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Pluskiewicz W, Adamczyk P, Drozdzowska B. Impaired Functional Status Increases Fracture Incidence in 10-year Follow-Up: The Results from RAC-OST-POL Study. J Clin Densitom 2023; 26:104-108. [PMID: 36567159 DOI: 10.1016/j.jocd.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/11/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The aim of study was to establish the influence of baseline functional status on fracture incidence. METHODOLOGY In a prospective 10-years observation in epidemiological sample of postmenopausal women from RAC-OST-POL Study a thesis that affected functional status enhance fracture incidence was verified. At baseline, data were collected in 978 women at mean age 66.48±7.6 years and after 10 years of follow-up 640 subjects at mean age 75.04±6.95 years remained in the study. Functional status at baseline was established using Stand up and Go test (SAG) and Activity of Daily Living (IADL). Afterwards, annually data on fracture incidence were collected by phone interviews. RESULTS In the period of observation 190 low-energy fractures in 129 women were noted. The whole group was divided into subgroups: without fracture (n=511), with one fracture (n=91) and those ones who had more than one fracture (n=38). In fractured and unfractured subgroup mean SAG results were 11.36±4.28 and 10.36±2.76, respectively and differed significantly (p<0.01). With increasing number of fractures the SAG time was longer - it was 11.15±4.49 in one fracture subgroup and 11.87±3.73 in multiple fractures subgroup, with both values significantly higher than in no fracture subjects. The mean value of IADL was 23.56±1.60. In 576 (90%) women IADL reached maximal value of 24 points. In the rest of them (n=64) IADL score was between 11 and 23 points. Mean value of IADL in fractured and unfractured subgroup were 23.27±1.97 and 23.64±1.47, respectively and differed significantly (p<0.01). CONCLUSION The measures of functional status predict fractures in a prospective observation of representative epidemiological female sample.
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Affiliation(s)
- Wojciech Pluskiewicz
- Department and Clinic of Internal Diseases, Diabetology, and Nephrology, Metabolic Bone Diseases Unit, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 3-Maja 13/15 street, Zabrze 41-800, Poland.
| | - Piotr Adamczyk
- Department of Paediatrcs, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Bogna Drozdzowska
- Department of Pathomorfology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
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Valentin G, Ravn MB, Jensen EK, Friis K, Bhimjiyani A, Ben-Shlomo Y, Hartley A, Nielsen CP, Langdahl B, Gregson CL. Socio-economic inequalities in fragility fracture incidence: a systematic review and meta-analysis of 61 observational studies. Osteoporos Int 2021; 32:2433-2448. [PMID: 34169346 DOI: 10.1007/s00198-021-06038-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/14/2021] [Indexed: 12/18/2022]
Abstract
UNLABELLED Individuals with low socio-economic status (SES) have a more than 25% higher risk of fragility fractures than individuals with high SES. Body mass index and lifestyle appear to mediate the effect of SES on fracture risk. Strategies to prevent fractures should aim to reduce unhealthy behaviours through tackling structural inequalities. INTRODUCTION This systematic review and meta-analysis aimed to evaluate the impact of socio-economic status (SES) on fragility fracture risk. METHODS Medline, Embase, and CINAHL databases were searched from inception to 28 April 2021 for studies reporting an association between SES and fragility fracture risk among individuals aged ≥50 years. Risk ratios (RR) were combined in meta-analyses using random restricted maximum likelihood models, for individual-based (education, income, occupation, cohabitation) and area-based (Index of Multiple Deprivation, area income) SES measures. RESULTS A total of 61 studies from 26 different countries including more than 19 million individuals were included. Individual-based low SES was associated with an increased risk of fragility fracture (RR 1.27 [95% CI 1.12, 1.44]), whilst no clear association was seen when area-based measures were used (RR 1.08 [0.91, 1.30]). The strength of associations was influenced by the type and number of covariates included in statistical models: RR 2.69 [1.60, 4.53] for individual-based studies adjusting for age, sex and BMI, compared with RR 1.06 [0.92, 1.22] when also adjusted for health behaviours (smoking, alcohol, and physical activity). Overall, the quality of the evidence was moderate. CONCLUSION Our results show that low SES, measured at the individual level, is a risk factor for fragility fracture. Low BMI and unhealthy behaviours are important mediators of the effect of SES on fracture risk. Strategies to prevent fractures and reduce unhealthy behaviours should aim to tackle structural inequalities in society thereby reducing health inequalities in fragility fracture incidence.
