scholarly journals POS1116 ENHANCING OSTEOPOROSIS MANAGEMENT: THE CONTRIBUTION OF FRAX® AND VFA IN TUNISIAN WOMEN

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 837.3-838
Author(s):  
C. Daldoul ◽  
N. El Amri ◽  
S. Laataoui ◽  
K. Baccouche ◽  
H. Zegaloui ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Fracture Risk ◽  
Osteoporotic Fractures ◽  
Interquartile Range ◽  
Therapeutic Decision ◽  
Major Osteoporotic Fractures ◽  
Menopausal Women ◽  
The Mean ◽  
The Difference ◽  
Post Menopausal

Background:The FRAX® is a tool proposed by the World Health Organization (WHO) to calculate 10-year fracture risk of hip fracture and major osteoporotic fractures. The utility of this tool is to help treatment decision when it is litigious. Previous low trauma fracture represent a factor in FRAX® calculation. However, asymptomatic osteoporotic vertebral fractures (VF) identified on X-rays or Vertebral Fracture Assessment (VFA) scans are rarely included. To the best of our knowledge, there was no previous evaluation of fracture risk in Tunisian women.Objectives:To compare hip fracture risk and major osteoporotic fractures risk using the FRAX® tool, without and with the consideration of asymptomatic VF on VFA. To evaluate the impact of FRAX® calculation and asymptomatic VF identified on VFA on osteoporosis management.Methods:We conducted a cross-sectional study over a period of 5 months at the rheumatology department. The study included post-menopausal women without a previous diagnosis of VF referred for BMD (Bone mineral density) measurement. Each participant had a BMD assessment and a VFA scan to detect VF. The FRAX® was calculated using femoral neck BMD initially without then with consideration of VF. The change of therapeutic decision was assessed after taking into consideration FRAX® and the VFA results.Results:The study included 210 post-menopausal women with a mean age of 61.5±8.5 years. The mean BMI was 31.04±5.52 kg/m2. One women was a current smoker and alcohol intake was not found in our sample. Thirty-seven percent of our participants had at least one fragility fracture. A severe fragility fracture was recorded in 10.5% and a previous hip fracture was reported in 5.24%. An early menopause was found in 19.5% of our women. Twenty percent of our population were receiving corticosteroids and 8.2% of our population had rheumatoid arthritis. The mean vertebral and total hip BMD was 0.955±0.165 g/cm2 and 0.850±0.135 g/cm2 respectively. Osteoporosis and low BMD were found in respectively 50% and 34.28%. The median probability of major osteoporotic fracture for our population was 1.5% with an interquartile range from 0.9 to 2.5% without using VFA data and 1.65% with an interquartile range from 1 to 2.6% while taking into consideration VFA results and the difference was statistically significant (p<0.0001). The median probability of hip fracture for our population was 0.4% with an interquartile range from 0.1 to 0.9% without using VFA data and 0.4% with an interquartile range from 0.1 to 1% while taking into consideration VFA results and the difference was statistically significant (p<0.0001). In all patients, the FRAX® was under the threshold intervention even after including the asymptomatic VF and it did not change the therapeutic decision. The presence of asymptomatic VF on VFA changed the therapeutic decision in 15% and indicated an anti-osteoporosis drug therapy.Conclusion:VFA scanning helped in the therapeutic decision in 15% of our population. In this evaluation, we showed that a comprehensive fracture risk pathway incorporating VFA has enhanced diagnosis of vertebral fractures and improved targeting of treatment better than FRAX® tool.Disclosure of Interests:None declared.

scholarly journals A Preliminary Evaluation of the Ability of Keratotic Tissue to Act as a Prognostic Indicator of Hip Fracture Risk

2018 ◽  
Vol 11 ◽  
pp. 117954411775405 ◽  
Author(s):  
J Renwick Beattie ◽  
Diane Feskanich ◽  
M Clare Caraher ◽  
Mark R Towler
Keyword(s):  
Raman Spectroscopy ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Spectroscopic Analysis ◽  
Prognostic Indicator ◽  
Health Study ◽  
Preliminary Evaluation ◽  
Predictive Values ◽  
Menopausal Women ◽  
Post Menopausal

