scholarly journals Prevalence of fracture risk among middle-aged and elderly population of Gujarat, India: an observational study

2020 ◽  
Vol 7 (11) ◽  
pp. 4429
Author(s):  
Bhoomika G. Brahmbhatt ◽  
Megha S. Sheth
Keyword(s):  
Hip Fracture ◽  
Observational Study ◽  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Elderly Population ◽  
Safety Zone ◽  
Middle Aged ◽  
Major Osteoporotic Fracture ◽  
Risk Of Fracture ◽  
Treatment Zone

Background: This study was conducted to estimate the prevalence of fracture risk among middle-aged and elderly population of Gujarat and to find out the prevalence of the clinical risk factors (CRF) and its significance with risk of fracture. To compare the risk of fracture among men and women.Methods: An observational study included 500 participants both men and women, in age group of 40-80 years. Participants were assessed with the fracture risk assessment tool (FRAX) without BMD to evaluate the 10-year probability of risk of Major osteoporotic fracture (MOF) and Hip fracture (HF). India-specific age-dependent thresholds were used to categorize the participants into safety zone and treatment zone followed by statistical analysis. Level of significance was kept at 5%.Results: Total 500 participants, 56.8% males and 43.2% females with mean age 56.3±9.7 years. As per the estimated prevalence, 22% participants were in treatment zone and 78% were in safety zone for HF risk and for major osteoporotic fracture risk, 24% participants were in treatment zone and 76% were in safety zone. In 18.6% participants the hip fracture risk was ≥3% and in 2% participants the major osteoporotic fracture risk was ≥20%. Women had more fracture risk compare to men, for HF [t (464.6)=-3.04, p=0.002] and for MOF [t (441.3)=-5.13, p<0.001]. Significant difference in fracture risk was found with presence of CRF except with smoking and alcohol use.Conclusions: FRAX can be used to identify the 10-year probability of fracture risk. The prevalence showed fewer participants in treatment zone and more in safety zone. Women had higher fracture probabilities than men.

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 ABSOLUTE FRACTURE RISK ASSESSMENT IN OUTPATIENTS WITH DISTAL RADIUS OSTEOPOROSIS

2012 ◽  
Vol 15 (3) ◽  
pp. 3-6
Author(s):  
A A Popov ◽  
M V Strunina ◽  
M V Telyushchenko
Keyword(s):  
Risk Assessment ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Clinical Decision Making ◽  
Absolute Risk ◽  
Fracture Risk Assessment ◽  
Mineral Density ◽  
Major Osteoporotic Fracture ◽  
Test Sensitivity

Objectives: to assess the absolute fracture risk in outpatients with osteoporosis (OP) at distant radius. Methods: individual absolute fracture risk was assessed using FRAX tool without hip neck bone mineral density (BMD) input in 3082 subsequent subjects (2911 females and 171 males) aged from 40 to 95 (median age 60), calculated by Finnish population data. Distant radius BMD was estimated in all patients by DTX200. Results: 774 (25.1 %) patients had had history of low traumatic fractures. BMD≤- .5 SD was detected in 1659 cases, fracture history in 558 (33.6%) of them (OR = 2.21; 95 % CI 1.93-2.55). Median 10-year probability of a major osteoporotic fracture was 4.90 % (25- 75 %; 1.10 - 55.0) and 10-year probability of a hip fracture was 0.8 % (0 - 46), absolute risk 10 % and higher was detected in 434 (64,3 %) patients. Calculated 10-year probability of a major osteoporotic fracture > 10 % was associated with previous low traumatic fractures: OR = 4,55; 95 % CI 4,06- 5,10, test sensitivity being 56.1 % with specificity 89.6 % . The same association was found for 10-year probability of hip fracture >3 %: OR = 3.57 (3.19 - 4.00), test sensitivity being 51,6 % with specificity 86,7 %. Conclusion: FRAX tool for individual absolute fracture risk assessment should be introduced into general practice for clinical decision making in prophylaxis of OP associated fractures.

