Naslov
Prevalencija osteopororskih deformacija kralježaka i faktori rizika za osteoporozu u starijoj populaciji grada Zagreba
(PREVALENCE OF OSTEOPOROTIC FRACTURES AND RISK FACTORS FOR OSTEOPOROSIS IN ELDERLY POPULATION OF ZAGREB)

Autori
Grazio, Simeon

Vrsta, podvrsta i kategorija rada
Ocjenski radovi, doktorska disertacija

Fakultet
Medicinski

Mjesto
Zagreb

Datum
21.12

Godina
2000

Stranica
172

Mentor
Jajić, Ivo

Ključne riječi
osteoporoza; frakture; kralježnica; epidemiologija; faktori rizika
(osteoporosis; fracture; spine; epidemiology; risk factors)

Sažetak
Ciljevi istraživanja: Utvrditi prevalenciju osteoporotskih fraktura kralješnice, odrediti faktore rizika, utjecaj fraktura na simptome i aktivnosti svakodnevnog života te procijeniti zdravstveno-socijalni i eventualno ekonomski utjecaj osteoporotskih fraktura kralješnice. Ispitanici i metode: 425 ispitanika (156 muškaraca, 269 žena), dobi 50 i više god., randomizirani uzorak gradske populacije grada Zagreba. Neposrednim intervjuom su prema upitniku dobiveni podaci o faktorima rizika, simptomima i aktivnostima svakodnevnog života. Također su izvršena antropometrijska mjerenja: tjelesna visina, težina, i snaga stiska šake. Kod svakog je bolesnika standardiziranim postupkom rendgenski snimljena grudna i slabinska kralješnica, a za definiranje fraktura kralješaka je upotrijebljena modificirana morfometrijska metoda po McCloskey-u i sur. Rezultati : Prevalencija ispitanika s frakturom kralješaka je bila 11, 8% (muškarci 15, 4%, žene 9, 7%), što Zagreb stavlja u sredini ljestvice gradova iz raznih djelova Europe. Od ukupno analiziranih 5525 kralješaka nađeno je 69 ( ili 1, 24%) frakturiranih. Najčešće su frakturirani donji torakalni i gornji lumbalni kralješci. Prevalencija ispitanika s frakturama kralješaka raste s dobi . Među faktorima rizika osteoporotskih fraktura kralješaka statistički su značajni: duže trajanje razdoblja nakon menopauze, manje uzimanje mlijeka i mliječnih proizvoda u žena i smanjeni indeks tjelesne mase. Prethodne frakture, dugotrajnija imobilizacija, recentna smanjena konzumacija mlijeka i mliječnih proizvoda, smanjena konzumacija mlijeka tijekom cijelog života, pušenje, učestalo pijenje alkoholnih pića, pojačana fizička aktivnost u dobi 25-49. god. u oba spola , kao i hipertireoza i uporaba kortikosteroida u žena te pozitivna obiteljska anamneza frakture kuka u muškaraca ukazuju na povećanje rizika za nastup frakture kralješaka, ali nije dostignuta statistička značajnost. Na smanjen rizik upućuju, ali također nisu dosegli statističku značajnost, prisustvo šećerne bolesti, prethodno uzimanje preparata kalcija, pojačana ukupna fizička i sportska aktivnost u dobi iznad 50-te godine života u oba spola te prethodno uzimanje fluorida samo u žena. Ikada doživljena bol u leđima kao i ona u zadnjih godinu dana, veći intenzitet zadnje atake boli u leđima nisu povezani s nalazom fraktura kralješaka, ali postoji tendencija povećanog rizika nalaza fraktura kralješaka u tih bolesnika uz nedostignutu statističku značajnost rezultata. Frakture kralješaka ne uzrokuju bitno smanjenje mogućnosti obavljanja aktivnosti svakodnevnog života u tih bolesnika u odnosu na one bez frakture. Ekstrapolacijom ovih rezultata na pučanstvo Republike Hrvatske iznad 50 god. života može se zaključiti da 96940 muškaraca i 80 111 žena ima frakture kralješaka. Zaključak: Osteoporotske frakture kralješaka relativno su česte u populaciji iznad 50 god. života. Potvrđena je važnost nekih faktora rizika, a za neke koji pokazuju takvu tendenciju nije bilo moguće utvrditi statističku značajanost . Za većinu subjektivnih tegoba nije nađena statistički značajna povezanost prema frakturama kralješka. Osobe s frakturama kralješaka nemaju bitno smanjene funkcijske sposobnosti u odnosu na osobe istog spola i dobi bez fraktura.

Izvorni jezik
Hrvatski

Znanstvena područja
Kliničke medicinske znanosti

Napomena
Aims: To establish prevalence of osteoporotic vertebral fractures, to determine risk factors, influence of fractures on symptoms and activities of daily life, as well as to estimate socio-medical impact of osteoporotic vertebral fractures. Subjects and methods: 425 subjects (156 men, 269 women ) age 50 and more years, randomised sample in city of Zagreb. Using direct interview administered questionnaire the information were obtained about risk factors, symptoms and activities of daily life. There were also performed antropometric measurements: body height, weight and grip strength. Lateral thoracic and lumbar spinal radiographs were taken using standardised procedure, and fractures were defined according to modified morphometric method proposed by McCloskey and al. Results: Prevalence of subjects with vertebral fractures was 11, 8% ( 15, 8% men, 9, 7% women), which pose Zagreb in the middle of the range (scale?) among the other cities from different parts of Europe. Out of 5525 analysed vertebrae 69 (or 1, 24%) were fractured. The most frequent fractured were lower thoracic and upper lumbar vertebrae. Prevalence of subjects with vertebral fractures raised with age. Among risk factors of osteoporotic vertebral fractures statistically significance showed longer postmenopausal period , lesser consumption of milk and milk products in women and lower body mass index. Previous fractures, prolonged immobilisation , lower consumption of milk and milk products, overall lesser consumption of milk, smoking, frequent intake of alcoholic beverages, heavier physical activity during 25-49 age period in both sexes, and hyperthyroidism and use of corticosteroids in women, as well as positive family history of hip fracture in men tend to represent higher relative risk for vertebral fractures but no statistical significance was obtained. Lower risk, but also without reaching statistical significant, on vertebral fractures tend to have diabetes mellitus, previous intake of calcium tablets, heavier overall physical and sport activity after the age of 50 for both sexes, as well as fluoride tablets in women. Ever experienced back pain, back pain in the past year and more severe pain of the last episode were not connected with vertebral fractures, but there is tendency of higher risk to find them in these patients with a remark that no statistical significance was obtained. Vertebral fractures do not cause significant impact in decrease of possibilities in performing activities of daily life. Extrapolating the results on population of Croatia age 50 years and more, we can conclude that 96940 men and 80111 women have vertebral fractures. Conclusion: Vertebral osteoporotic fractures are relatively frequent in population of age 50 years and more. The improtance of certain risk factors was confirmed, and for some who showed such a tendency it was not possible to establish their statistical singificance. For most of the symptoms it was not found statistically significant connection with vertebral fractures. Subjects with vertebral fractures had no significantly decreased functional abilities comparing to subjects of the same sex and age group without fractures.

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