Studies have shown that Raman spectroscopic analysis of fingernail clippings can help differentiate between post-menopausal women who have and who have not suffered a fracture. However, all studies to date have been retrospective in nature, comparing the proteins in nails sourced from women, post-fracture. The objective of this study was to investigate the potential of a prospective test for hip fracture based on spectroscopic analysis of nail tissue. Archived toenail samples from post-menopausal women aged 50 to 63 years in the Nurses’ Health Study were obtained and analysed by Raman spectroscopy. Nails were matched case-controls sourced from 161 women; 82 who underwent a hip fracture up to 20 years after nail collection and 81 age-matched controls. A number of clinical risk factors (CRFs) from the Fracture Risk Assessment (FRAX) tool had been assessed at toenail collection. Using 80% of the spectra, models were developed for increasing time periods between nail collection and fracture. Scores were calculated from these models for the other 20% of the sample and the ability of the score to predict hip fracture was tested in model with and without the CRFs by comparing the odds ratios (ORs) per 1 SD increase in standardised predictive values. The Raman score successfully distinguished between hip fracture cases and controls. With only the score as a predictor, a statistically significant OR of 2.2 (95% confidence interval [CI]: 1.5-3.1) was found for hip fracture for up to 20 years after collection. The OR increased to 3.8 (2.6-5.4) when the CRFs were added to the model. For fractures limited to 13 years after collection, the OR was 6.3 (3.0-13.1) for the score alone. The test based on Raman spectroscopy has potential for identifying individuals who may suffer hip fractures several years in advance. Higher powered studies are required to evaluate the predictive capability of this test.

scholarly journals SAT0473 COMPARSION OF THE FRACTURE RISK IN WOMEN WITH AND WITHOUT SCOLIOSIS THROUGH DUAL-ENERGY X-RAY ABSORPTIOMETRY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1193.2-1194
Author(s):  
N. Kirilov ◽  
S. Todorov ◽  
N. Nikolov ◽  
M. Nikolov
Keyword(s):  
Fracture Risk ◽  
Hip Fractures ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
Major Osteoporotic Fractures ◽  
Cobb’S Angle ◽  
The Mean

Background:Osteoporosis is known to be a risk factor for fragility fractures [4, 5]. On one hand, vertebral body fragility fractures often lead to additional spine deformity [2]. On the other hand, it was found that with the progression of the spinal curvature in osteoporotic patients, the fragility fractures develop more frequently. The increased incidence of these fractures could be explained with a predominance of the mechanical forces on the one side of the already weakened osteoporotic vertebrae [3].Objectives:The aim of this study is to compare the fracture risk (FRAX) for major osteoporotic fractures (MOF) and for hip fractures (HF) in women with and without scoliosis through dual-energy X-ray absorptiomentry (DXA)Methods:In the current study, 59 women underwent DXA scans. Scoliosis was defined as Cobb’s angle ≥ 5◦ according to the Chaklin’s classification [6, 7]. Cobb’s angle was measured from DXA images with DICOM software. We evaluated the following risk factors: previous fractures, parental hip fractures, secondary osteoporosis, rheumatoid arthritis, use of corticosteroids, current smoking and alcohol consumption more than 3 units daily. We estimated FRAX MOF and FRAX HF on the basis of these risk factors and on the basis of the femoral neck bone mineral density (BMD). The calculations were done through FRAX tool published on the website of the University of Sheffield [1].Results:The mean age of the women was 63 years (yrs.) ± 10 yrs. (range 43 yrs. – 89 yrs.). Subjects with scoliosis were significantly older (67 yrs.) than those without scoliosis (59 yrs.), (p = 0.004). Mean weight and height didn’t differ between the groups with- and without scoliosis. Mean lumbar spine BMD and T-score differed significantly between the groups, (p = 0.02). Women with scoliosis had lower mean BMD (0.786 g/cm2) and lower mean T-score (-2.1 standard deviations (SDs)) compared to those without scoliosis (mean BMD: 0.912 g/cm2 and mean T-score: 0.9 SDs). The mean FRAX MOF (19.3%) and FRAX HF (5.9%) of the subjects with scoliosis were significantly higher than those of the women without scoliosis (FRAX MOF: 14.9% and FRAX HF: 3.1%), (p = 0.004 for FRAX MOF and p = 0.010 for FRAX HF).Conclusion:Women with scoliosis showed significantly higher fracture risk for major osteoporotic fractures and for hip fractures compared to those without scoliosis.References:[1]https://www.sheffield.ac.uk/FRAX/index.aspx[2]Mao YF, Zhang Y, Li K, et al. Discrimination of vertebral fragility fracture with lumbar spine bone mineral density measured by quantitative computed tomography. J Orthop Translat. 2018;16:33–39. Published 2018 Oct 10. doi:10.1016/j.jot.2018.08.007.[3]Sabo A, Hatgis J, Granville M, Jacobson RE. Multilevel Contiguous Osteoporotic Lumbar Compression Fractures: The Relationship of Scoliosis to the Development of Cascading Fractures. Cureus. 2017;9(12):e1962. Published 2017 Dec 19. doi:10.7759/cureus.1962.[4]Kirilova E, Cherkezov D, Gonchev B, Zheleva Z. OSIRIS Index for the assessment of the risk for osteoporosis in menopausal women, National conference with international participation, 6-7 october 2019, Kardzhali “Science and society 2019”, RKR print OOD ISSN 1314-3425[5]Madzharova R, Kirilova E, Petranova T, Nikolova M. Assessment of the activity for self care in women with osteoporosis, Science and TechnologieVolume VIII, 2018, Number 1: MEDICAL BIOLOGY STUDIES, CLINICAL STUDIES, SOCIAL MEDICINE AND HEALTH CARE,1-6.[6]Chaklin VD, Orthopedy - Moscow: Medgiz – 1965 – C. 209[7]Chaklin VD. Pathology, clinical manifestation and treatment of the scoliosis, 1stcongress of the union of the orthopedists and traumatologists, Moscow: Medgiz, 1957 – T.2. – p 798Disclosure of Interests:None declared

