Evaluation of the risk factors of asymptomatic vertebral fractures in postmenopausal women with osteopenia at the femoral neck

CONTEXT AND OBJECTIVES: Controversy exists regarding the relationship between atherosclerosis and osteoporosis. The aim of this study was to determine the relationship between intima-media thickness (IMT) of the common carotid artery (CCA), presence of calcified atherosclerotic plaques and bone mineral density (BMD) evaluated by dual energy X-ray absorptiometry (DXA), in postmenopausal women. DESIGN AND SETTING: Cross-sectional study at Second Internal Medicine Clinic, Cluj-Napoca, Romania. METHODS: We studied the IMT (left and right CCA and mean IMT) and T-score (lumbar spine L2-L4, femoral neck and total hip) in 100 postmenopausal women (mean age 64.5 years). The presence of calcified atherosclerotic plaque and osteoporotic vertebral fractures was also noted. RESULTS: IMT in the left and right CCA and mean IMT were significantly associated with T-score measured for the lumbar spine L2-L4, femoral neck and total hip, with lower T-score, in the osteoporotic group than in the normal and osteopenic groups (P < 0.05). IMT had a significantly negative correlation with the lumbar spine T-score and femoral neck T-score; and mean IMT with lowest T-score. Mean IMT (P < 0.001), high blood pressure (P = 0.005) and osteoporotic vertebral fractures (P = 0.048) showed statistical significance regarding the likelihood of developing atherosclerotic plaque. CONCLUSIONS: In women referred for routine osteoporosis screening, the relationship between CCA, atherosclerosis and osteoporosis can be demonstrated using either cortical or trabecular BMD. Vertebral fractures may be considered to be a likelihood factor for atherosclerotic plaque development.

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Assessment of volumetric bone mineral density of the femoral neck in postmenopausal women with and without vertebral fractures using quantitative multi-slice CT

Journal of Zhejiang University SCIENCE B ◽

10.1631/jzus.b0820409 ◽

2009 ◽

Vol 10 (7) ◽

pp. 499-504 ◽

Cited By ~ 8

Author(s):

Sheng-yong Wu ◽

Hui-hui Jia ◽

Didier Hans ◽

Jing Lan ◽

Li-ying Wang ◽

...

Keyword(s):

Bone Mineral Density ◽

Femoral Neck ◽

Postmenopausal Women ◽

Bone Mineral ◽

Vertebral Fractures ◽

Volumetric Bone Mineral Density ◽

Mineral Density

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Decreased serum IGF-I and dehydroepiandrosterone sulphate may be risk factors for the development of reduced bone mass in postmenopausal women with endogenous subclinical hyperthyroidism

Acta Endocrinologica ◽

10.1530/eje.0.1360277 ◽

1997 ◽

Vol 136 (3) ◽

pp. 277-281 ◽

Cited By ~ 23

Author(s):

János Földes ◽

Péter Lakatos ◽

Júlia Zsadányi ◽

Csaba Horváth

Keyword(s):

