scholarly journals OP20 The impact of the secular increase in body mass index on hip fracture risk in the norwegian population

2021 ◽  
Author(s):  
Helena K Kjeldgaard ◽  
Kristin Holvik ◽  
Martin O’Flaherty ◽  
Grethe S Tell ◽  
Haakon E Meyer
Keyword(s):  
Body Mass Index ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Body Mass ◽  
Hip Fracture Risk ◽  
Norwegian Population ◽  
The Impact ◽  
Secular Increase

scholarly journals Associations of body mass index and diabetes with hip fracture risk: a nationwide cohort study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Hsiu-Ling Huang ◽  
Cheng-Chin Pan ◽  
Yu-Fen Hsiao ◽  
Ming-Chih Chen ◽  
Chuan-Yu Kung ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Body Mass ◽  
Hip Fracture Risk

scholarly journals MON-389 Fracture Risk Assessment Models for Patients With T2DM

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Andreea Maria Banica ◽  
Luciana Mihaela Oprea ◽  
Iuliana Ilie ◽  
Viviana Elian ◽  
Andra Caragheorgheopol ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Fracture Risk Assessment ◽  
Diabetic Patients ◽  
Major Osteoporotic Fracture ◽  
Hip Fracture Risk ◽  
Diabetic Population ◽  
The Impact

Abstract Introduction Bone mineral density (BMD) measurement, a tool used to diagnose osteoporosis (OP) and to predict fracture risk, has not been found very useful in type 2 diabetic (T2DM) patients. They have a 69% higher fracture risk despite having higher hip and lumbar spine BMD than the non-diabetic population. The aim of this study was to examine the impact of 3 different fracture risk assessment (FRAX) models using surrogate adjustments for T2DM in predicting osteoporotic fracture risk over 10 years. Material and Methods Observational retrospective study included 98 patients with OP or osteopenia: 94 women and 4 men admitted in the National Institute of Endocrinology between 2011-2019. 50 % (n= 49) of the patients had T2DM, while the other half were non-diabetic patients. BMI, BMD, lipid profile, serum creatinine, calcium, phosphorus, 25(OH)vitamin D, HbA1c were assessed. BMD was measured on a GE Lunar osteodensitometer. The risk of major osteoporotic fracture in 10 years was assessed with FRAX adjusted for Romania. For diabetic patients, FRAX was adjusted by adding 10 years to patients’ age (model 1), by using rheumatoid polyarthritis as a substitute for T2DM (model 2) or by lowering T score with 0.5 DS (model 3). Results Non-diabetic patients had a lower BMI (p=0.001) and a lower BMD (p=0.03) than diabetic patients. A higher BMI correlated with a higher hip BMD (p=0.004). For diabetic patients, FRAX risk without adjustment was statistically significant lower than FRAX risk calculated with model 1 and 2 (p< 0.001) for both major and hip fracture risk. Unadjusted FRAX risk was lower than the one calculated with model 3 only for hip fracture risk (p<0.001). Model 1 FRAX adjustment led to a statistically significant risk of both major osteoporotic fracture (p= 0.004) and hip fracture (p=0.04) over 10 years in diabetic patients than non-diabetic patients, though diabetic patients had higher BMD. The same observation was made when FRAX was adjusted by model 2 (p=0.001) or by model 3 (p=0.001). HbA1c correlated inversely with FRAX adjusted with all three models. Discussion FRAX calculator does not include T2DM among secondary causes of OP and this precludes a proper risk assessment independent of BMD. Trabecular bone assessment (TBS) captures a larger portion of the diabetes-associated fracture risk than BMD, however TBS it is not fully independent of the BMD. We examined 3 models of adjusted FRAX in T2DM patients that showed an important increase in fracture risk prediction when adding BMD - independent risk factors into FRAX calculator. Conclusion T2DM patients have a greater risk of major osteoporotic fracture in 10 years at the same BMD compared with non-diabetic population. New models of FRAX adjusted for T2DM are needed in assessing the intervention threshold for OP/osteopenia of patients with T2DM.

scholarly journals The Impact of Disease and Drugs on Hip Fracture Risk

2016 ◽  
Vol 100 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Breiffni Leavy ◽  
Karl Michaëlsson ◽  
Anna Cristina Åberg ◽  
Håkan Melhus ◽  
Liisa Byberg
Keyword(s):  
Hip Fracture ◽  
Fracture Risk ◽  
Hip Fracture Risk ◽  
The Impact

Multiple Regression Analysis of Hip Fracture Risk Assessment via Finite Element Analysis

2020 ◽  
Author(s):  
Rabina Awal ◽  
Tanvir Faisal
Keyword(s):  
Regression Analysis ◽  
Hip Fracture ◽  
Bone Density ◽  
Fracture Risk ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Mineral Density ◽  
Hip Fracture Risk ◽  
Loading Direction ◽  
The Impact

