scholarly journals Associations Between Bone Impact Microindentation and Clinical Risk Factors for Fracture

Endocrinology ◽  
2019 ◽  
Vol 160 (9) ◽  
pp. 2143-2150 ◽  
Author(s):  
Pamela Rufus-Membere ◽  
Kara L Holloway-Kew ◽  
Adolfo Diez-Perez ◽  
Mark A Kotowicz ◽  
Julie A Pasco
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Clinical Risk Factors ◽  
Material Strength ◽  
Mineral Density ◽  
Clinical Risk ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
Prior Fracture ◽  
Impact Microindentation

Abstract Impact microindentation (IMI) measures bone material strength index (BMSi) in vivo. However, clinical risk factors that affect BMSi are largely unknown. This study investigated associations between BMSi and clinical risk factors for fracture in men. BMSi was measured using the OsteoProbe in 357 men (ages 33 to 96 years) from the Geelong Osteoporosis Study. Risk factors included age, weight, height, body mass index (BMI), femoral neck bone mineral density (BMD), parental hip fracture, prior fracture, type 2 diabetes mellitus (T2DM), secondary osteoporosis, smoking, alcohol consumption, sedentary lifestyle, medications, diseases, and low serum vitamin D levels. BMSi was negatively associated with age (r = −0.131, P = 0.014), weight (r = −0.109, P = 0.040), and BMI (r = −0.083, P = 0.001); no correlations were detected with BMD (r = 0.000, P = 0.998) or height (r = 0.087, P = 0.10). Mean BMSi values for men with and without prior fracture were 80.2 ± 6.9 vs 82.8 ± 6.1 (P = 0.024); parental hip fracture, 80.1 ± 6.1 vs 82.8 ± 6.9 (P = 0.029); and T2DM, 80.3 ± 8.5 vs 82.9 ± 6.6 (P = 0.059). BMSi did not differ in the presence vs absence of other risk factors. In multivariable models, mean (± SD) BMSi remained associated with prior fracture and parental hip fracture after adjusting for age and BMI: prior fracture (80.5 ± 1.1 vs 82.8 ± 0.4, P = 0.044); parental fracture (79.9 ± 1.2 vs 82.9 ± 0.4, P = 0.015). No other confounders were identified. We conclude that in men, BMSi discriminates prior fracture and parental hip fracture, which are both known to increase the risk for incident fracture. These findings suggest that IMI may be useful for identifying men who have an increased risk for fracture.

scholarly journals Redefining osteoporosis treatment: who to treat and how long to treat

2006 ◽  
Vol 50 (4) ◽  
pp. 694-704 ◽  
Author(s):  
E. Michael Lewiecki ◽  
Stuart L. Silverman
Keyword(s):  
Risk Factors ◽  
Fracture Risk ◽  
Weight Bearing ◽  
Pharmacological Therapy ◽  
Clinical Risk Factors ◽  
Common Disease ◽  
Mineral Density ◽  
Clinical Risk ◽  
Increased Risk ◽  
Bmd Testing

Osteoporosis is a common disease that is associated with increased risk of fractures and serious clinical consequences. Bone mineral density (BMD) testing is used to diagnose osteoporosis, estimate the risk of fracture, and monitor changes in BMD over time. Combining clinical risk factors for fracture with BMD is a better predictor of fracture risk than BMD or clinical risk factors alone. Methodologies are being developed to use BMD and validated risk factors to estimate the 10-year probability of fracture, and then combine fracture probability with country-specific economic assumptions to determine cost-effective intervention thresholds. The decision to treat is based on factors that also include availability of therapy, patient preferences, and co-morbidities. All patients benefit from nonpharmacological lifestyle treatments such a weight-bearing exercise, adequate intake of calcium and vitamin D, fall prevention, avoidance of cigarette smoking and bone-toxic drugs, and moderation of alcohol intake. Patients at high risk for fracture should be considered for pharmacological therapy, which can reduce fracture risk by about 50%.