Risk Factors ◽

Femoral Neck ◽

Postmenopausal Women ◽

Premenopausal Women ◽

Subclinical Hyperthyroidism ◽

Dehydroepiandrosterone Sulphate ◽

Additional Risk ◽

Igf I ◽

Overt Hyperthyroidism ◽

Igfbp 3

Abstract Postmenopausal women with endogenous subclinical hyperthyroidism seem to have reduced bone mass, which does not correlate with serum thyroid hormone levels. Relative insufficiencies of IGF-I and dehydroepiandrosterone sulphate (DHEAS) might be additional risk factors for low bone density in these patients. We measured IGF-I, IGF-binding protein-3 (IGFBP-3) and DHEAS levels together with bone mineral density (BMD) of the femoral neck and lumbar spine in women with an autonomously functioning thyroid nodule. Sixty-three women were classified as subclinical hyperthyroid (31 pre- and 32 postmenopausal) and 39 as overt hyperthyroid (16 pre- and 23 postmenopausal) and results were compared with data obtained from 41 age-matched euthyroid healthy women. In premenopausal women BMD was reduced only in the overt hyperthyroid group, and only in the spine, to 92% (P < 0·05). Serum IGF-I as well as IGFBP-3 were increased in the manifest hyperthyroid group, to 157% (P < 0·001) and 129% (P < 0·05) respectively, whereas DHEAS levels did not change in either premenopausal patient group. In postmenopausal women BMD was significantly reduced both in the subclinical hyperthyroid group (spine to 90% and femoral neck to 88%; P < 0·05), as well as in the hyperthyroid group (spine to 78% and femoral neck to 86%; P < 0·01). In contrast to premenopausal women, serum IGF-I and IGFBP-3 did not change in the two groups who were postmenopausal and serum DHEAS levels were reduced to 58% (P < 0·001) in both postmenopausal groups with subclinical as well as overt hyperthyroidism. In the same two groups of patients, serum IGF-I and DHEAS levels correlated with BMD (femoral neck; both r = 0·50, P < 0·05). In conclusion, women with a solitary autonomous thyroid nodule with subclinical hyperthyroidism have reduced BMD only if they are postmenopausal. This is probably due to the effect of subtle increases in thyroid hormone production together with lack of oestrogen protection of the skeleton. But additional risk factors for the development of enhanced bone loss might be a state of relative IGF-I and DHEAS insufficiency in these patients as well as in postmenopausal women with overt hyperthyroidism. European Journal of Endocrinology 136 277–281

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Use of clinical risk factors to identify postmenopausal women with vertebral fractures

Osteoporosis International ◽

10.1007/s00198-006-0209-8 ◽

2006 ◽

Vol 18 (1) ◽

pp. 35-43 ◽

Cited By ~ 41

Author(s):

J. H. Tobias ◽

A. P. Hutchinson ◽

L. P. Hunt ◽

E. V. McCloskey ◽

M. D. Stone ◽

...

Keyword(s):

Risk Factors ◽

Postmenopausal Women ◽

Vertebral Fractures ◽

Clinical Risk Factors ◽

Clinical Risk

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Low bone density, vertebral fracture and FRAX score in kidney transplant recipients: A cross-sectional cohort study

PLoS ONE ◽

10.1371/journal.pone.0251035 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0251035

Author(s):

Arzu Velioglu ◽

Burcu Kaya ◽

Basar Aykent ◽

Bige Ozkan ◽

Melis Sevil Karapinar ◽

...

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Vertebral Fracture ◽

Bone Density ◽

Femoral Neck ◽

Vertebral Fractures ◽

Menopausal Status ◽

Mineral Density ◽

Low Bone Density ◽

Increased Risk

Background Kidney transplantation (KT) recipients are at increased risk of low bone density (LBD) and fractures. In this retrospective study, we investigated bone mineral density (BMD), vertebral fractures, calculated risk for major osteoporotic fractures (MOF), and hip fractures in the KT recipients. Patients-method Patients who completed at least one year after KT were included in the analysis. Demographic, clinical, and laboratory data were recorded. Measurements of BMD were performed by dual-energy X-ray absorptiometry. Vertebral fractures were assessed using semi-quantitative criteria with conventional radiography. The ten-year risk for MOF and hip fracture were calculated using the FRAX@ tool with BMD. Results One hundred fifty-three KT recipients were included in the study. The population included 77 women. The mean age at evaluation was 46,5±11,9 years. Seventy-eight (50.9%) patients had normal femoral neck BMD while osteoporosis and osteopenia at the femoral neck were present in 12 (7.8%) and 63 (41.1%) of the patients, respectively. Age at evaluation was the risk factor for LBD (OR 1.057; 95% CI 1.024–1.091; p = 0.001). In female KT recipients, LBD was principally affected by menopausal status whereas in males, mammalian target of rapamycin (mTOR) inhibitor use and lower BMI levels were the risk factors. The prevalent vertebral fracture was found in 43.4% of patients. In multivariate analysis, only steroid use (OR 0.121; 95% CI 0.015–0.988; p = 0.049) was found to be associated with prevalent fracture. Among all KT recipients, 1.9% had a high MOF probability (≥20% risk of fracture), and 23.5% had high hip fracture probability (≥3% risk of hip fracture) according to FRAX. Conclusion Exploring the prevalence of LBD and vertebral fracture and the risk factors would help clinicians to modify long-term follow-up strategies. Furthermore, the high hip fracture risk probability in our cohort suggested that there is a need for longitudinal studies to confirm the validity of the FRAX tool in the transplant population.

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