scholarly journals SUN-374 Decisions to Accept or Decline Pharmacologic Osteoporosis Therapy After Attending a Novel Patient-Centred Educonsult Program for Osteoporosis (PEP-OP)

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Crystal Sixian Liu ◽  
Lynn Feasel ◽  
Gregory A Kline ◽  
Emma O Billington
Keyword(s):  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Fragility Fractures ◽  
Pharmacologic Therapy ◽  
Similar Proportion ◽  
Major Osteoporotic Fracture ◽  
Osteoporosis Therapy ◽  
T Score ◽  
Osteoporosis Care ◽  
Tc Model

Abstract Osteoporosis affects >200 million people, resulting in >8.9 million annual fragility fractures worldwide. Available medications can reduce fracture risk by 40–60%, although access to specialty osteoporosis services is limited, and many individuals remain unaware of their fracture risk and their treatment options. As the one-on-one ‘traditional consultation’ (TC) model of osteoporosis care is not time efficient (i.e. a single TC often requires >45 minutes), there is a need to identify innovative consultative models that can improve accessibility to osteoporosis care while maintaining quality. At our Osteoporosis Centre, we have implemented a group counseling model for this purpose: the Patient-Centred Educonsult Program for Osteoporosis (PEP-OP). Each two-hour PEP-OP session - co-facilitated by an osteoporosis physician and a nurse - provides up to 10 patients (the equivalent to 3–5 half-day physician clinics under the TC model) with a combined consultative and educational experience consisting of an individualized fracture risk assessment and extensive review of medications available to lower fracture risk. Patients are then encouraged to make an informed, autonomous decision about osteoporosis treatment initiation. Although the PEP-OP can accommodate a greater patient volume than the TC, and we have previously reported that the PEP-OP results in high patient satisfaction, it is not known whether PEP-OP produce similar results compared to TC in terms of treatment decisions. In this cohort study, we compared decisions to initiate osteoporosis therapy in PEP-OP (N=100) and TC (N=43) attendees. Ten-year risk of major osteoporotic fracture was estimated for each participant using the FRAX calculator, and participants were stratified based on whether their ten-year risk was ≥20% or <20%. Proportion of participants in each risk category who decided to initiate treatment were compared between the PEP-OP and TC groups. PEP-OP and TC groups were comparable in terms of age (63.3 vs 64.9 years), BMI (24.4 vs 24.9 kg/m2), previous fragility fractures (35 vs 25%), parental hip fractures (19 vs 23%), lumbar neck T-score (-2.5 vs -2.3), femoral neck T-score (-2.1 vs -2.1) and average FRAX estimate (13.1 vs 13.3%). The proportion of participants at high ten-year risk of major osteoporotic fracture (≥20%) who decided to initiate treatment was similar in both the PEP-OP (7/16, 44%) and TC (5/10, 50%) groups, according to the Chi Square Test (p=0.76). Among those with FRAX estimate of <20%, a similar proportion of patients in the PEP-OP (15/84, 18%) and TC (4/33, 12%) groups chose to undergo treatment (X2, p=0.45). In summary, decisions to initiate pharmacologic therapy were similar for the PEP-OP and the TC. Considering that the PEP-OP is acceptable to patients and is more efficient than the TC, this care model should be considered by other centers wishing to improve access to high-quality osteoporosis care.

93 Does Spinal Bone Mineral Density Predict An Absolute 10 Year Probability of Sustaining A Major Osteoporotic Fracture

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
A Nandi ◽  
N Obiechina ◽  
A Timperley ◽  
F Al-Khalidi
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Osteoporotic Fracture ◽  
Negative Correlation ◽  
Pearson Correlation ◽  
Fragility Fractures ◽  
Mineral Density ◽  
Major Osteoporotic Fracture ◽  
T Score ◽  
The Mean

