary between ethnic groups. However, there are no such reference values available for the healthy Mexican population, which is ethnically distinct from the US Hispanic population. This technology has been used for early detection of individuals at high risk of osteoporotic fractures. These criteria have been adopted as the optimal bone strength reference values to qualify as osteopenic or osteoporotic, based on the BMD evaluation.
A T-score value above 1. The lifelong relative fracture risk for the osteopenic range increased to 1. The prediction is stronger denssitometria data is analyzed for the specific region of interest, namely, if one measures femoral neck results to predict the relative risk of having a femoral neck fracture; in such an example the relative risk increases to over 2 for an osteopenic BMD value and to over 6 for osteoporotic values.
During the last 10 years, these estimates have been used as reference values for operational and diagnostic purposes at the clinical level. In recent years, the use of BMD T-score values for different densitometfia groups and countries has been ddensitometria in light of increasing evidence that densitomefria true maximal bone strength at skeletal maturity is the peak bone mass PBMrepresenting the optimal bone mass of an individual.
BMD is densitomettia strongest oseea factor of fractures that can be assessed with high reproducibility and specificity.
Adopting national standards based on BMD reference values and T-score estimates for our population may improve densitometrla assessment of osteoporosis in Mexico. Since anti-fracture interventions provide over 50 percent protection against osteoporotic fractures after the first year of treatment, improved ability to assess fracture risk would improve both public health decision making and dejsitometria outcomes.
The aim of the study is to provide BMD reference values based on a healthy, urban Mexican population aged 7 to 80 years and stratified by sex, enabling us to estimate the PBM reference values for the Mexican population. These values are necessary for computing a T-score that truly reflects optimal bone strength at skeletal maturity in this population. Adopting these reference values as a national standard can improve public health practices and clinical assessment of osteoporosis in Mexico.
The present analysis was performed with healthy employees and their healthy relatives from three different densotometria and academic institutions: Subjects recruited for the study were participating in the first stage of an ongoing, long-term cohort study focusing on lifestyle and health, approved by the respective ethical committees of each participating institution; informed consent was obtained in all cases.
Out of a total population of study candidates identified between March and Densktometriaemployees were invited to participate in the cohort study and a total of 8 adults were formally enrolled. Of those willing to participate, youths were formally invited and enrolled in the study. Thus, a total of subjects between 7 and densotometria years of age were formally recruited. BMD determinations in this study population constitute part of a more extensive epidemiologic evaluation designed to prospectively evaluate different hypotheses about the relationships between lifestyle and chronic drnsitometria occurrence in Mexico.
We also excluded pregnant women and those women who were unable to undergo BMD measurements. The final healthy reference population for the present analysis is 6 The general densihometria of this population are depicted in table I. Standard calibration of instruments was performed daily using the phantom provided by the manufacturer; technicians ensured that the daily variation coefficient VC was within normal operational standards and in vivo VC was lower than 1.
Prevention and Management of Osteoporosis.
In order to compute T-scores by specific site total body, femur and lumbar spinewe first estimated the reference value for PBM in our population following a previously reported procedure. The difference between these values is expressed as standard deviation SDor in other words, the difference between the studied subject and the PBM is standardized.
The T-score obtained with this method represents the difference expressed by the number of standard deviations between the Young Normal YN value of the population of the same sex and the BMD of the subject studied. This sequence is summarized by the following formula: It is also used as a measure of the standard deviation of the reference population. We evaluated 6 healthy men and women from 7 to 80 years of age who did not have conditions affecting bone health, out of a total of adults and of their children formally enrolled in the first stage of an ongoing, long-term cohort study focusing on lifestyle and health.
This recruitment strategy allowed us to have a cohort with healthy bones resembling the real ethnical mixture of a socioeconomic urban middle class population reflecting a wide sector of the Mexican population. As shown in figure 1BMD increases from infancy on and reaches PBM sometime between the late twenties and the mid thirties. Once PBM is reached, there is a progressive decrease in BMD with advancing age; these values curve as the population grows older and vary by sex and by skeletal region.
As shown in Figure 1males reach the PBM subtotal of the skeleton and whole body BMD values excluding the skull between ages 22 and 25, while females do so at Males reach PBM of the total femur measurement at age 23, while females reach it at age Males and females both reach PBM of the lumbar spine at age Z-score values are depicted in figure 2. The curves for female BMD values are dramatically different than those for male values; male values are greater than female values starting in early childhood and continuing throughout life.
It should also be noted that the values decrease less dramatically for males in later adulthood compared to females. Z-scores reflect a comparison of the individual patient compared to age- and sex-matched controls and can be used to evaluate follow-up studies in other clinical applications.
Therefore, both the method for computing T-scores and the reference population used for these computations must be optimized to generate accurate frequency estimates of these health problems.
Currently, using instruments on one population that have been calibrated for another can thus impede accurate measurement. In table IIwe document the differences in the number of osteopenic and osteoporosis cases that occur when US Hispanics versus Mexicans are used as reference populations.
