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 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 Evaluation of the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding

2021 ◽  
Vol 10 (10) ◽  
pp. 3885
Author(s):  
Kushla Pathania ◽  
Surbhi Sharma
Keyword(s):  
Diagnostic Accuracy ◽  
Postmenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Cross Sectional ◽  
Predictive Values ◽  
Menopausal Women ◽  
Submucous Fibroid ◽  
Post Menopausal

Background: Abnormal uterine bleeding is a very common gynaecological condition that affects all age groups. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Aim was to evaluate the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding.Methods: The present study was prospective cross sectional study conducted in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child Indira Gandhi Medical College Shimla for period of one year w.e.f. 1st May 2018 to 30th April 2019. The study was started after hospital ethical committee approval. 76 patients peri and post-menopausal women were enrolled in the study after taking written consent.Results: On TVS- all the study subjects underwent TVS examination, submucous fibroid was detected in 10 subjects (n= 76) i.e. 13.1% (all perimenopausal). On hysteroscopy submucous fibroid was detected in 11 (14.4%) subjects, on histopathology it was confirmed in 11 subjects (14.4%). Out of 11, 8 patients underwent hysterectomy, 1 myomectomy, 2 patients had hysteroscopic removal of fibroid. 1 subject with AUB-LSM was wrongly diagnosed as AUB-P. Sensitivity, specificity, positive and negative predictive values of transvaginal sonography versus hysteroscopy was 90.09%, 100%, 100%, 98.5% respectively.Conclusions: TVS is an important initial modality for evaluating the patient of AUB. It is quick, simple, painless, least invasive, less expensive and readily available procedure and does not need full bladder like TAS. On the other hand, hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.

scholarly journals Diabetes and kidney cancer risk among post-menopausal women: The Iowa women’s health study

Maturitas ◽  
2021 ◽  
Vol 143 ◽  
pp. 190-196
Author(s):  
Shuo Wang ◽  
Mark D. Lo Galbo ◽  
Cindy Blair ◽  
Bharat Thyagarajan ◽  
Kristin E. Anderson ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Women’S Health ◽  
Women's Health ◽  
Kidney Cancer ◽  
Health Study ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Iowa Women's Health Study

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

scholarly journals Potential Explanatory Factors for Higher Incident Hip Fracture Risk in Older Diabetic Adults

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Elsa S. Strotmeyer ◽  
Aruna Kamineni ◽  
Jane A. Cauley ◽  
John A. Robbins ◽  
Linda F. Fried ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Fracture Risk ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Hip Fracture Risk ◽  
Explanatory Factors ◽  
Artery Disease ◽  
Study Participants

Type 2 diabetes is associated with higher fracture risk. Diabetes-related conditions may account for this risk. Cardiovascular Health Study participants (N=5641; 42.0% men; 15.5% black; 72.8±5.6 years) were followed 10.9±4.6 years. Diabetes was defined as hypoglycemic medication use or fasting glucose (FG)≥126 mg/dL. Peripheral artery disease (PAD) was defined as ankle-arm index <0.9. Incident hip fractures were from medical records. Crude hip fracture rates (/1000 person-years) were higher for diabetic vs. non-diabetic participants with BMI <25 (13.6, 95% CI: 8.9–20.2 versus 11.4, 95% CI: 10.1–12.9) and BMI≥25 to <30 (8.3, 95% CI: 5.7–11.9 versus 6.6, 95% CI: 5.6–7.7), but similar for BMI≥30. Adjusting for BMI, sex, race, and age, diabetes was related to fractures (HR = 1.34; 95% CI: 1.01–1.78). PAD (HR = 1.25 (95% CI: 0.92–1.57)) and longer walk time (HR = 1.07 (95% CI: 1.04–1.10)) modified the fracture risk in diabetes (HR = 1.17 (95% CI: 0.87–1.57)). Diabetes was associated with higher hip fracture risk after adjusting for BMI though this association was modified by diabetes-related conditions.

scholarly journals Urinary isoflavonoids and risk of type 2 diabetes: a prospective investigation in US women

