Avaliação da densidade mineral óssea, composição corporal e escore do osso trabecular em pacientes com psoríase grave

• Ano de defesa: 2022
• Autor(a) principal: Ues, Bruna
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Santa Maria; Brasil; Ciências da Saúde; UFSM; Programa de Pós-Graduação em Ciências da Saúde; Centro de Ciências da Saúde
• Palavras-chave em Português: Psoríase; Escore do osso trabecular; Densidade mineral óssea; Composição corporal; Psoriasis; Trabecular bone score; Bone mineral density; Body composition; CNPQ::CIENCIAS DA SAUDE
• Link de acesso: http://repositorio.ufsm.br/handle/1/25894

Psoriasis is a disease of systemic involvement and insidious nature, which occurs with sub-clinical chronic inflammation, leading to a higher risk of comorbidities. The trabecular bone score, in turn, is an index for estimating bone microarchitecture by means of analysis in lumbar vertebrae, and is a predictor of fracture risk, regardless of bone mineral density. Therefore, this work aims to evaluate the trabecular bone score, bone mineral density, and body composition in patients diagnosed with psoriasis being followed up at the dermatology outpatient clinic of Santa Maria University Hospital. This is a cross-sectional study, with patients over 18 years of age and diagnosed with severe psoriasis at follow-up from July 2021 to March 30, 2022. Patients with diabetes mellitus, chronic kidney disease, hypertension, body mass index greater than 35, and a diagnosis of psoriasis more than 15 years ago were excluded. The clinical variables analyzed were gender, age, menopause, smoking, alcohol consumption, duration of disease, age at diagnosis, immunosuppression/use of oral corticosteroids, current treatment, diagnosis of other autoimmune diseases, abdominal circumference, weight, height, and body mass index. Through bone densitometry and body composition examinations, the mineral density in the femur and lumbar spine, trabecular bone score, android to gynoid ratio, body fat index, and appendicular muscle mass index were measured. The sample contains 17 patients, nine female and eight male, aged between 24 and 70 years, with a diagnosis of severe psoriasis. The median time of illness in the analyzed group was 10 years. One patient had degraded microarchitecture, six patients were diagnosed with osteopenia, and one patient had osteoporosis. There was a statistically significant difference in the prevalence of altered bone mass for the patients over 50 years old in the sample when compared to the general population of the same age group. The data suggest that there may need to be several years of bone exposure to psoriatic skin disease before significant bone loss emerges. The densitometric evaluation associated with the trabecular bone score is of great value, as patients with psoriasis without joint disease may also show signs of bone loss, even without a significant decrease in bone mass when compared to healthy controls. In addition, psoriasis has a high psychosocial burden and, in its severe form, can predispose patients to obesity. There is also evidence of benefit in earlier screening for bone changes in patients with severe psoriasis over the age of 50 years, with the inclusion of bone assessment in the management of the disease to screen for potential fractures and consequent reduction in overall morbidity associated with psoriatic disease.