scholarly journals Hip geometry in hip fracture patients in Greenland occurring over a 7.7-year period

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Inuuteq Fleischer ◽  
Mogens Laursen ◽  
Stig Andersen
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Cortical Thickness ◽  
Geometric Analysis ◽  
Osteoporotic Fractures ◽  
Premature Death ◽  
Neck Length ◽  
Hip Geometry ◽  
Lesser Trochanter

Abstract Background Hip geometry influences hip fracture risk. Hip fractures are common, and they are associated with pain, disability, premature death and marked costs on society. Osteoporotic fractures are frequent in Arctic populations and increase with advancing age in this society with a steep rise in life expectancy. Greenland Inuit is a distinct ethnic group, and data on hip geometry is missing. We thus aimed to describe hip geometry in 7.7 years of consecutive hip fracture patients in Greenland. Methods We evaluated collodiaphysial angle, femoral neck length, the outer and inner diameter of the femur at 2 and 5 centimetres below the centre of the lesser trochanter and the cortical thickness from pelvic and hip radiographs in all patients operated in Greenland over 7.7 years. We included all 84 patients with one non-fractured hip visible for geometric analysis. Analyses were conducted in duplicate. Results We found a collodiaphysial angle of 134.8/132.6o in men/women (p = 0.06) and a femoral neck length of 38.0/33.9 mm in men/women (p = 0.001). Cortical thickness was affected by sex in the adjusted analysis (p < 0.001). Cortical thickness index at 5 cm below the centre of the lesser trochanter decreased with age (p = 0.026) and may be influenced by height (2 cm below the centre of the lesser trochanter, p = 0.053). Conclusion Our findings differed from European data and suggest a delicate balance in hip geometry in Arctic populations. Ethnic peculiarities influence the structure of the hip and may influence fracture risk. A focus on hip geometry and risk factors for osteoporotic fractures in Arctic populations is warranted.

scholarly journals POS0131 10-YEAR PROBABILITY OF A MAJOR OSTEOPOROTIC FRACTURES IN WOMEN WITH OSTEOARTHRITIS OF THE KNEE JOINT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 277.2-277
Author(s):  
E. Usova ◽  
O. Malyshenko ◽  
M. Letaeva ◽  
J. Averkieva ◽  
M. Koroleva ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Knee Joint ◽  
Fracture Risk ◽  
Proximal Femur ◽  
Assessment Tool ◽  
Osteoporotic Fractures ◽  
Control Group ◽  
Major Osteoporotic Fractures ◽  
Fracture Risk Assessment Tool ◽  
Clinically Significant