scholarly journals SAT0094 ASSESMENT OF BONE MINERAL DENSITY AND FRACTURE RISK IN PATIENTS WITH RHEUMATOID ARTHRITIS AND SARCOPENIA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 980.2-981
Author(s):  
O. Dobrovolskaya ◽  
Z. Kolkhidova ◽  
A. Menshikova ◽  
N. Demin ◽  
N. Toroptsova
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Hip Fracture ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Osteoporotic Fracture ◽  
Proximal Femur ◽  
Mineral Density ◽  
Major Osteoporotic Fracture

Background:The problem of sarcopenia (SP) in rheumatoid arthritis (RA) is particularly significant in terms of assessing the risk of fractures, since SP leads to falls, which are an independent risk factor for fractures along with RA and osteoporosis.Objectives:To evaluate the bone mineral density (BMD) and fracture risk in women with RA and SP.Methods:79 women with RA based on the 2010 ACR/EULAR classification criteria were included: 20 (25%) women with confirmed SP (age median 59 [53; 64]) according to EWGSOP2 criteria and 59 (75%) women without SP (age median 60 [55; 67]) (p>0.05). We assessed clinical data: age, body mass index (BMI), disease duration, anthropometric measurements, C-reactive protein level, disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR), previous medication use including glucocorticoids and methotrexate, muscle strength and function. Dual-energy X-ray absorptiometry (DXA) to measure BMD of lumbar spine (LS), femoral neck (FN) and total hip (TH) was performed. The 10-year probability of major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture) and the 10-year probability hip fracture was calculated using the Russian version of the FRAX® tool. Statistical analysis was performed using non-parametric methods. All patients signed an informed consent to participate.Results:Median BMD in LS was 0.892 [0.772; 1.024] g/cm2in patients with SP and 0.910 [0.785; 1.028] g/cm2- without SP (p>0.05). There was significant difference between groups in the proximal femur BMD: 0.760 [0.731; 0.826] g/cm2in TH and 0.681 [0.607; 0.703] g/cm2in FN in patients with SP and 0.838 [0.735; 0.921] g/cm2in TH and 0.719 [0.622; 0.804] g/cm2in FN in patients without SP (p=0.009 and p=0.048, respectively). The frequency of osteoporosis was 35% and 22% in patients with and without SP (p>0,05). The 10-year probability of major osteoporotic fracture with / without femoral neck BMD data was 22,0% [17,0; 32,0] / 19,5% [18,5; 22,5 and 13,3% [9,8; 18,5] / 12,8% [9,3; 17,0] in patients with SP and without SP (р<0.05) and the 10-year probability of hip fracture with / without femoral neck BMD data - 3,1% [3,0; 7,5] / 3,1% [2,3; 3,3] and 1,4% [0,9; 2,78] / 0,65 [0,4; 1,7], respectively (р<0.05).Conclusion:There were no differences in the frequency of osteoporosis between patients with SP and without SP, however women with SP had proximal femur BMD less than women without SP. The probability of major osteoporotic fracture and hip fracture was significantly higher in patients with RA and SP compared with patients without SP.Disclosure of Interests:None declared

scholarly journals Improved prediction of fracture risk leveraging a genome-wide polygenic risk score

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Tianyuan Lu ◽  
Vincenzo Forgetta ◽  
Julyan Keller-Baruch ◽  
Maria Nethander ◽  
Derrick Bennett ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fracture Risk ◽  
Risk Prediction ◽  
Osteoporotic Fracture ◽  
Clinical Risk Factors ◽  
European Ancestry ◽  
Major Osteoporotic Fracture ◽  
Risk Of Fracture ◽  
Clinical Risk ◽  
Genome Wide