Abstract Introduction Spine and hip bone mineral density (BMD) have previously been shown to predict the risk of sustaining future fractures. Although these have been shown in population studies, there is a paucity of trials looking at the relationship between BMD and 10 year probability of major osteoporotic fractures (Using FRAX UK without BMD) in patients with previous fragility fractures. Aims To evaluate the correlation between spinal T-score and an absolute 10 year probability of sustaining a major osteoporotic fracture (using FRAX without BMD) in patients with prior fragility fractures. Methods A retrospective cross-sectional analysis of 202 patients (29 males and 173 females) with prior fragility fractures attending a fracture prevention clinic between January and August 2019 was performed. Patients with pathological and high impact traumatic fractures were excluded. The BMD at the spine was determined using the lowest T-score of the vertebrae from L1 to L4. Using the FRAX (UK) without BMD, the absolute 10 year probability of sustaining a major osteoporotic fracture was calculated for each patient. Statistical analysis was performed using SPSS 26 software. Results The mean T-score at the spine was −1.15 (SD +/− 1.90) for all patients, −0.68 (SD +/− 0.45) for males and − 1.23 (SD +/− 0.14) for females. The mean FRAX score without BMD for major osteoporotic fracture was 18.5% (SD +/− 8.84) for all patients, 11.41% (SD +/−0.62) and 19.7% (SD +/−0.68) for males and females respectively. Pearson correlation coefficient showed a statistically significant, slightly negative correlation between spinal T- score and the FRAX (UK) without BMD (r = −0.157; p < 0.05). Correlation was not statistically significant when males (r = 0.109; p = 0.59) and females (r = 0.148; p = 0.053) were considered independently. Conclusion In patients with prior fragility fracture spinal BMD has a statistically significant negative correlation with an absolute 10 year probability of sustaining a major osteoporotic fracture.

scholarly journals Spine-Hip T-Score Difference Predicts Major Osteoporotic Fracture Risk Independent of FRAX®: A Population-Based Report From CAMOS

2011 ◽  
Vol 14 (3) ◽  
pp. 286-293 ◽  
Author(s):  
William D. Leslie ◽  
Christopher S. Kovacs ◽  
Wojciech P. Olszynski ◽  
Tanveer Towheed ◽  
Stephanie M. Kaiser ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Population Based ◽  
Major Osteoporotic Fracture ◽  
T Score ◽  
Score Difference

scholarly journals POS0164 THE NEED FOR ANTI-OSTEOPOROTIC INTERVENTION IN POSTMENOPAUSAL WOMEN WITH RHEUMATOID ARTHRITIS BASED ON THE FRACTURE RISK ASSESSMENT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 294.1-295
Author(s):  
O. Dobrovolskaya ◽  
A. Feklistov ◽  
O. Nikitinskaya ◽  
A. Efremova ◽  
N. Toroptsova
Keyword(s):  
Rheumatoid Arthritis ◽  
High Risk ◽  
Fracture Risk ◽  
Postmenopausal Women ◽  
Osteoporotic Fracture ◽  
Fragility Fractures ◽  
Low Risk ◽  
Moderate Risk ◽  
Major Osteoporotic Fracture ◽  
History Of