Background:The relationship between osteoporosis and osteoarthritis (OA) is complex and contradictory. Some studies suggest a protective effect of OA in osteoporosis [1-2]. However, other studies show that increased bone mineral density (BMD) in OA not only does not reduce the risk of fractures, but can also increase it [3-4].Objectives:To assess the 10-year probability of osteoporotic fractures using the FRAX calculator in women with OA of the knee joint.Methods:The study included 22 women (average age 63.7±1.01 years) diagnosed with ACP of the knee joint according to the ACR criteria (1991). The Control Group included 24 conditionally healthy women without OA knee joint, with an average age of 63.6±1.37 years.The BMD (g/cm2) and the T-criterion (standard deviation, SD) of the neck of the femur and lumbar spine (LI-LIV) were evaluated by the method of two-power X-ray absorption (DXA) (apparatus «Lunar Prodigy Primo», USA). 10-year probability of major osteoporotic fractures (clinically significant fracture of the spine, distal fracture of the forearm, fracture of the proximal femur, or fracture of the shoulder) and fracture of the proximal thigh with the FRAX calculator (version 3.5 for Russian population).Results:An osteopenic syndrome in the cohort under investigation was found in 42 (91.3%) patients, of whom osteopenia in 24 (52.2%) women and osteoporosis in 18 (39.1%). A normal BMD is registered in 4 (8.7%) patients.In the group of patients with knee joint OA, only 2 (9.1%) of women had a normal BMD, 11 (50.0%) of osteoporosis, and 9 (40.9%). Osteopenic syndrome is generally found in 20 (90,9%) patients.In the control group, osteopenic syndrome has been diagnosed in 22 (91,7%) of whom: osteopenia in 13 (54.2%), osteoporosis in 9 (37.5%) patients. Two (8.3%) women had a normal BMD. There were no statistically significant differences in the structure of the osteopenic syndrome among the studied groups (p=0.961).An analysis of the 10-year probability of major osteoporotic fractures found that women with OA knee joint had the above probability of 12.3±0.91, and in the control group 14.2±1.06 (p=0.085).The 10-year probability of fracture of the proximal femur in women with OA was statistically less significant than in the control group: 1.55 (0.70;1.98) and 2.10 (1.20;2.95), (p=0.031), respectively.Conclusion:The total incidence of the osteopenic syndrome in the cohort under investigation was 91.3% (90.9% in women with OA, 91.7% in the control group). The frequency of registration of osteopenia and osteoporosis in women with OA did not differ statistically significantly from the control group. The probability of major osteoporotic fractures within 10 years was comparable in these groups. The probability of a proximal femur fracture in women with OA was statistically significant, but not clinically significant, compared to the control group.References:[1]Yamamoto Y, Turkiewicz A, Wingstrand H, et al. Fragility Fractures in Patients with Rheumatoid Arthritis and Osteoarthritis Compared with the General Population. J Rheumatol. 2015 Nov;42(11):2055-8.[2]Vala CH, Kärrholm J, Kanis JA, et al. Risk for hip fracture before and after total knee replacement in Sweden. Osteoporos Int. 2020 May;31(5):887-895.[3]Kim BY, Kim HA, Jung JY, et al. Clinical Impact of the Fracture Risk Assessment Tool on the Treatment Decision for Osteoporosis in Patients with Knee Osteoarthritis: A Multicenter Comparative Study of the Fracture Risk Assessment Tool and World Health Organization Criteria. J Clin Med. 2019 Jun 26;8(7):918.[4]Soh SE, Barker AL, Morello RT, et al. Applying the International Classification of Functioning, Disability and Health framework to determine the predictors of falls and fractures in people with osteoarthritis or at high risk of developing osteoarthritis: data from the Osteoarthritis Initiative. BMC Musculoskelet Disord. 2020 Feb 29;21(1):138.Disclosure of Interests:None declared

STUDIES ON THE INFLUENCE OF AGE ON OESTROGENS IN POST-MENOPAUSAL WOMEN WITH ATROPHIC ENDOMETRIUM AND NORMAL LIVER FUNCTION

1969 ◽  
Vol 62 (3) ◽  
pp. 461-467 ◽  
Author(s):  
B.-J. Procopé ◽  
H. Adlercreutz
Keyword(s):  
Age Groups ◽  
Normal Liver ◽  
Time Lapse ◽  
Mean Value ◽  
Vaginal Smear ◽  
Normal Liver Function ◽  
Menopausal Women ◽  
The Mean ◽  
Post Menopausal ◽  
Considerable Individual Variation