Abstract An accurate assessment of hip fracture risk requires a proper consideration of parameters affecting the fracture. In general, hip fracture is assessed based on Bone Mineral Density (BMD) and load amount, but hip fracture is an outcome of the interaction of the parameters such as loading directions, bone density, which are often disregarded. Assessing the effect of the parameters individually may not correctly reflect the root cause of the hip fracture. Hence, this research aims at analyzing the significance of parameters and their interaction in assessing the fracture risk. A multiple regression analysis has been conducted considering bone density (\rho_ash), different loading directions during sideways fall, represented by load angle (\alpha) about femoral shaft on the coronal plane and angle (\beta) about femoral neck axis on the transverse plane as independent parameters and fracture risk index (FRI) as a dependent parameter. The statistical results showing the significant value of 0.7321 for , and 0.0001 for and ?_ash indicate that the effect of loading direction (\alpha) does not have impact on fracture risk in comparison with the loading direction (\beta) and (\rho_ash). Furthermore, the analysis of the interaction of parameters shows that the impact of \beta on fracture risk may depends more on bone density.

scholarly journals Is the effect of Mediterranean diet on hip fracture mediated through type 2 diabetes mellitus and body mass index?

2020 ◽  
Author(s):  
Adam Mitchell ◽  
Tove Fall ◽  
Håkan Melhus ◽  
Alicja Wolk ◽  
Karl Michaëlsson ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Type 2 Diabetes Mellitus ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Mediterranean Diet ◽  
Body Mass ◽  
Direct Effect

Abstract Background We examined whether the inverse association between adherence to a Mediterranean diet and hip fracture risk is mediated by incident type 2 diabetes mellitus (T2DM) and body mass index (BMI). Methods We included 50 755 men and women from the Cohort of Swedish Men and the Swedish Mammography Cohort who answered lifestyle and medical questionnaires in 1997 and 2008 (used for calculation of the Mediterranean diet score 9mMED; low, medium, high) and BMI in 1997, and incident T2DM in 1997–2008). The cumulative incidence of hip fracture from the National Patient Register (2009–14) was considered as outcome. Results We present conditional odds ratios (OR) 9[95% confidence interval, CI) of hip fracture for medium and high adherence to mMED, compared with low adherence. The total effect ORs were 0.82 (0.71, 0.95) and 0.75 (0.62, 0.91), respectively. The controlled direct effect of mMED on hip fracture (not mediated by T2DM, considering BMI as an exposure-induced confounder), calculated using inverse probability weighting of marginal structural models, rendered ORs of 0.82 (0.72, 0.95) and 0.73 (0.60, 0.88), respectively. The natural direct effect ORs (not mediated by BMI or T2DM, calculated using flexible mediation analysis) were 0.82 (0.71, 0.95) and 0.74(0.61, 0.89), respectively. The path-specific indirect and partial indirect natural effects ORs (through BMI or T2DM) were close to 1. Conclusions Mediterranean diet has a direct effect on hip fracture risk via pathways other than through T2DM and BMI. We cannot exclude mediating effects of T2DM or BMI, or that their effects cancel each other out.

scholarly journals Proton Pump Inhibitors, Histamine-2 Receptor Antagonists, and Hip Fracture Risk among Patients on Hemodialysis

2018 ◽  
Vol 13 (10) ◽  
pp. 1534-1541 ◽  
Author(s):  
Chandan Vangala ◽  
Jingbo Niu ◽  
Colin R. Lenihan ◽  
William E. Mitch ◽  
Sankar D. Navaneethan ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Fracture Risk ◽  
Receptor Antagonist ◽  
Proton Pump ◽  
Index Date ◽  
Calcium Absorption ◽  
Receptor Antagonists ◽  
Hip Fracture Risk ◽  
Dialysis Vintage ◽  
The Impact

Background and objectivesAn association between proton pump inhibitor (PPI) use and hip fracture risk has been described in the general population, where the primary causative hypothesis focuses on impaired gastrointestinal calcium absorption. The impact of acid suppressor use on hip fracture risk in a high-risk subset, patients with ESKD requiring hemodialysis, is unknown and could help further distinguish the reason for higher susceptibility among PPI users.Design, setting, participants, & measurementsUsing the US Renal Data System, we identified all hip fracture events recorded between 2009 and 2014 among patients dependent on hemodialysis. Eligible cases were matched on index date with ten controls. We identified PPI and histamine-2 receptor antagonist use from Medicare Part D claims covering 3 years before the index date and stratified according to proportion of days covered by filled prescriptions. Using logistic regression with multiple imputation for missing data, we estimated unadjusted and multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs).ResultsWe studied 4551 cases and 45,510 controls. Patients were older, more likely to be female and white, and had shorter dialysis vintage; fewer were obese. A larger proportion of patients had any prior PPI (70% versus 63%) or histamine-2 receptor antagonist (25% versus 23%) use. Use of PPI was associated with higher risk of hip fracture (adjusted OR, 1.19; 95% CI, 1.11 to 1.28). This association remained within subgroups of low, moderate, and high PPI use, yielding adjusted ORs of 1.16 (95% CI, 1.06 to 1.27), 1.21 (95% CI, 1.11 to 1.31), and 1.19 (95% CI, 1.08 to 1.31), respectively.ConclusionsAmong patients with ESKD on hemodialysis, PPIs and not histamine-2 receptor antagonists were associated with hip fracture events.

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