Background:Rheumatoid arthritis (RA) is a chronic disabling disease that is associated with bone loss. Previous studies estimated that approximately one-third of the RA patients had osteoporosis (OP). However, most fragility fractures occur in patients not suffering from OP, that can be partly explained by impaired quality of bone, which is not measured with DXA. Therefore, only the measurement of bone mineral density is not sufficient to determine the indication for OP treatment. Another tool for assessing the need for anti-osteoporotic therapy is to calculate the 10-year probability of a major fracture using the fracture risk assessment tool (FRAX).Objectives:To assess the need for anti-osteoporotic therapy in women with rheumatoid arthritis (RA) based on the identification of individuals with fragility fractures and high risk of fracture according to FRAX.Methods:295 postmenopausal women with RA were included in the study. The average age was 63±7 years, the duration of RA was 11 [4;16] years, the duration of postmenopausal period was 13 [6; 20] years. 121 (41%) patients took glucocorticoids (cumulative dose 9025 [3650; 20720] mg in prednisolone equivalent). A survey was conducted to identify patients with risk factors and a history of fragility fractures. The 10-year probability of a major osteoporotic fracture was assessed using the FRAX tool. In patients treated with glucocorticoids at a dose >7.5 mg in prednisolone equivalent the estimates of probabilities of a major osteoporotic fracture were adjusted in accordance with the recommendations [1]. Dual-energy X-ray absorptiometry (DXA) of the proximal femur was performed in patients with a moderate risk (probabilities between the upper and lower assessment age-dependent intervention threshold) and the risk of fracture was recalculated with including femoral neck BMD.Results:83 (28.1%) patients had a prior fragility fracture: 44 (14,9%) – 1, 20 (6,8%) – 2 and 19 (6.4%) – 3 or more. Vertebral fractures were the most common, they accounted for 62,1% of all fractures, distal forearm was the second frequent fractures localization (18.2%). Only 2 (0.7%) women had hip fracture. The average 10-year probability of a major osteoporotic fracture was 17 % [11; 28] in RA women. 92 (31.2%) persons were at high risk, 28 (9.5%) patients - at low risk, and 175 (59.3%) - at moderate risk. After recalculation of fracture risk with including femoral neck BMD in people at moderate risk 48 (16.3 %) patients became at high risk, 9 (3.1%) – at very high risk, and 118 (40.0%) - at low risk.Thus, 149 (50.5%) RA patients were at very high or high risk and 146 (49,5%) – at low risk of major osteoporotic fracture according to FRAX, among the last – only 3 persons had a history of fragility fracture after age of 40 years.Conclusion:Our study demonstrated that a half of postmenopausal women with RA had indications for anti-osteoporotic treatment based on the results of a 10-year probability of major fragility fractures using FRAX tool.References:[1]Kanis JA, Johansson H, Oden A, McCloskey EV. Guidance for the adjustment of FRAX according to the dose of glucocorticoids. Osteoporos Int. 2011;22(3):809-816. doi:10.1007/s00198-010-1524-7.Disclosure of Interests:None declared

scholarly journals POS0163 INCIDENT FRACTURE RISK PREDICTION USING THE FRAGILITY SCORE CALCULATED BY LUMBAR SPINE RADIOFREQUENCY ECHOGRAPHIC MULTI SPECTROMETRY (REMS) SCANS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 294.2-294
Author(s):  
D. Ciardo ◽  
P. Pisani ◽  
F. A. Lombardi ◽  
R. Franchini ◽  
F. Conversano ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Fracture Risk ◽  
Fragility Fracture ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Bone Fragility ◽  
P Value ◽  
T Score ◽  
Caucasian Women