Socioeconomic and clinical risk factors of hip fracture among the elderly: a case-control study

2019 ◽  
Vol 25 (10) ◽  
pp. 1-16
Author(s):  
Georgia Zacharopoulou ◽  
Vasiliki Zacharopoulou ◽  
Eleni Voudouri ◽  
Lili Leondiou ◽  
Zacharias Dermatis
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Elderly Population ◽  
Case Control Study ◽  
The Elderly ◽  
Case Control ◽  
Clinical Risk Factors ◽  
Clinical Risk ◽  
Increased Risk ◽  
Control Study

Background/Aims The aim of the study was to investigate the socioeconomic and clinical risk factors for hip fracture among a community-dwelling elderly population in Greece. It also aimed to identify characteristics associated with reducing mobility. Methods A case-control study was conducted on 202 patients who had a hip fracture and on 202 other members of the elderly population who did not have a hip fracture as the control group. Results In the multivariate analysis, the variables related to an increased risk of hip fracture were: gender (odds ration [OR]=10.88; 95%confidence Interval [CI]=2.28–51.98), income (OR=32.50; 95%CI=2.96–356.43), income adequacy (OR=129,34; 95%CI=7,09–2360,88), inability to pay expenses/medication (OR=0.02; 95%CI=0.003–0.09), depression (OR=0.03; 95%CI=0.002–0.35), multimorbidity (OR=0.01; 95%CI=0.001–0.97), number of medication (OR=0.02; 95%CI=0.001–0.28) and history of falls (OR=0.08; 95%CI=0.01–0.40). Factors related to deterioration of mobility were: age (OR=28.43; 95%CI:5.45–148.32), dementia (OR=15.60; 95%CI:1.80–135.27), walking ability (OR=0.20; 95%CI:0.07–0.56), balance (OR=9.10; 95%CI:1.89–43.75), use of walking aid (OR=7.42; 95%CI:2.70–20.39), and length of hospitalisation (OR=3.01; 95%CI:1.27–7.14). Conclusions Socioeconomic and clinical factors that lead to an increased risk of hip fracture were identified, as well as factors affecting post-operative functional ability that could guide prevention programmes.

scholarly journals Prognostic value of lower bone mineral density in predicting adverse cardiovascular disease in Asian women

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318764
Author(s):  
Jiesuck Park ◽  
Yeonyee Elizabeth Yoon ◽  
Kyoung Min Kim ◽  
In-Chang Hwang ◽  
Wonjae Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Cardiovascular Disease ◽  
Clinical Diagnosis ◽  
Bone Mineral ◽  
Prognostic Value ◽  
Clinical Risk Factors ◽  
Mineral Density ◽  
Clinical Risk ◽  
Incremental Prognostic Value

ObjectiveWe investigated whether the evaluation of bone mineral density (BMD) provides independent and incremental prognostic value for predicting atherosclerotic cardiovascular disease (ASCVD) in women.MethodsA total of 12 681 women aged 50–80 years (mean, 63.0±7.8 years) who underwent dual-energy X-ray absorptiometry were retrospectively analysed. We assessed the hazard ratio (HR) for ASCVD events (ASCVD death, non-fatal myocardial infarction and ischaemic stroke) according to the BMD or a clinical diagnosis of osteopenia or osteoporosis, with adjustment for clinical risk factors, including age, body mass index, hypertension, type 2 diabetes, hyperlipidaemia, current smoking and previous fracture. We also evaluated whether the addition of BMD or a clinical diagnosis of osteopenia or osteoporosis to clinical risk factors improved the prediction for ASCVD events.ResultsIn total, 468 women (3.7%) experienced ASCVD events during follow-up (median, 9.2 years). Lower BMD at the lumbar spine, femur neck and total hip was independently associated with higher risk for ASCVD events (adjusted HR per 1-standard deviation decrease in BMD: 1.16, p<0.001; 1.29, p<0.001; 1.38, p<0.001; respectively). A clinical diagnosis of osteoporosis was also independently associated with higher risk for ASCVD events (adjusted HR: 1.79, p<0.001). The addition of BMD or a clinical diagnosis of osteopenia or osteoporosis to clinical risk factors demonstrated significant incremental value in discriminating ASCVD events (addition of total hip BMD, p for difference <0.001).ConclusionThe evaluation of BMD provides independent and incremental prognostic value for ASCVD in women and thus may improve risk stratification in women.

