THU0699 Predictors of fracture and low bone mineral density in patients with history of parental fracture

Background: Abnormalities in the bone metabolism observed in chronic liver disease are referred to as hepatic osteodystrophy. Osteoporosis and osteopenia are each part of this condition. Both conditions have a significant impact on morbidity, causing fractures that may result in chronic pain, long-lasting immobility, and deformity. Prevalence of fracture in patients with liver transplantation ranges from 15% - 65%. A high rate of fracturing is seen within the initial 1–2 years after transplantation. Aim: To determine the prevalence of low bone mineral density (osteopenia and osteoporosis) in Indian patients with cirrhosis of liver awaiting liver transplantation as per currently used Hologic DXA database Methods: This was a prospective observational study done at the department of gastroenterology and hepatology, Apollo Hospitals, Chennai from April 2011 to March 2013. All patients who fulfilled the inclusion criteria underwent detailed history taking, physical examination and relevant laboratory investigations. One hundred patients were selected for the scope of the study. Results: Sixty-eight per cent of patients were in the age group of 45 to 65 years. The mean age ± SD of the study subjects was 51.2 ± 9.7 years. The mean age for male patients was 50.5 ± 10.1 years, and for females was 54 ± 7.3 years. Cirrhosis was due to alcohol in 36% of the patients, viral hepatitis in 28% (HBV in 10% and HCV in 18%) patients. 42% were in Child’s class B, and the remaining 58% were in Child’s class C. MELD score was less than 20 in 62% patients. One third was diabetic; one third gave the history of backache. History of smoking was present in one fifth (20%) patients, and a history of fracture (most of them were traumatic) was present in 13% of patients. By using Hologic DXA database at the lumbar spine, osteopenia and osteoporosis were diagnosed in 44% and 38 % patients respectively. At the femoral neck, osteopenia and osteoporosis were diagnosed in 45% and 9% of patients. By using ICMR database at the lumbar spine, osteopenia and osteoporosis were diagnosed in 38% and 17% patients respectively. Similarly, at the femoral neck, osteopenia and osteoporosis were diagnosed in 34% and 5%. By using the Hologic DXA database, osteopenia and osteoporosis were diagnosed in 42% and 40 % patients. By using ICMR database, osteopenia and osteoporosis were diagnosed in 43% and 19% patients respectively. Conclusion: In light of the above results, the present study revealed a high prevalence of low bone mineral density (osteopenia and osteoporosis) in Indian patients with cirrhosis of liver awaiting liver transplantation. The lumbar spine was the most frequently and severely affected site in hepatic osteodystrophy. Keywords: Osteopenia, Osteoporosis, Low Bone Mineral Density, Liver Cirrhosis

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Low Bone Mineral Density in Elite Female Athletes With a History of Secondary Amenorrhea in Their Teens

Clinical Journal of Sport Medicine ◽

10.1097/jsm.0000000000000571 ◽

2018 ◽

Vol Publish Ahead of Print ◽

Cited By ~ 4

Author(s):

Sayaka Nose-Ogura ◽

Osamu Yoshino ◽

Michiko Dohi ◽

Mika Kigawa ◽

Miyuki Harada ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Female Athletes ◽

Mineral Density ◽

Secondary Amenorrhea ◽

Low Bone Mineral Density ◽

History Of

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Asymptomatic vertebral fractures in patients with low bone mineral density

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.02.145 ◽

2016 ◽

Vol 62 (2) ◽

pp. 145-150 ◽

Cited By ~ 1

Author(s):

Caio Cesar Leite de Negreiros ◽

Marina Guareschi Berigo ◽

Robson Luiz Dominoni ◽

Deisi Maria Vargas

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Vertebral Fractures ◽

Cross Sectional Study ◽

Vertebral Fracture Assessment ◽

Mineral Density ◽

Cross Sectional ◽

Test Technique ◽

Low Bone Mineral Density ◽

History Of

Summary Objective: Vertebral fracture assessment (VFA) is a test technique that can be used to detect asymptomatic vertebral fractures (AVF). It uses dual energy X-ray bsorptiometry (DXA) and can be performed concurrently with bone densitometry. This study aims to assess the prevalence of AVF in patients with low bone mass. Methods: Cross-sectional study including 135 individuals with low bone mineral density (BMD) with a T-score < -2.0 standard deviation (SD) in a densitometry clinic located in the city of Blumenau (state of Santa Catarina). Anthropometric, clinical and lifestyle variables were obtained from history-taking and physical examination. Densitometric variables were obtained by bone mineral densitometry and VFA (Explorer, Hollogic®). Vertebral fractures were classified according to the Genant criteria. Student's t, chi-square and logistic regression were performed for statistical analysis. Results: AVFs occurred in 24.4% of the subjects. They were older compared to those without AVF (65±9.25 versus 60.1±8.66; p=0.005), and had a history of lowimpact fractures (38.24% versus 19.8%; OR 2.5; p=0.03). Half of the patients that reported steroid therapy had AVFs, compared to one fifth of those who did not use steroids (50% versus 21.49%; OR 3.6; p=0.01). Conclusion: Asymptomatic vertebral fractures were present in approximately one fourth of patients. The risk factors associated were history of low-impact fracture, use of steroids and age > 61 years.

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Predictors of fragility fracture and low bone mineral density in patients with a history of parental fracture

Osteoporosis and Sarcopenia ◽

10.1016/j.afos.2019.03.001 ◽

2019 ◽

Vol 5 (1) ◽

pp. 6-10

Author(s):

Mrinalini Dey ◽

Marwan Bukhari

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Fragility Fracture ◽

Mineral Density ◽

Low Bone Mineral Density ◽

History Of

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Efficacy and safety of once-monthly ibandronate treatment in patients with low bone mineral density – ESTHER study: 24 months of follow-up

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1212722s ◽

2012 ◽

Vol 140 (11-12) ◽

pp. 722-727 ◽

Cited By ~ 2

Author(s):

Katarina Simic-Pasalic ◽

Study ESTHER

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Economic Problem ◽

Activity Level ◽

New Drugs ◽

Efficacy And Safety ◽

Mineral Density ◽

Low Bone Mineral Density ◽

History Of

Introduction. Osteoporosis is a major health and economic problem worldwide. The use of new drugs, such as ibandronate, is aimed at improving treatment of osteoporosis and currently poor compliance with BP therapy. Objective. To investigate efficacy and safety of ibandronate applied monthly, orally, in women with low bone mineral density (BMD). Methods. The prospective study was conducted in 34 centers in Serbia and included 77 women treated for 24 months with monthly ibandronate. The efficacy of treatment was assessed by change in bone mass values obtained by BMD measurement at the end of 24 months follow-up versus baseline and 12-months follow-up values. Compliance and safety, i.e. adverse effects (AE) were recorded. Results. Participants were postmenopausal (96%), osteoporotic (79.7%) females, diagnosed by lumbar spine DXA measurement (81%), with history of prior BP therapy in 33.8% women. The physical activity level significantly increased to the substantial level of activity (5.2% vs. 21.3%, p=0.003) during the study. After 12 and 24 months of treatment, BMD values significantly increased (p=0.002 and p<0.001). BP experienced patients improved more than BP na?ve patients at both time points (p=0.012 and p=0.027, respectively). During the second 12 months of treatment the adherence was 96%; AE were recorded as mild gastrointestinal disturbances in 3.9%. Conclusion. Treatment by using ibandronate once monthly for 24 months was generally well tolerated and led to a significant increase in BMD in women with low BMD.

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