ALTA DENSIDADE MINERAL ÓSSEA: DENTRO DA NORMALIDADE OU MASCARANDO A FRAGILIDADE ÓSSEA?

Background: The aim of this study is to evaluate individuals with high BMD and correlate with clinical and laboratory parameters. Methods: We performed a search over the last 4 years, in the archives of bone densitometry of the Department of Endocrinology (Hospital de Clinicas, Federal University of Parana), in all patients with Z-score ≥ 2.0 SD in spine or femur. After selection, we reviewed the medical records of each patient, evaluating their comorbidities and medical history. Results: We selected 104 patients with mean age of 62 years, with 96% of the sample being women. The mean weight was 70 kg, and body mass index 29kg/m². A statistically significant correlation between the presence of artifacts and abnormal densitometric diagnosis (p <0.001) was observed. In patients with increased bone density in spine, approximately 60% had osteopenia or osteoporosis at one or more sites, whereas in patients with arthrosis, 68% had a diagnosis of osteoporosis or osteopenia. Furthermore, a significant correlation between artifacts and Z-score ≥ 2.0 SD in the femoral neck was found (p = 0.008). Of all comorbidities analyzed, there was correlation between hypertension and presence of artifacts (p <0.001), such as arthrosis and scoliosis. It was also observed that 72% of patients with hypothyroidism had artifacts (p = 0.014). Conclusion: We found a high prevalence of patients with high bone mass and abnormal diagnosis in densitometry. These results show that analysis of only one site in densitometry can lead to a wrong diagnosis, especially in patients with degenerative disease.