scholarly journals Evaluation of association of fragility fracture and bone mineral density in Nepalese population

2013 ◽  
Vol 2 (2) ◽  
pp. 130-134
Author(s):  
Md. Farid Amanullah ◽  
BP Shrestha ◽  
GP Khanal ◽  
NK Karna ◽  
S Ansari ◽  
...  

Background: Fragility fractures are one of the major health problems. Many factors are associated with it some of which are modifiable and some are not. If we know the value of T-score at which fragility fracture occurs and associated factors responsible for fragility fracture than we will be able to control this burden to the society. The objective of this study is to determine association between fragility fracture and bone mineral density (BMD) using bone densitometry and to know the value of T-score at which fragility fracture occurs. Methods: Patients presenting to B.P. Koirala Institute of Health Sciences with fragility fracture of distal end of radius, fracture around hip and vertebral fractures were included in the study to know the value of T-score at which fragility fracture occurs and their associated risk factor. Patients less than 50 years of age, high energy trauma fracture and pathological fractures were excluded from the study. Results: We found that being multipara, smoking, alcohol consumption, post-hysterectomized patients and steroid intake had significant association with fragility fracture. There was no association with religion, geographic location, associated medical illness, age, sex, associated injury and site of injury. Conclusion: The patients with risk factor for fragility fracture like smoking, alcohol consumption, multipara women, post-hysterectomized women and those who are on long term steroid therapy should undergo BMD test and the value at -3.254 are prone to fragility fracture and should be treated accordingly. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 130-134 DOI: http://dx.doi.org/10.3126/njms.v2i2.8956

Author(s):  
Harry A. Hogan ◽  
H. Wayne Sampson

Alcohol consumption is a known risk factor exacerbating postmenopausal osteoporosis [1,2]. The current study was undertaken to investigate these effects using the rat animal model. Recent studies with rats have shown deleterious effects due to alcohol [3,4], but no significant effects when combined estrogen deficiency induced by ovariectomy (OVX) [5]. This last study did not report mechanical properties, however. The objective of the current study was to investigate the effects of alcohol and OVX on trabecular bone mechanical properties and bone mineral density (BMD) in adult female rats. An important issue in evaluating osteoporosis and related bone maladies clinically is the relation between bone mineral density (BMD) and fracture risk or incidence. Thus, an additional goal of the current study was to examine the relationships (correlations) between trabecular bone BMD and mechanical properties.


2008 ◽  
Vol 93 (7) ◽  
pp. 2594-2601 ◽  
Author(s):  
Thierry Chevalley ◽  
Jean-Philippe Bonjour ◽  
Serge Ferrari ◽  
Rene Rizzoli

Abstract Background: Shorter estrogen exposure from puberty onset to peak bone mass attainment may explain how late menarche is a risk factor for osteoporosis. The influence of menarcheal age (MENA) on peak bone mass, cortical, and trabecular microstructure was studied in 124 healthy women aged 20.4 ± 0.6 (sd) yr. Methods: At distal radius, areal bone mineral density (aBMD) was measured by dual-energy x-ray absorptiometry, and volumetric bone mineral density (BMD) and microstructure were measured by high-resolution peripheral computerized tomography, including: total, cortical, and trabecular volumetric BMD and fraction; trabecular number, thickness, and spacing; cortical thickness (CTh); and cross-sectional area (CSA). Results: Median MENA was 12.9 yr. Mean aBMD T score of the whole cohort was slightly positive. aBMD was inversely correlated to MENA for total radius (R = −0.21; P = 0.018), diaphysis (R = −0.18; P = 0.043), and metaphysis (R = −0.19; P = 0.031). Subjects with MENA more than the median [LATER: 14.0 ± 0.7 (±sd) yr] had lower aBMD than those with MENA less than the median (EARLIER: 12.1 ± 0.7 yr) in total radius (P = 0.026), diaphysis (P = 0.042), and metaphysis (P = 0.046). LATER vs. EARLIER displayed lower total volumetric BMD (315 ± 54 vs. 341 ± 56 mg HA/cm3; P = 0.010), cortical volumetric BMD (874 ± 49 vs. 901 ± 44 mg HA/cm3; P = 0.003), and CTh (774 ± 170 vs. 849 ± 191 μm; P = 0.023). CTh was inversely related to CSA (R = −0.46; P < 0.001). In LATER reduced CTh was associated with 5% increased CSA. Conclusions: In healthy young adult women, a 1.9-yr difference in mean MENA was associated with lower radial aBMD T score, lower CTh without reduced CSA, a finding compatible with less endocortical accrual. It may explain how late menarche is a risk factor for forearm osteoporosis.