Background:The main consequence of osteoporosis is the occurrence of fractures due to bone fragility, with important sequelae in terms of disability and mortality. It has been already demonstrated that the information about bone mass density (BMD) alone is not sufficient to predict the risk of fragility fractures, since several fractures occur in patients with normal BMD [1].The Fragility Score is a parameter that allows to estimate skeletal fragility thanks to a trans-abdominal ultrasound scan performed with Radiofrequency Echographic Multi Spectrometry (REMS) technology. It is calculated by comparing the results of the spectral analysis of the patient’s raw ultrasound signals with reference models representative of fragile and non-fragile bones [2]. It is a dimensionless parameter, which can vary from 0 to 100, in proportion to the degree of fragility, independently from BMD.Objectives:This study aims to evaluate the effectiveness of Fragility Score, measured during a bone densitometry exam performed with REMS technology at lumbar spine, in identifying patients at risk of incident osteoporotic fractures at a follow-up period of 5 years.Methods:Caucasian women with age between 30 and 90 were scanned with spinal REMS and DXA. The incidence of osteoporotic fractures was assessed during a follow-up period of 5 years. The ability of the Fragility Score to discriminate between patients with and without incident fragility fractures was subsequently evaluated and compared with the discriminatory ability of the T-score calculated with DXA and with REMS.Results:Overall, 533 women (median age: 60 years; interquartile range [IQR]: 54-66 years) completed the follow-up (median 42 months; IQR: 35-56 months), during which 73 patients had sustained an incident fracture.Both median REMS and DXA measured T-score values were significantly lower in fractured patients than for non-fractured ones, conversely, REMS Fragility Score was significantly higher (Table 1).Table 1.Analysis of T-score values calculated with REMS and DXA and Fragility Score calculated with REMS. Median values and interquartile ranges (IQR) are reported. The p-value is derived from the Mann-Whitney test.Patients without incident fragility fracturePatients with incident fragility fracturep-valueT-score DXA[median (IQR)]-1.9 (-2.7 to -1.0)-2.6 (-3.3 to -1.7)0.0001T-score REMS[median (IQR)]-2.0 (-2.8 to -1.1)-2.7 (-3.5 to -1.9)<0.0001Fragility Score[median (IQR)]29.9 (25.7 to 36.2)53.0 (34.2 to 62.5)<0.0001By evaluating the capability to discriminate patients with/without fragility fractures, the Fragility Score obtained a value of the ROC area under the curve (AUC) of 0.80, higher than the AUC of the REMS T-score (0.66) and of the T-score DXA (0.64), and the difference was statistically significant (Figure 1).Figure 1.ROC curve comparison of Fragility Score, REMS and DXA T-score values in the classification of patients with incident fragility fractures.Furthermore, the correlation between the Fragility Score and the T-score values was low, with Pearson correlation coefficient r=-0.19 between Fragility Score and DXA T-score and -0.18 between the Fragility Score and the REMS T-score.Conclusion:The Fragility Score was found to be an effective tool for the prediction of fracture risk in a population of Caucasian women, with performances superior to those of the T-score values. Therefore, this tool presents a high potential as an effective diagnostic tool for the early identification and subsequent early treatment of bone fragility.References:[1]Diez Perez A et al. Aging Clin Exp Res 2019; 31(10):1375-1389.[2]Pisani P et al. Measurement 2017; 101:243–249.Disclosure of Interests:None declared

scholarly journals The accuracy of different FRAX tools in predicting fracture risk in Japan: A comparison study.

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902091727
Author(s):  
Gang Xu ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
Shinji Miwa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
First Generation ◽  
Japanese Society ◽  
Comparison Study ◽  
Major Osteoporotic Fracture ◽  
Mineral Research ◽  
Mobile Software ◽  
Significant Difference

Introduction: The web version of Fracture Risk Assessment (FRAX) tool is widely used in many countries to predict the 10-year probability of major osteoporotic fracture (MF) and hip fracture (HF) rate. However, other FRAX tools, calculator older version (first generation), calculator new version (second generation), and application of mobile software had also been used in Japan. Purpose: The aim of this study is to investigate the consistency of results obtained from the four predicting tools for MF and HF rate in both male and female groups. Methods: The data were extracted from 2016 medical examination report of Japanese Ministry of Health of Labor and Welfare. The MF and HF rates were calculated from 40 to 90 years old under different risk factors using four FRAX tools while the consistency of predicting value was evaluated. Results: The predicted MF or HF rates were extremely similar among calculator new version, mobile software, and website version in each risk factors. On other hand, for calculator older version, the predicted MF or HF rates are a little higher than other versions. The significant difference is only present in patients aged 75 and above, and this exceeds the FRAX threshold older than 75 years old by Japanese Society for Bone and Mineral Research. Conclusions: The application of four FRAX tools generated consistent results in predicting the 10-year probability of major osteoporotic fracture and HF for clinical practice, which provides an effective evidence for clinical application.