scholarly journals Pelvic Organ Prolapse and Relationship with Skeletal Integrity

2009 ◽  
Vol 5 (3) ◽  
pp. 325-333 ◽  
Author(s):  
Lubna Pal
Keyword(s):  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Fracture Risk ◽  
Postmenopausal Women ◽  
Pelvic Organ ◽  
Clinical Risk Factors ◽  
Mineral Density ◽  
Female Population ◽  
Clinical Risk ◽  
Age Related

Health burden related to osteoporotic fractures in an aging female population far exceeds that imposed by other chronic disorders such as cardiovascular disease and breast cancer. Bone mineral density assessment and clinical risk factors provide independent insights into fracture risk in individuals. A finite list of clinical risk factors are identified as prognostic of fracture risk, namely among aging women, including low body mass, compromised reproductive physiology (e.g., prolonged periods of amenorrhea and early menopause), parental and personal histories of fracture, and alcohol and tobacco use. Pelvic organ prolapse is a common gynecologic entity and a contributor to age-related morbidities. The purpose of this review is to communicate data identifying pelvic organ prolapse as another clinical risk factor for fracture risk in postmenopausal women and to increase the caregiver's vigilance in anticipating and instituting preventive care strategies to a population (i.e., postmenopausal women with clinically appreciable pelvic organ prolapse) that may be at an enhanced lifetime risk for skeletal fractures.

scholarly journals Hip bone mineral density, bone turnover and risk of fracture in patients on long-term suppressive L-thyroxine therapy for differentiated thyroid carcinoma

2005 ◽  
Vol 153 (1) ◽  
pp. 23-29 ◽  
Author(s):  
A Caroline Heijckmann ◽  
Maya S P Huijberts ◽  
Piet Geusens ◽  
Jolanda de Vries ◽  
Paul P C A Menheere ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Vertebral Fracture ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Carcinoma ◽  
Clinical Risk Factors ◽  
Type I ◽  
Mineral Density ◽  
Clinical Risk

Objective: Untreated hyperthyroidism and treatment with high doses of thyroid hormone are associated with osteoporosis. However, their effect on bone turnover, their contribution to bone mineral density (BMD) in the context of other clinical risk factors for osteoporosis and the prevalence of vertebral fractures is not well documented. Design: Cross-sectional study. Methods: We studied 59 patients receiving L-thyroxine suppressive therapy for differentiated thyroid carcinoma (DTC). BMD of the hip was measured by dual X-ray absorptiometry (DXA) and lateral DXA pictures of the lumbar and thoracic vertebrae were performed. Bone resorption was measured by C-telopeptides of type I collagen (ICTP) and bone formation by procollagen type I N-propeptide (PINP). Clinical risk factors for osteoporosis were evaluated using a questionnaire. Results: Z-scores of BMD were similar as the NHANES (National Health and Nutrition Examination Survey) III reference group in women and men, also after long-term (>10 years) suppression therapy. Patients in the lowest and highest quartile of BMD showed significant differences in the presence of clinical risk factors. ICTP levels were significantly higher than in age-matched controls, PINP levels were not different. We found four patients with a prevalent vertebral fracture. Conclusions: We conclude that patients with well-differentiated thyroid carcinoma are not at increased risk of developing low bone mass nor have a higher prevalence of vertebral fracture at least when treated with relatively low doses of l-thyroxine.

scholarly journals Identification of patients at increased risk of suicide in hepatobiliary and pancreatic cancer: an analysis of epidemiologic and clinical risk factors

