scholarly journals Characterization of Bone Metabolism in Hungarian Psoriatic Arthritis Patients: A Case–Control Study.

2020 ◽  
Author(s):  
Zsofia Petho ◽  
Edit Kalina ◽  
Zoltan Pap ◽  
Katalin Hodosi ◽  
Rebeka Falcsik ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Bone Mass ◽  
Fracture Risk ◽  
Disease Activity ◽  
Bone Metabolism ◽  
Osteoporotic Fracture ◽  
Independent Predictor ◽  
Low Bone Mass ◽  
Major Osteoporotic Fracture ◽  
Volumetric Bmd

Abstract Background: Skeletal manifestations are predominant in psoriatic arthritis (PsA). The aim of this cross-sectional, case-controlled study is the complex assessment of areal and volumetric bone mineral density (BMD), fracture risk, vitamin D status and bone turnover markers, and its association with disease-related variables.Methods: Lumbar spine (L1-L4) and femur neck (FN) areal, and distal radius (DR) volumetric BMD, 10-year probability of major and hip osteoporotic fracture as assessed by the fracture risk assessment (FRAX) tool, markers of bone metabolism and disease activity were assessed.Results: Upon comparison of the disease and age- and sex-matched control groups, there was a statistically significant difference in FN areal (0.955±0.145 g/cm2 vs. 1.034±0.148 g/cm2; p=0.001) and DR total volumetric (285.7±61.8 mg/cm3 vs. 369.6±23.6 mg/cm3; p<0.001) BMD, 10 year probability for major osteoporotic (5.0% (0.7%-32%) vs. 3.5% (0%-17.5%); p=0.003) and hip (1.1% (0%-16%) vs. 0.5% (0%-6.1%); p=0.002) fracture and 25-hydroxyvitamin D status (53 (10-120) nmol/L vs. 67 (10-137; p<0.001) nmol/L). As compared to areal assessment, volumetric BMD measurements identified a significantly higher number of patients with low bone mass (T-Score £ -1.00) (34% vs. 88%, p<0.001). Upon multiple linear regression analysis, disease activity score, as determined by DAS28 assessment, was an independent predictor of 10-year probability for major osteoporotic fracture (B (95%CI) = 1.351 (0.379–2.323); p = 0.007).Conclusion: In the studied PsA cohort, disease activity was an independent predictor of 10-year probability for a major osteoporotic fracture, and complemented assessment of volumetric and areal BMD assured better efficacy at identifying those with low bone mass.

scholarly journals Characterization of bone metabolism in hungarian psoriatic arthritis patients: a case–control study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zsófia Pethő ◽  
Edit Kalina ◽  
Zoltán Pap ◽  
Katalin Hodosi ◽  
Rebeka Falcsik ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Disease Activity ◽  
Bone Mineral ◽  
Osteoporotic Fracture ◽  
Case Control Study ◽  
Independent Predictor ◽  
Mineral Density ◽  
Major Osteoporotic Fracture ◽  
Volumetric Bmd ◽  
Control Study

Abstract Background Skeletal manifestations are predominant in psoriatic arthritis (PsA). The aim of this cross-sectional, case-control study is the complex assessment of areal and volumetric bone mineral density (BMD), fracture risk, vitamin D status and bone turnover markers, and its association with disease-related variables. Methods Lumbar spine (L1-L4) and femoral neck (FN) areal, and distal radius (DR) volumetric BMD, 10-year probability of major and hip osteoporotic fracture as assessed by the fracture risk assessment (FRAX) tool, markers of bone metabolism and disease activity were assessed. Results Upon comparison of the disease and age- and sex-matched control groups, there was a statistically significant difference in FN areal (0.952 (0.607–1.292) g/cm2 vs. 1.016 (0.760–1.550) g/cm2; p = 0.001) and DR total volumetric (284.3 (138.9–470.3) mg/cm3 vs. 367.0 (287.0–412.0) mg/cm3; p < 0.001) BMD, 10 year probability for major osteoporotic (3.7% (0.7–32%) vs. 2.6% (0–17.5%); p = 0.003) and hip (0.4% (0–16%) vs. 0.05% (0–6.1%); p = 0.002) fracture and 25-hydroxyvitamin D status (47.5 (10–120) nmol/L vs. 64 (10–137; p < 0.001) nmol/L). As compared to areal assessment, volumetric BMD measurements identified a significantly higher number of patients with low bone mineral density (T-Score ≤ − 1.00) (34% vs. 88%, p < 0.001). Upon multiple linear regression analysis, disease activity score, as determined by DAS28 assessment, was an independent predictor of 10-year probability for major osteoporotic fracture (B (95%CI) = 1.351 (0.379–2.323); p = 0.007). Conclusion In the studied PsA cohort, disease activity was an independent predictor of 10-year probability for a major osteoporotic fracture, and complemented assessment of volumetric and areal BMD assured better efficacy at identifying those with low bone mineral density.

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.

Low Bone Mass and Severity of Cholestasis Affect Fracture Risk in Patients With Primary Biliary Cirrhosis

2010 ◽  
Vol 138 (7) ◽  
pp. 2348-2356 ◽  
Author(s):  
Núria Guañabens ◽  
Dacia Cerdá ◽  
Ana Monegal ◽  
Francesca Pons ◽  
Llorenç Caballería ◽  
...  
Keyword(s):  
Primary Biliary Cirrhosis ◽  
Bone Mass ◽  
Fracture Risk ◽  
Biliary Cirrhosis ◽  
Low Bone Mass

scholarly journals Direct effects of physical training on markers of bone metabolism and serum sclerostin concentrations in older adults with low bone mass

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Gabriella Császárné Gombos ◽  
Viktória Bajsz ◽  
Emese Pék ◽  
Béla Schmidt ◽  
Eszter Sió ◽  
...  
Keyword(s):  
Older Adults ◽  
Bone Mass ◽  
Bone Metabolism ◽  
Physical Training ◽  
Direct Effects ◽  
Low Bone Mass

scholarly journals Haemophilia and low bone mass. Ok, but what about fracture risk?

Haemophilia ◽  
2016 ◽  
Vol 22 (1) ◽  
pp. 11-14 ◽  
Author(s):  
P. Anagnostis ◽  
S. N. Karras ◽  
S. Vakalopoulou ◽  
E. Terpos
Keyword(s):  
Bone Mass ◽  
Fracture Risk ◽  
Low Bone Mass

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 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 &gt;200 million people, resulting in &gt;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 &gt;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 &lt;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 &lt;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.

Changes in the relative expression of circulating microRNAs linked to bone metabolism in HIV-infected Individuals with low bone mass

2020 ◽  
Author(s):  
Maria Yavropoulou ◽  
Artemis Kolynou ◽  
Polyzois Makras ◽  
Lemonia Skoura ◽  
Sideris Nanoudis ◽  
...  
Keyword(s):  
Bone Mass ◽  
Bone Metabolism ◽  
Low Bone Mass ◽  
Circulating Micrornas ◽  
Relative Expression
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