ALTA DENSIDADE MINERAL ÓSSEA: DENTRO DA NORMALIDADE OU MASCARANDO A FRAGILIDADE ÓSSEA?
Resumo
Objetivo: O objetivo deste estudo foi avaliar indivíduos com alta DMO e correlacionar com parâmetros clínicos e laboratoriais. Métodos: Foi realizada uma pesquisa ao longo dos últimos 4 anos, nos arquivos da densitometria óssea do Departamento de Endocrinologia (Hospital de Clínicas da Universidade Federal do Paraná), em pacientes com Z-score ≥ 2,0 DP na coluna ou fêmur. Após a seleção, foram revisados os prontuários de cada paciente, avaliando sua história médica e comorbidades. Resultados: Foram selecionados 104 pacientes com idade média de 62 anos, sendo 96% da amostra do sexo feminino. O peso médio encontrado foi 70 kg e o índice de massa corporal foi 29 kg/m². Observou-se uma correlação estatisticamente significativa entre presença de artefatos e diagnóstico densitométrico anormal (p <0,001). Em pacientes com aumento da densidade óssea da coluna, aproximadamente 60% apresentavam osteopenia ou osteoporose em um ou mais locais, enquanto que em pacientes com artrose, 68% tiveram o diagnóstico de osteoporose ou osteopenia. Além disso, uma correlação significativa entre artefatos e Z-score ≥ 2,0 DP no colo do fêmur foi encontrada (p = 0,008). De todas as comorbidades analisadas, houve correlação entre hipertensão e presença de artefatos (p <0,001), como artrose e escoliose. Observou-se ainda que 72% dos pacientes com hipotireoidismo apresentaram artefatos (p = 0,014). Conclusão: Encontramos elevada prevalência de pacientes com alta massa óssea e diagnóstico final anormal na densitometria. Estes resultados mostram que a análise de um único sítio de densitometria pode conduzir ao diagnóstico incorreto, especialmente em pacientes com doença degenerativa.
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DOI: http://dx.doi.org/10.5380/rmu.v2i1.40667
DOI (PDF): http://dx.doi.org/10.5380/rmu.v2i1.40667.g24958
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