HPB ◽  
2017 ◽  
Vol 19 ◽  
pp. S55
Author(s):  
P. Martinez Quinones ◽  
A. Talukder ◽  
N. Walsh ◽  
A. Lawson ◽  
A. Jones ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Cancer ◽  
Clinical Risk Factors ◽  
Clinical Risk ◽  
Increased Risk

scholarly journals Clinical Risk Factors for Osteoporotic Fractures in Men With Non-Metastatic Prostate Cancer on Androgen Deprivation Therapy With or Without Anti-Osteoporosis Treatment

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A243-A244
Author(s):  
Hajerah Sonnabend ◽  
Vishnu Priya Pulipati ◽  
Sanford Baim ◽  
Todd Beck ◽  
J Alan Simmons ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cancer Therapy ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Clinical Risk Factors ◽  
Mineral Density ◽  
Steroid Use ◽  
Clinical Risk ◽  
Significant Difference

Abstract Introduction: Androgen deprivation therapy (ADT) decreases bone mineral density and increases osteoporotic fracture (OsteoFx) risk. Hypothesis: To assess OsteoFx clinical risk factors (CRF) most predictive of future OsteoFx among men with prostate cancer on ADT. Methods: 4370 electronic medical records were reviewed of adult men with prostate cancer on cancer therapy +/- anti-osteoporosis therapy (Anti-OsteoRx) from 2011–2019. Cancer therapy included ADT (anti-androgens, GnRH agonists & antagonists, orchiectomy) and supplemental cancer therapy (SupplRx) (prostatectomy, brachytherapy, radiation, immunotherapy, and chemotherapy). Anti-OsteoRx included bisphosphonates, denosumab, and parathyroid hormone analogs. Patients with other cancers within 5 years of initial visit, metastasis, and traumatic fractures were excluded. Retrospective analysis was done to determine baseline characteristics, type and duration of ADT, Anti-OsteoRx, SupplRx, and osteoporosis CRF. Results: 615 men on ADT +/- SupplRx +/- Anti-OsteoRx were included in the study. 10.08% had OsteoFx irrespective of SupplRx or Anti-OsteoRx. Comparing the OsteoFx group to the non-fracture group, the following CRF were found to be statistically significant (p &lt;0.05): age at prostate cancer diagnosis (75.10 +/- 11.80 vs 71.59 +/- 9.80 y), diabetes mellitus (DM) (33.9 vs 19%), pre-existing comorbidities affecting bone (PreCo) (41.9 vs 24.8%), steroid use (11.3 vs 4.0%), and anti-convulsant and proton-pump inhibitor (med) use (45.2 vs 26.8%). 9.89% of 374 men on ADT only without (wo) Anti-OsteoRx fractured. Statistically significant CRF for OsteoFx were age (76.86 +/- 10.55 vs 73.02 +/- 10.06 y), DM (40.5 vs 19.6%), PreCo (45.9 vs. 26.4%), and med use (48.6 vs. 25.5%). In the following subgroups there were no statistically significant difference in CRF:•7.64% of 170 men on ADT + SupplRx wo Anti-OsteoRx •19.23% of 52 men on ADT only + Anti-OsteoRx •10.52% of 19 men on ADT + SupplRx + Anti-OsteoRx To increase statistical power, patients on ADT +/- SupplRx were assessed:•Among 71 men on ADT +/- SupplRx + Anti-OsteoRx, there were no statistically significant differences in CRF•Among the 544 men on ADT +/- SupplRx wo Anti-OsteoRx, significant CRF for OsteoFx were age (75.16 + 11.70 vs 71.37 + 9.85 y), DM (38 vs 19.4%), PreCo (38 vs 24.1%), steroid use (12 vs 3.8%), and med use (48 vs 24.3%) Discussion: Men with prostate cancer requiring ADT have a higher incidence of osteoporosis defined by DXA prior to initiating ADT compared to age-matched cohorts (Hussain et al). Our study revealed ADT with CRF is associated with OsteoFx irrespective of SupplRx or Anti-OsteoRx. Limitations include inability to evaluate efficacy of Anti-OsteoRx due to insufficient power. Conclusion: OsteoFx risk assessment utilizing CRF, FRAX, DXA with timely intervention may prevent OsteoFx in these high-risk patients.

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