ABSTRACT A group of 104 post-menopausal women, who were at least 50 years old and with a time lapse of at least 2 years since the last menstruation, were investigated for their urinary oestrogen content. All the women had an atrophic endometrium as judged by histological investigation of a biopsy specimen. In 66 of the subjects the mean value of the karyopyknotic and eosinophilic indices in the vaginal smear was also calculated. The women, whose ages ranged from 50 to 79 years, were divided into 6 age groups. The median values for the excretion of oestrone, oestradiol, oestriol and total oestrogens and the mean karyopyknotic and eosinophilic indices for all age groups were very constant though there was considerable individual variation. It was also shown that the median values for all subjects were practically identical with those of 57 ovariectomized women reported in a previous study. It is concluded that in the majority of post-menopausal women with atrophic endometrium the ovarian contribution to the production of oestrogens is insignificant. It can also be concluded that with increasing age the normal liver does not significantly change the metabolism of oestrogens in post-menopausal women, as judged by the excretion of oestrone, oestradiol and oestriol, and the oestrogenic effect on the vaginal smear.

SAT0364 Are differences of hip shape responsible for increased femoral neck fracture risk in post-menopausal women?:

2013 ◽  
Vol 71 (Suppl 3) ◽  
pp. 595.2-595
Author(s):  
A.G.S. Oldroyd ◽  
M. Nickkho-Amiry ◽  
B. Evans ◽  
C. Greenbank ◽  
M. Bukhari
Keyword(s):  
Femoral Neck ◽  
Fracture Risk ◽  
Femoral Neck Fracture ◽  
Menopausal Women ◽  
Neck Fracture ◽  
Post Menopausal

Long-Term Prediction of Incident Hip Fracture Risk in Elderly White Women: Study of Osteoporotic Fractures

2004 ◽  
Vol 52 (9) ◽  
pp. 1479-1486 ◽  
Author(s):  
Brent C. Taylor ◽  
Pamela J. Schreiner ◽  
Katie L. Stone ◽  
Howard A. Fink ◽  
Steven R. Cummings ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Fracture Risk ◽  
White Women ◽  
Osteoporotic Fractures ◽  
Hip Fracture Risk ◽  
Term Prediction ◽  
Long Term Prediction

Prostaglandin F2α metabolite and F2-isoprostane excretion rates in migraine

2001 ◽  
Vol 102 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Johanna HELMERSSON ◽  
Peter MATTSSON ◽  
Samar BASU
Keyword(s):  
Oxidative Stress ◽  
Migraine Attack ◽  
Prostaglandin F2α ◽  
Urine Samples ◽  
Menopausal Women ◽  
The Mean ◽  
Post Menopausal ◽  
Excretion Rates ◽  
And Control ◽  
And Oxidative Stress

The pathophysiology theory of migraine postulates a local, neurogenic inflammation and the possible involvement of oxidative stress. We analysed the levels of 15-oxo-dihydro-prostaglandin F2α (a metabolite of prostaglandin F2α) and 8-iso-prostaglandin F2α (a major isoprostane), which are biomarkers for inflammation and oxidative stress respectively, in urine from 21 patients with migraine, with and without aura. Urine samples from migraine patients were collected during a migraine attack, and control samples were collected from the same subjects on a migraine-free morning. The mean basal levels of 15-oxo-dihydro-prostaglandin F2α and 8-iso-prostaglandin F2α in the morning control urine samples were 0.54±0.11 and 0.31±0.13nmol/mmol of creatinine respectively. The mean levels of 15-oxo-dihydro-prostaglandin F2α and 8-iso-prostaglandin F2α in the urine samples collected during the migraine attack in the 21 patients were 0.53±0.13 and 0.32±0.11nmol/mmol of creatinine respectively. Thus there were no differences in the 15-oxo-dihydro-prostaglandin F2α and 8-iso-prostaglandin F2α excretion rates during the migraine attack compared with on the migraine-free day. However, the basal 8-iso-prostaglandin F2α excretion levels on the migraine-free day were significantly lower in pre-menopausal women (0.24±0.08nmol/mmol of creatinine, n = 11) compared with post-menopausal women (0.39±0.14nmol/mmol of creatinine; n = 7; P = 0.009). In conclusion, in this study we found no support for the involvement of inflammation and oxidative stress in migraine pathophysiology. Our results indicate, however, a lower level of oxidative stress in pre-menopausal compared with post-menopausal women.

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