2021 ◽  
Vol 14 (2) ◽  
pp. 155-165
Author(s):  
Arjun Bharat Mahadik ◽  
Ashok Bhimrao Giri ◽  
Akshay Sonaji Bhambre ◽  
Swapnil Ashok Mundhe ◽  
Ramdas D. Shinde

Osteoporosis is a major public health threat in this 21st century. It has high prevalence among postmenopausal women & elder patients (age > 60 years). It is a skeletal disorder characterized by compromised bone strength and suffer having greater chances of fractures. Osteoporosis is a condition where bones became weak & brittle that may increase chances of fracture in the patients. According to the WHO criteria, osteoporosis is defined as a bone mineral density (BMD) that lies 2.5 standard deviations or more below the average value for young healthy women (a T-score of <-2.5 SD). Osteoporosis is occurs due to too much bone mineral density is decreased that results into the changes in the structure of bone. Etiological factors includes advanced age, sex (women > male), sedentary lifestyle, minimal/ absence of sun exposure, smoking, alcohol consumption, hormonal imbalance and disease conditions such as diabetes, malignancies (multiple myeloma, lymphoma, leukemia). The diagnosis of condition must be confirmed by using spine dual energy X- ray absorptiometry (DXA) with WHO T-score thresholds. Osteopenia or low bone mass is having T-score of –1 to -2.4 & on the basis of T score, it will be classified in to two types that is primary and secondary osteoporosis. Primary osteoporosis more common in disease such as postmenopausal osteoporosis (type1) and senile osteoporosis (type2). It has severe morbid consequences, the prevention and management of this condition and associated fractures is considered to the essential to the maintenance of health status or quality of life (QoL) of patient. Patient can prevent to suffer from this condition by applying various tools of lifestyle medicines i.e. staying physically active or doing weight bearing exercises. Smoking cessation, moderate alcohol consumption are also became major approaches to manage or prevent occurrence of condition. Nutritious diet rich in calcium, vitamin D, Vitamin A, Vitamin C and other nutrition also play a key role in the management or prevention of disease.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Malika A Swar ◽  
Marwan Bukhari

Abstract Background/Aims  Osteoporosis (OP) is an extra-articular manifestation of rheumatoid arthritis (RA) that leads to increased fracture susceptibility due to a variety of reasons including immobility and cytokine driven bone loss. Bone loss in other populations has well documented risk factors. It is unknown whether bone loss in RA predominantly affects the femoral neck or the spine. This study aimed to identify independent predictors of low bone mineral density (BMD) in patients RA at the lumbar spine and the femoral neck. Methods  This was a retrospective observational cohort study using patients with Rheumatoid arthritis attending for a regional dual X-ray absorptiometry (DEXA) scan at the Royal Lancaster Infirmary between 2004 and 2014. BMD in L1-L4 in the spine and in the femoral neck were recorded. The risk factors investigated were steroid use, family history of osteoporosis, smoking, alcohol abuse, BMI, gender, previous fragility fracture, number of FRAX(tm) risk factors and age. Univariate and Multivariate regression analysis models were fitted to explore bone loss at these sites using BMD in g/cm2 as a dependant variable. . Results  1,527 patients were included in the analysis, 1,207 (79%) were female. Mean age was 64.34 years (SD11.6). mean BMI was 27.32kg/cm2 (SD 5.570) 858 (56.2%) had some steroid exposure . 169(11.1%) had family history of osteoporosis. fragility fracture history found in 406 (26.6%). 621 (40.7%) were current or ex smokers . There was a median of 3 OP risk factors (IQR 1,3) The performance of the models is shown in table one below. Different risk factors appeared to influence the BMD at different sites and the cumulative risk factors influenced BMD in the spine. None of the traditional risk factors predicted poor bone loss well in this cohort. P129 Table 1:result of the regression modelsCharacteristicB femoral neck95% CIpB spine95%CIpAge at scan-0.004-0.005,-0.003&lt;0.01-0.0005-0.002,0.00050.292Sex-0.094-0.113,-0.075&lt;0.01-0.101-0.129,-0.072&lt;0.01BMI (mg/m2)0.0080.008,0.0101&lt;0.010.01130.019,0.013&lt;0.01Fragility fracture-0.024-0.055,0.0060.12-0.0138-0.060,0.0320.559Smoking0.007-0.022,0.0350.650.0286-0.015,0.0720.20Alcohol0.011-0.033,0.0 5560.620.0544-0.013,0.1120.11Family history of OP0.012-0.021,0.0450.470.0158-0.034,0.0650.53Number of risk factors-0.015-0.039,0.0080.21-0.039-0.075,-0.0030.03steroids0.004-0.023,0.0320.030.027-0.015,0.0690.21 Conclusion  This study has shown that predictors of low BMD in the spine and hip are different and less influential than expected in this cohort with RA . As the FRAX(tm) tool only uses the femoral neck, this might underestimate the fracture risk in this population. Further work looking at individual areas is ongoing. Disclosure  M.A. Swar: None. M. Bukhari: None.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Moritz Mühlenfeld ◽  
André Strahl ◽  
Ulrich Bechler ◽  
Nico Maximilian Jandl ◽  
Jan Hubert ◽  
...  