2015 ◽  
Vol 114 (10) ◽  
pp. 1694-1701 ◽  
Author(s):  
Ming Ding ◽  
Adrian A. Franke ◽  
Bernard A. Rosner ◽  
Edward Giovannucci ◽  
Rob M. van Dam ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Urinary Excretion ◽  
Hormone Replacement ◽  
Health Study ◽  
Inverse Association ◽  
Validated Questionnaire ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Incident Cases

AbstractTo examine the association between urinary excretion of isoflavonoids and risk of type 2 diabetes (T2D), we conducted a nested case–control study among 1111 T2D pairs identified during 1995–2008 in the Nurses’ Health Study (NHS) and NHSII, who were free of diabetes, CVD and cancer at urine sample collection. Urinary excretion of daidzein and genistein, as well as their metabolites O-desmethylangolensin (O-DMA), dihydrogenistein (DHGE) and dihydrodaidzein (DHDE) was assayed using liquid chromatography MS. Self-reported T2D incident cases were confirmed using a validated questionnaire. Higher urinary excretion of daidzein and genistein was associated with a lower risk of T2D in the combined cohorts. Comparing extreme tertiles of the urinary markers, the OR of T2D were 0·71 (95 % CI 0·55, 0·93) for daidzein and 0·74 (95 % CI 0·56, 0·97) for genistein, although the test for linear trend was not significant for genistein (Ptrend=0·03 and 0·15, respectively). DMA, DHDE and DHGE were non-significantly associated with a lower T2D risk. The inverse association of daidzein with T2D risk was stronger among post-menopausal women who did not use hormone replacement therapy (Pinteraction=0·001): the OR was 0·58 (95 % CI 0·34, 0·97) comparing extreme tertiles among these women. In conclusion, urinary excretion of isoflavones was associated with a lower T2D risk in US women, especially among post-menopausal women who did not use hormone. Further research is warranted to replicate these observations among western populations with similarly low overall isoflavone intake.

scholarly journals Does thyroid function influence fracture risk? Prospective data from the HUNT2 study, Norway

2013 ◽  
Vol 169 (6) ◽  
pp. 845-852 ◽  
Author(s):  
Anders Svare ◽  
Tom Ivar Lund Nilsen ◽  
Bjørn Olav Åsvold ◽  
Siri Forsmo ◽  
Berit Schei ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Fracture Risk ◽  
Reference Group ◽  
Positive Association ◽  
Population Based ◽  
Health Study ◽  
Thyroid Peroxidase ◽  
Forearm Fractures ◽  
Hip Fracture Risk ◽  
Increased Risk

ObjectiveTo prospectively study the relation between TSH and risk of hip and forearm fractures.DesignA population-based cohort study.MethodsIn a substudy of the second survey of the Nord Trøndelag Health Study, Norway (HUNT2, 1995–97), linked with a hospital-based fracture registry, we investigated the relation between baseline TSH and risk of hip and/or forearm fractures.PopulationA total of 16 610 women and 8595 men aged 40 years or more, without previous self-reported thyroid disease and hip or forearm fractures.ResultsDuring 12.5 years follow-up, a total of 1870 women and 342 men experienced hip or forearm fractures. Overall, there was no relation between baseline TSH and fracture risk. However, there was weak evidence that women with TSH <0.5 and >3.5 mU/l had a slightly increased risk of hip fractures (hazard ratio (HR) 1.30, 95% CI 0.97–1.94 and HR 1.19, 95% CI 0.93–1.52) compared with the reference group with TSH of 1.5–2.4 mU/l. Supplementary analyses showed higher hip fracture risk in women with TSH >4.0 mU/l and negative thyroid peroxidase antibodies (TPOAb) compared with the reference group (HR 1.75, 95% CI 1.24–2.46).ConclusionWe found no statistically significant relation between baseline TSH and subsequent fracture risk, but the data suggest a weak positive association with hip fracture risk among women with both low and high TSH. The latter association was confined to women with negative TPOAb status.

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