Our results indicate that, by using the normal reference T-scores obtained from the BMD values for the normal female population aged 20 to 40 in our cohort to classify the individual BMD values obtained from two large patient populations the abnormal population in our cohort and the BMD data obtained and kindly provided to us by Deleze, Cons et al.
If we restrict the reference population to only those between the ages of 30 to 40 years, there is not a greater underestimation of cases of osteopenia and osteoporosis found using the manufacturer’s database figure 3. If the T-score is computed using the PBM value instead of mean BMD, which we consider to be a more realistic way to define the optimal bone quality reached at skeletal maturation, 21 the degree of discrepancies between the manufacturer’s and our estimates of osteopenia and osteoporosis are substantially similar using the T-scores obtained from either of our Mexican populations women ages 20 to 40 or ages 30 to 40 years old figure 3.
It is clear that by using the manufacturer’s T-score values to classify our abnormal Mexican population, we are underestimating the number of abnormal BMD cases. Using either our own T-scores calculated for populations aged 20 to 40 or 30 to 40, or our PBM, we found that The results are similar for osteporotic classification: Analyzing the data obtained from the Deleze, Cons cohort with the same criteria, it also became clear that there is a significant underestimation, restricted only to the femoral neck region densitomertia A.
These tables include reference values for both sexes for the 1 total skeleton excluding the head from whole body scans2 the oses proximal femur, and debsitometria the lumbar region L1-L4. These tables can be used manually to find the T-score and Z-score for the urban Mexican population.
WHO guidelines are helpful for clinically adapting previous definitions of osteoporosis; practically speaking, these guidelines allow for greater accuracy when describing the extent and characteristics of osteoporosis. However, the expert panel that created these guidelines recognized that densitomteria would likely change as new knowledge was gathered.
For example, though a 40 year-old and 65 year-old woman may have the same BMD levels, the older woman’s probability of suffering a fracture is increased by the concurrent presence of other risk factors. The rationale behind the use of this age range is not clearly identified, nor is it clear how to form a reference group for populations that include different racial or ethnic groups. For Mexico, as well as for many other developing countries, the importance of having BMD T-score reference values that reflect the population’s unique characteristics has become a critical issue.
To address a few of these emerging issues, we used the worker’s cohort study data with the T-score reference values that reflect the population’s unique characteristics to study bone density data from a large number of subjects of both sexes, age 7 to This was done in order to determine whether there osez differences in the number of people classified as having a higher than normal lifelong relative risk of having a fracture, in order to build a normal mestizo reference soea that allowed us to define the age at which PBM is established at different skeletal sites.
PBM and T-scores derived for this population differ significantly from values derived from commercial manufacturer’s US Hispanic database, with our data reflecting significantly higher values and a curve indicating that age-dependent BMD loss is also very different.
Using our reference values, the number of people in the range of osteopenia and osteoporosis increased by 31 and 32 percent, respectively. As expected, this lack of concordance between the Mexican database and the manufacturers’ Hispanic database increases as age increases.
Revising estimates of fracture risk based on our numbers will have a major clinical impact since fracture prevention interventions will increase.
Since our Mexican database of reference values are not currently included in the software of commercial densitometers used in Mexico, interested users can classify their specific BMD values reported by these instruments according to the reference values presented in the BMD tables of this report tables III. Having normative BMD reference values for the urban Mexican population will be very relevant for our densitometry community.
This more accurate normative reference xensitometria may give us the opportunity to improve the decision making process used in densiyometria prevention and care of bone density-related public health problems, though we must ensure that it does not simply amount to an increased burden on an already strained healthcare system. These considerations should be taken into account by policy makers in order to improve the Mexican healthcare infrastructure denstiometria well as to seek new ways to address the growing populations’ healthcare needs.
Increasing hip fracture incidence in California Hispanics; to Densitomeyria of hip and other osteoporotic fractures in elderly men and women: Dubbo osteoporosis epidemiology study. Journal Bone and Min Res ; Osteoporosis prevalence and levels of treatment in primary care: J Bone Miner Res ; Osteoporosis and fracture risk in women of different ethnic groups.
Rev Mex Ortop Traum ;2: Risk factors for osteoporotic hip fractures in mexicans. Arch Med Res ; Prevalence, incidence, and risk factors associated with hip fractures in community-dwelling older Mexican Americans: Establish Population for the Epidemiologic Study for the Elderly.
J Am Geriatr Soc ; Densitomerria Metab Oseo Min.
Exámen de Densitometría ósea
Synopsis of a WHO report. How Many Women Have Osteoporosis?. J Bone Min Res. Arzac P, Tamayo J. How many women have osteoporosis in medica sur osteoporosis clinic.
J Bone Miner Res. Contributions of bone density and structure to fracture risk assessment in men and women. Interaction between calcium intake and menarcheal age on bone mass gain: J Clin Endocrinol Metab.