Assessing hip fracture risk in type-2 diabetic patients using CT-based autonomous finite element methods

2021 ◽  
Vol 103-B (9) ◽  
pp. 1497-1504
Author(s):  
Dani Rotman ◽  
Gal Ariel ◽  
Jorge Rojas Lievano ◽  
Haggai Schermann ◽  
Nir Trabelsi ◽  
...  
Keyword(s):  
Finite Element ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Bone Strength ◽  
Strength Parameter ◽  
Control Group ◽  
Diabetic Patients ◽  
Study Group ◽  
Hip Fracture Risk

Aims Type 2 diabetes mellitus (T2DM) impairs bone strength and is a significant risk factor for hip fracture, yet currently there is no reliable tool to assess this risk. Most risk stratification methods rely on bone mineral density, which is not impaired by diabetes, rendering current tests ineffective. CT-based finite element analysis (CTFEA) calculates the mechanical response of bone to load and uses the yield strain, which is reduced in T2DM patients, to measure bone strength. The purpose of this feasibility study was to examine whether CTFEA could be used to assess the hip fracture risk for T2DM patients. Methods A retrospective cohort study was undertaken using autonomous CTFEA performed on existing abdominal or pelvic CT data comparing two groups of T2DM patients: a study group of 27 patients who had sustained a hip fracture within the year following the CT scan and a control group of 24 patients who did not have a hip fracture within one year. The main outcome of the CTFEA is a novel measure of hip bone strength termed the Hip Strength Score (HSS). Results The HSS was significantly lower in the study group (1.76 (SD 0.46)) than in the control group (2.31 (SD 0.74); p = 0.002). A multivariate model showed the odds of having a hip fracture were 17 times greater in patients who had an HSS ≤ 2.2. The CTFEA has a sensitivity of 89%, a specificity of 76%, and an area under the curve of 0.90. Conclusion This preliminary study demonstrates the feasibility of using a CTFEA-based bone strength parameter to assess hip fracture risk in a population of T2DM patients. Cite this article: Bone Joint J 2021;103-B(9):1497–1504.

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.

Finite Element Analysis of Proximal Femur QCT Scans for the Assessment of Hip Fracture Risk In Older Men

2008 ◽  
Vol 11 (3) ◽  
pp. 467-468 ◽  
Author(s):  
Tony M. Keaveny ◽  
Lynn M. Marshall ◽  
Carrie M. Nielson ◽  
Steven R. Cummings ◽  
Paul F. Hoffmann ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Proximal Femur ◽  
Older Men ◽  
Element Analysis ◽  
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&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 Finite Element Analysis of the Proximal Femur and Hip Fracture Risk in Older Men

2009 ◽  
Vol 24 (3) ◽  
pp. 475-483 ◽  
Author(s):  
Eric S Orwoll ◽  
Lynn M Marshall ◽  
Carrie M Nielson ◽  
Steven R Cummings ◽  
Jodi Lapidus ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Proximal Femur ◽  
Older Men ◽  
Element Analysis ◽  
Hip Fracture Risk

scholarly journals Effect of hypothyroidism on lipid profile of type 2 diabetic patients

2020 ◽  
Vol 7 (5) ◽  
pp. 754
Author(s):  
Damanpreet Singh ◽  
Gurinder Mohan ◽  
Arshdeep Bansal
Keyword(s):  
Type 2 Diabetes ◽  
Lipid Profile ◽  
Diabetic Complication ◽  
Control Group ◽  
P Value ◽  
Diabetic Patients ◽  
Study Group ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Background: Hypothyroidism is an endocrine disorder resulting from deficiency of thyroid hormones, and Diabetes is a metabolic disorder that share the phenotype of hyperglycaemia. Both the endocrinopathies have been found to be associated with dyslipidaemia and atherosclerosis that result into various complications. Our aim was to assess the difference of dyslipidaemia in patients suffering from hypothyroidism with diabetes as compared to diabetes alone.Methods: Study was conducted in department of medicine in SGRDIMSR, Sri Amritsar. A total of 120 patients were enrolled for the present study, the one who presented to hospital from January 2018 to August 2019 diagnosed with diabetes mellitus type 2. The patients were divided into two groups. 60 patients having type 2 diabetes without hypothyroidism (control group). 60 patients having type 2 diabetes with hypothyroidism (study group). Fasting lipid profile were performed in both the groups and were analysed for the study.Results: Dyslipidaemia was seen more in study group as compared to control group with mean cholesterol of 488.3(±144.43) and mean triglyceride levels of 354.30(±128.57) in study  group as compared to control group with mean cholesterol and triglyceride levels of 179.7(±81.47) and 177.08(±118.18) with p-value of 0.001 and 0.01 respectively which were significant. Also, obesity and diabetic complication were more in patients of dual endocrinopathies as compared to diabetes alone which were also significant statistically.Conclusions: From our study it is concluded that type 2 diabetes with hypothyroidism causes more dyslipidaemia as compare to type 2 diabetes alone. So proper screening of thyroid profile of type 2 diabetic patients and its correction helps in achieving better lipidemic control which further prevent complications.

scholarly journals Elevated Hip Fracture Risk in Type 1 Diabetic Patients: A Population-Based Cohort Study in Sweden

Diabetes Care ◽  
2005 ◽  
Vol 28 (12) ◽  
pp. 2850-2855 ◽  
Author(s):  
J. Miao ◽  
K. Brismar ◽  
O. Nyren ◽  
A. Ugarph-Morawski ◽  
W. Ye
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Population Based ◽  
Diabetic Patients ◽  
Hip Fracture Risk ◽  
Type 1 Diabetic Patients
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