Association between a family history of fractures and bone mineral density in early postmenopausal women

Bone ◽  
1999 ◽  
Vol 24 (5) ◽  
pp. 507-512 ◽  
Author(s):  
M.J Grainge ◽  
C.A.C Coupland ◽  
S.J Cliffe ◽  
C.E.D Chilvers ◽  
D.J Hosking
Menopause ◽  
2019 ◽  
Vol 26 (11) ◽  
pp. 1284-1288
Author(s):  
Lijuan Yang ◽  
Xiang Hu ◽  
Hailing Zhang ◽  
Wei Pan ◽  
Weihui Yu ◽  
...  

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Malika A Swar ◽  
Marwan Bukhari

Abstract Background/Aims  Osteoporosis (OP) is an extra-articular manifestation of rheumatoid arthritis (RA) that leads to increased fracture susceptibility due to a variety of reasons including immobility and cytokine driven bone loss. Bone loss in other populations has well documented risk factors. It is unknown whether bone loss in RA predominantly affects the femoral neck or the spine. This study aimed to identify independent predictors of low bone mineral density (BMD) in patients RA at the lumbar spine and the femoral neck. Methods  This was a retrospective observational cohort study using patients with Rheumatoid arthritis attending for a regional dual X-ray absorptiometry (DEXA) scan at the Royal Lancaster Infirmary between 2004 and 2014. BMD in L1-L4 in the spine and in the femoral neck were recorded. The risk factors investigated were steroid use, family history of osteoporosis, smoking, alcohol abuse, BMI, gender, previous fragility fracture, number of FRAX(tm) risk factors and age. Univariate and Multivariate regression analysis models were fitted to explore bone loss at these sites using BMD in g/cm2 as a dependant variable. . Results  1,527 patients were included in the analysis, 1,207 (79%) were female. Mean age was 64.34 years (SD11.6). mean BMI was 27.32kg/cm2 (SD 5.570) 858 (56.2%) had some steroid exposure . 169(11.1%) had family history of osteoporosis. fragility fracture history found in 406 (26.6%). 621 (40.7%) were current or ex smokers . There was a median of 3 OP risk factors (IQR 1,3) The performance of the models is shown in table one below. Different risk factors appeared to influence the BMD at different sites and the cumulative risk factors influenced BMD in the spine. None of the traditional risk factors predicted poor bone loss well in this cohort. P129 Table 1:result of the regression modelsCharacteristicB femoral neck95% CIpB spine95%CIpAge at scan-0.004-0.005,-0.003<0.01-0.0005-0.002,0.00050.292Sex-0.094-0.113,-0.075<0.01-0.101-0.129,-0.072<0.01BMI (mg/m2)0.0080.008,0.0101<0.010.01130.019,0.013<0.01Fragility fracture-0.024-0.055,0.0060.12-0.0138-0.060,0.0320.559Smoking0.007-0.022,0.0350.650.0286-0.015,0.0720.20Alcohol0.011-0.033,0.0 5560.620.0544-0.013,0.1120.11Family history of OP0.012-0.021,0.0450.470.0158-0.034,0.0650.53Number of risk factors-0.015-0.039,0.0080.21-0.039-0.075,-0.0030.03steroids0.004-0.023,0.0320.030.027-0.015,0.0690.21 Conclusion  This study has shown that predictors of low BMD in the spine and hip are different and less influential than expected in this cohort with RA . As the FRAX(tm) tool only uses the femoral neck, this might underestimate the fracture risk in this population. Further work looking at individual areas is ongoing. Disclosure  M.A. Swar: None. M. Bukhari: None.


1992 ◽  
Vol 127 (3) ◽  
pp. 226-230 ◽  
Author(s):  
Emerentia CH van Beresteijn ◽  
Jan PRM van Laarhoven ◽  
Anthony GH Smals

The objective was to study the independent relationships of body mass index and endogenous estradiol to cortical bone mineral density and the rate of cortical bone loss at the radius in healthy early postmenopausal women. Fifty-one healthy early postmenopausal women (aged 58–66 years) participated. The women were a subset of a population participating in a 10-year longitudinal study to elucidate the influence of dietary calcium on the rate of cortical bone loss. Cortical bone mineral density at the radius, body weight and body height were measured annually (1979–89). Concentrations of sex steroids were measured in serum samples collected during the last year of follow-up (1989). Endogenous estradiol levels, although significantly positively correlated with body mass index, were not independently related to bone mass indices of the radius. Body mass index, on the other hand, was found to be positively related to cortical bone mineral density and negatively to the rate of bone loss, even after adjustments had been made for confounding factors. Our results suggest that the level of total estradiol is not an important determinant of cortical bone mass indices in healthy early postmenopausal women. Other factors of overweight such as mechanical loading may be important.


Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3353-3353
Author(s):  
Zahra Pakbaz ◽  
Zhe Zhang ◽  
Ellen Fung ◽  
Nancy Sweeters ◽  
Sylvia Singer ◽  
...  

Abstract Low bone mineral density (BMD) is commonly seen in regularly transfused thalassemia patients; however, there have been few reports for bone mineral density assessment in transfusion independent thalassemia patients. The present report includes the results of BMD assessments in patients with transfusion independent thalassemia who were referred to the bone density clinic through 2002–2006. BMD was evaluated by dual energy x-ray absorptiometry (DXA, Hologic Delphi A). A convenience sample of 24 patients (Females=15) with transfusion independent thalassemia were measured with a mean age of 22.1 ± 13.8 years. Subjects younger than 10 yrs old (n = 7) underwent scans for Lumbar spine (LS; L1-L4) and whole body (WB), patients ages 10–20 (n = 5) were assessed for LS, WB, and non-dominant hip, and for patients older than 20 (n = 12), LS and hip scans were completed. Z-scores specific for age and gender were generated using Zemel BS et al.(J. Bone Min Res 2004) database. Z-scores less than −2.0 were considered as low bone density. Calcium intake was assessed by a brief food frequency questionnaire. Past medical history, medications, history of fractures, and family history of osteoporosis were obtained by chart review and patient interview. Data is presented as Mean ± SD. T-test was used to assess differences in continuous variables. The mean LS Z-score (n = 24) was −1.5 ± 1.0 and the mean hip Z-score (n = 17) was −0.5 ± 1.1. Mean WB Z-score (n = 10) was −2.0 ± 1.2. There was a significant (p<0.001) difference between spine and hip Z-scores. Overall 46% had a Z-score less than −2.0. Thirty-three percent of patients have spine Z-scores of less than −2.0 and 25% spine Z-scores between −2.0 and −1.0. Average spine Z-score in patients younger than 10 years old (n=7) was −1.6 ± 0.5. In WB scans, 50% of the patients had WB Z-scores worse than −2.0. None of the young patients (5–9 yrs; n = 7) consumed inadequate intake of calcium (< 2/3 of RDA age specific) while 75% of patients ages 10–20 (n = 4) years old consumed inadequate intake of calcium (dietary + supplement). Neither spine nor hip Z-score was related to patients’ gender, age, and calcium intake. Two patients reported fractures in the past and two reported family history of osteoporosis. Six patients had delayed puberty and one has hypogonadism. Seven patients have short stature. This data suggests that low bone mass is not only a problem in transfused thalassemia patients, but is also observed in non-transfused patients. The significance and pathophysiology of low bone mass should be studied further in non-transfused patient population, especially in younger children.


2016 ◽  
Vol 8 (11) ◽  
pp. 36 ◽  
Author(s):  
Chander Kumar Lohana ◽  
Nafisa Samir

<p><strong>BACKGROUND: </strong>Postmenopausal females are susceptible to osteoporosis due to clinical manifestations. It not only causes morbidity; but, is considered to strikingly decline quality of life among patients. Among different developing regions, the prevalence rate of osteoporosis among postmenopausal women is alarming in the face of poor management and awareness about its risk factors.</p><p><strong>AIM:</strong> The aim of this study was to investigate the incidence of osteoporosis and its known risk factors among postmenopausal women appearing for bone mineral density in Karachi.</p><p><strong>METHODOLOGY: </strong>This descriptive cross-sectional study was undertaken from the period of “March 2006 to March 2007” in “Aga Khan University hospital”, Karachi. A total of 245 females, who came to the radiology department at Aga Khan Hospital for DXA scan, were recruited. All the relevant data was collected through questionnaires. Data analysis was undertaken by using SPSS version 11.5 to generate frequencies and proportion percentages.</p><p><strong>RESULTS: </strong>The study demonstrated that 99 females (40%) amongst all subjects were osteopenic, 114 females (47%) were osteoporotic; whereas, 32 females (13%) were normal. A decline was observed in bone mineral density with advancing age and duration of menopause. The distribution of osteoporosis was observed to be common in women, who had more children, low BMI, history of prior fractures, history of premature menopause, and were avoiding exercise.</p><p><strong>CONCLUSION:</strong> This study confirmed a high frequency of osteoporosis and osteopenia in postmenopausal women. Therefore, early screening is required to detect the decrease in bone mineral density among postmenopausal females to prevent fragility fracture. There is an imperative requirement for vast public awareness in this regard.</p>


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