Abstract Background Accurately quantifying the risk of osteoporotic fracture is important for directing appropriate clinical interventions. While skeletal measures such as heel quantitative speed of sound (SOS) and dual-energy X-ray absorptiometry bone mineral density are able to predict the risk of osteoporotic fracture, the utility of such measurements is subject to the availability of equipment and human resources. Using data from 341,449 individuals of white British ancestry, we previously developed a genome-wide polygenic risk score (PRS), called gSOS, that captured 25.0% of the total variance in SOS. Here, we test whether gSOS can improve fracture risk prediction. Methods We examined the predictive power of gSOS in five genome-wide genotyped cohorts, including 90,172 individuals of European ancestry and 25,034 individuals of Asian ancestry. We calculated gSOS for each individual and tested for the association between gSOS and incident major osteoporotic fracture and hip fracture. We tested whether adding gSOS to the risk prediction models had added value over models using other commonly used clinical risk factors. Results A standard deviation decrease in gSOS was associated with an increased odds of incident major osteoporotic fracture in populations of European ancestry, with odds ratios ranging from 1.35 to 1.46 in four cohorts. It was also associated with a 1.26-fold (95% confidence interval (CI) 1.13–1.41) increased odds of incident major osteoporotic fracture in the Asian population. We demonstrated that gSOS was more predictive of incident major osteoporotic fracture (area under the receiver operating characteristic curve (AUROC) = 0.734; 95% CI 0.727–0.740) and incident hip fracture (AUROC = 0.798; 95% CI 0.791–0.805) than most traditional clinical risk factors, including prior fracture, use of corticosteroids, rheumatoid arthritis, and smoking. We also showed that adding gSOS to the Fracture Risk Assessment Tool (FRAX) could refine the risk prediction with a positive net reclassification index ranging from 0.024 to 0.072. Conclusions We generated and validated a PRS for SOS which was associated with the risk of fracture. This score was more strongly associated with the risk of fracture than many clinical risk factors and provided an improvement in risk prediction. gSOS should be explored as a tool to improve risk stratification to identify individuals at high risk of fracture.

Physical activity in middle-aged women and hip fracture risk: the UFO study

2010 ◽  
Vol 22 (2) ◽  
pp. 499-505 ◽  
Author(s):  
U. Englund ◽  
P. Nordström ◽  
J. Nilsson ◽  
G. Bucht ◽  
U. Björnstig ◽  
...  
Keyword(s):  
Physical Activity ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Middle Aged ◽  
Hip Fracture Risk

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.

The risk of fracture in incident multiple sclerosis patients: The Danish National Health Registers

2012 ◽  
Vol 18 (11) ◽  
pp. 1609-1616 ◽  
Author(s):  
Marloes T Bazelier ◽  
Joan Bentzen ◽  
Peter Vestergaard ◽  
Egon Stenager ◽  
Hubert GM Leufkens ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Hip Fracture ◽  
National Health ◽  
Osteoporotic Fracture ◽  
Population Based ◽  
Risk Of Fracture ◽  
Increased Risk ◽  
Disability Status ◽  
Multiple Sclerosis Patients ◽  
Health Registers

Background: Patients with multiple sclerosis (MS) may be at increased risk of fractures owing to osteoporosis and falling. Objective: To evaluate the risk of fracture in incident MS patients drawn from a dedicated MS registry compared with population-based controls. Methods: We conducted a population-based cohort study (1996–2007) utilising the Danish National Health Registers that were linked to the Danish MS Registry and the Danish MS Treatment Registry. Incident MS patients (2963 cases) were 1:6 matched by year of birth, gender, calendar time and region to persons without MS (controls). Cox proportional hazards models and logistic regression were used to estimate the risk of fracture in MS. Time-dependent adjustments were made for age, history of diseases and drug use. Results: Compared with controls, patients with MS had no overall increased risk of fracture (adjusted hazard ratio (adj. HR): 1.0, 95% CI: 0.9–1.2). However, the risk of femur/hip fracture (adj. HR: 1.9, 95% CI: 1.1–3.4) was significantly increased compared to controls. As compared with unexposed patients, MS patients who had been exposed to a short course of methylprednisolone in the prior year had no significantly increased risk of osteoporotic fracture (adj. HR: 1.2, 95% CI: 0.5–2.9). Disabled MS patients with Expanded Disability Status Scale [EDSS] scores between 6 and 10, had a 2.6-fold increased risk of osteoporotic fracture (adjusted odds ratio (adj. OR): 2.6, 95% CI: 1.0–6.6) compared to patients with an EDSS score between 0 and 3. Conclusion: Patients with MS had a higher risk of femur/hip fracture than controls. Disability status is probably more important than glucocorticoid use in the aetiology of MS and osteoporotic fracture.

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