Abstract Background Patients with rheumatic diseases have a high risk for joint destruction and secondary osteoarthritis (OA) as well as low bone mineral density (BMD, i.e., osteoporosis). While several factors may lead to low BMD in these patients, the value of BMD measurements in rheumatic patients with end-stage OA scheduled for total joint arthroplasty is unknown. Methods In this retrospective cross-sectional study of 50 adults with secondary OA due to rheumatic diseases, we evaluated dual energy X-ray absorptiometry (DXA) measurements of both hips and the spine performed within 3 months prior to arthroplasty (n = 25 total hip arthroplasty, THA; n = 25 total knee arthroplasty, TKA). We analyzed various demographic and disease-specific characteristics and their effect on DXA results by using group comparisons and multivariate linear regression models. Results Although patients undergoing TKA were younger (63.2 ± 14.2 vs. 71.0 ± 10.8 yr., p = 0.035), osteoporosis was observed more frequently in patients scheduled for TKA than THA (32% vs. 12%). Osteopenia was detected in 13/25 patients (52%) in both the THA and TKA cohort. In the THA cohort, female sex, lower BMI and prednisolone use were associated with lower T-score in the hip. In TKA patients, higher OA grade determined by Kellgren-Lawrence score was associated with lower T-score in the hip of the affected side. Conclusions Osteoporosis is present in a considerable frequency of rheumatic patients with end-stage OA, and THA and TKA patients show distinct frequencies and risk factors of low BMD. Our findings point to a potential value of DXA regarding preoperative evaluation of bone status.


2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
A Nandi ◽  
N Obiechina ◽  
A Timperley ◽  
F Al-Khalidi

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 &lt; 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.


2016 ◽  
Vol 22 (3) ◽  
pp. 231-234
Author(s):  
Juan José Rábade Espinosa ◽  
Teresa Valverde Esteve ◽  
Ana Pablos Monzó ◽  
Carlos Pablos Abella ◽  
Vicente Carratalá Deval

ABSTRACT Introduction: Several studies have analyzed the relationship between physical activity and bone density. However, the prescription of exercise is not entirely clear as to the type, quantity and intensity. Objective: The objective of this study was to determine if there is a relationship between the amount of exercise and changes in bone mineral density. Methods: Fifty-two women, members of the Municipal Program of Physical Activity for Seniors, voluntarily underwent two ultrasonographies of the calcaneus within a 6-month interval. During this period, all physical activity was recorded. Afterwards, a lineal correlation study was carried out between the amount of exercise and bone changes, expressed as T-Score variation, first in total number of participants and then in groups. Considering the average body weight obtained for all women, two groups were created ("light" < 69 kg and "heavy" > 69 kg). Later, women who had participated in less than 72% of the targeted program were excluded from both groups, and the differences between the groups "light and trained" and "heavy and trained" were analyzed. To do so, the nonparametric Mann-Whitney U test was used. Results: A significant relationship of r= -0.59 was found between the total amount of exercise and the T-Score variation in the group of women above 69 kg. Significant differences were found between the "light and trained" group and the "heavy and trained" group with respect to the variation of T-Score. Conclusion: The effect of exercise on bone mineral density is determined, somehow, by body weight. This interaction is due, possibly, to mechanical demands difference.


Bone ◽  
2020 ◽  
Vol 136 ◽  
pp. 115366
Author(s):  
Leen Antonio ◽  
Lærke Priskorn ◽  
Inge A. Olesen ◽  
Jørgen H. Petersen ◽  
Dirk Vanderschueren ◽  
...  

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