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&lt; 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&lt;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 Comparison of osteoporotic fracture risk in surgical and natural menopausal patients

2021 ◽  
Vol 67 (3) ◽  
pp. 322-327
Author(s):  
Ayça Utkan Karasu ◽  
Yetkin Karasu ◽  
Müzeyyen Gülnur Özakşit ◽  
Yusuf Üstün ◽  
Yaprak Üstün Engin
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Assessment Tool ◽  
Lumbar Vertebrae ◽  
Mineral Density ◽  
Natural Menopause ◽  
T Score ◽  
Surgical Menopause

Objectives: This study aims to compare the fracture risk calculated with Fracture Risk Assessment Tool (FRAX®) in patients with natural and surgical menopause. Patients and methods: Between April 2019 and July 2019, 285 postmenopausal patients (mean age 57.3 years; range, 40 to 78 years) who were admitted to the menopause clinic were enrolled in this prospective cross-sectional study. Of these, 220 were in natural menopause and 65 were in surgical menopause. Demographic data, medical history, and International Physical Activity Questionnaire scores were collected through face-to-face interviews with the patients. Femoral neck and lumbar vertebrae (L1-L4) T-scores were evaluated using dual-energy X-ray absorptiometry. Fragility fracture risk was assessed using FRAX®. Results: The groups were similar in terms of age, body mass index, duration of menopause, smoking, alcohol use, and history of fracture (p>0.05). The risk of major osteoporotic fracture and hip fracture calculated without adding bone mineral density (BMD) was similar between groups (p=0.417 and p=0.234). The risk of hip fracture calculated with the addition of BMD was higher in natural menopause patients (p=0.023). Lumbar vertebrae T-scores were similar between two groups regardless of age; femoral neck T-scores were higher in surgical menopause (T-score=-0.8) than natural menopause group (T-score=-1.25) aged under 60 years, whereas this difference disappeared after 60 years of age. Conclusion: In our study, the fracture risk and the severity of osteoporosis were not different in surgical menopausal patients compared to the natural menopausal patients. Hip fracture risk calculated using BMD was lower in patients under 50 years of age in surgical menopausal patients. However, the fracture risks were similar in both groups after 50 years of age.

scholarly journals Emerging Therapies to Prevent Skeletal Morbidity in Men With Prostate Cancer

2011 ◽  
Vol 29 (27) ◽  
pp. 3705-3714 ◽  
Author(s):  
Philip J. Saylor ◽  
Richard J. Lee ◽  
Matthew R. Smith
Keyword(s):  
Prostate Cancer ◽  
Fracture Risk ◽  
Androgen Deprivation Therapy ◽  
Osteoporotic Fracture ◽  
Kinase Inhibitor ◽  
Fragility Fractures ◽  
Androgen Deprivation ◽  
Castration Resistant Prostate Cancer ◽  
Mineral Density ◽  
Radium 223

Skeletal morbidity is a prominent burden to men with advanced prostate cancer throughout the natural history of the disease. Bone metastases can cause pain and greatly elevate the risk for fractures and other structural complications. Distinct from the problem of metastases, treatment-related osteoporosis and associated fragility fractures are potential complications of androgen-deprivation therapy. Bone-targeted therapies for prostate cancer have therefore been the focus of considerable research and drug development efforts. The osteoclast is a validated therapeutic target in the management of prostate cancer. Osteoclast inhibition with zoledronic acid (a bisphosphonate) or with denosumab (a monoclonal antibody to RANK ligand) reduces risk for skeletal events in men with castration-resistant prostate cancer metastatic to bone. Osteoclast inhibition with any of several bisphosphonates improves bone mineral density, a surrogate for osteoporotic fracture risk. Denosumab and toremifene (a selective estrogen receptor modulator) have each been shown to reduce osteoporotic fracture risk among men receiving androgen-deprivation therapy. Beta-emitting radiopharmaceuticals reduce pain due to metastatic disease. Investigations involving alpha-emitting radium-223, endothelin-A receptor antagonists atrasentan and zibotentan, proto-oncogene tyrosine-protein kinase (SRC) inhibitor dasatinib, and tyrosine kinase inhibitor cabozantinib (XL184) are ongoing in clinical trials and are also discussed.

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

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