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Affiliation(s)
- G Valentin
- Department of Public Health and Health Services Research, DEFACTUM, Central Denmark Region, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - M B Ravn
- Department of Public Health and Health Services Research, DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - E K Jensen
- Department of Public Health and Health Services Research, DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - K Friis
- Department of Public Health and Health Services Research, DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - A Bhimjiyani
- Department of Clinical Biochemistry, Royal Free Hospital, London, UK
| | - Y Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - A Hartley
- MRC Integrative Epidemiology Unit, Bristol Medical School, Oakfield House, Bristol, BS8 2BN, UK
| | - C P Nielsen
- Department of Public Health and Health Services Research, DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - B Langdahl
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
| | - C L Gregson
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Learning & Research Building, Southmead Hospital, Bristol, BS10 5NB, UK
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Estimation of Prevalence of Osteoporosis Using OSTA and Its Correlation with Sociodemographic Factors, Disability and Comorbidities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132338. [PMID: 31269706 PMCID: PMC6650858 DOI: 10.3390/ijerph16132338] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 06/30/2019] [Accepted: 06/30/2019] [Indexed: 01/10/2023]
Abstract
Osteoporosis is a growing concern for an aging society. The study aimed to estimate the prevalence of older adults who were at risk of osteoporosis and explore factors associated with osteoporosis. The relationship between the risk of osteoporosis, chronic conditions and disability was also explored. We hypothesized that respondents with high risk index of osteoporosis would be associated with greater disability. Participants aged 60 years and above (N = 2565) who were representative of Singapore’s multiethnic population were recruited. The Osteoporosis Self-Assessment Tool for Asians (OSTA) was used to classify the risk of osteoporosis. Information on sociodemographic details and chronic diseases were collected, while severity of disability was measured using the World Health Organization Disability Assessment Schedule 2.0. The overall prevalence of the respondents who were at risk of osteoporosis was 52%. Those belonging to an older age, Chinese, female, never married or widowed, lower education and retired were associated with a higher risk of osteoporosis. A diagnosis of diabetes or hypertension was a protective factor against the risk of osteoporosis. High risk of osteoporosis was not associated with disability. Our findings highlighted specific factors associated with the risk of osteoporosis that could be useful for the prevention of osteoporosis and fractures.
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Tariq S, Baig M, Tariq S, Shahzad M. Status of bone health and association of socio-demographic characteristics with Bone Mineral Density in Pakistani Females. Pak J Med Sci 2019; 35:812-817. [PMID: 31258600 PMCID: PMC6572968 DOI: 10.12669/pjms.35.3.551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/13/2019] [Accepted: 04/17/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND & OBJECTIVE The "silent thief" of bone osteoporosis is associated with various modifiable factors, identifying these factors is important in decreasing the prevalence of this highly prevalent disease. Therefore, this study was planned to identify these risk factors for osteoporosis in premenopausal and postmenopausal Pakistani women. METHODS A total of 1205 pre and postmenopausal females between the ages of 20 to 80 years were selected. Detailed history about the socio-demographic characteristics including age, education, profession, marital and resident status was recorded. Medical and gynecological history was also taken after informed consent Bone health of females was assessed using calcaneal ultrasound bone densitometer. SPSS 22.0 was used to analyze data. RESULTS Univariate analysis showed that age (30-39 yrs, and 60-69 yrs), occupation (housewives) and education (secondary and primary education, illiterate) were significantly associated with low bone mass density (LBMD). Multivariate analysis showed that age 30-39 years (OR=0.25 95%CI 0.13 - 0.49), age 40-49 years (OR=0.30 95%CI 0.15 - 0.59), age 50-59 years (OR=0.42 95%CI 0.22 - 0.79), primary education (OR=3.83, 95%CI 2.30 - 6.38) and illiteracy (OR=3.83 95%CI 2.52 - 5.82), were significantly associated with LBMD. The prevalence of osteopenia and osteoporosis was 29.8%, 27.2%, respectively, while 43% subjects had normal BMD. CONCLUSION It is concluded that, within Pakistani population, the prevalence of osteopenia is high even at an early age group and the odds of having LBMD are more in less educated or illiterate women.
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Affiliation(s)
- Saba Tariq
- Saba Tariq, MBBS, M.Phil. Associate Professor of Pharmacology, Research Scholar (Pharmacology), University of Health Sciences, Lahore, Pakistan., University Medical & Dental College, Faisalabad- 38000, Pakistan
| | - Mukhtiar Baig
- Prof. Mukhtiar Baig, MBBS, M.Phil, PhD. Department of Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah- 21589, KSA
| | - Sundus Tariq
- Sundus Tariq, MBBS, M.Phil. Associate Professor of Physiology, Research Scholar (Physiology), University of Health Sciences, Lahore, Pakistan., University Medical & Dental College, Faisalabad- 38000, Pakistan
| | - Muhammad Shahzad
- Muhammad Shahzad, M.Phil, PhD. Associate Professor of Pharmacology, University of Health Sciences, Lahore, Pakistan
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Adamczyk P, Werner A, Bach M, Żywiec J, Czekajło A, Grzeszczak W, Drozdzowska B, Pluskiewicz W. Risk Factors for Fractures Identified in the Algorithm Developed in 5-Year Follow-Up of Postmenopausal Women From RAC-OST-POL Study. J Clin Densitom 2018; 21:213-219. [PMID: 28826886 DOI: 10.1016/j.jocd.2017.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/07/2017] [Accepted: 07/21/2017] [Indexed: 11/21/2022]
Abstract
The aim of the study was to establish factors with an impact on fracture risk and to develop an algorithm to predict osteoporotic fracture. A total of 978 postmenopausal women from the epidemiological, population-based RAC-OST-POL study with a mean age of 65.7 ± 7.3 years were enrolled. At baseline, bone mineral density at hip and clinical risk factors for fracture were collected. Afterward, each person was asked annually on fracture incidence in the 5-year follow-up. Finally, data for complete 5-year observation were gathered for the group of 802 patients. During the follow-up, 92 osteoporotic fractures occurred in 78 women. The most common fracture site was the forearm (n = 45). The following baseline factors were found as significant for fracture incidence: femoral neck bone mineral density, prior fractures, steroid use, falls within previous 12 months, and height. Fracture risk was predicted by the following formula: Riskoffractureincidence=11+e-(-9.899+1.077∗STEROIDS+0.681∗PRIORFALLS+0.611∗PRIORFRACTURES-0.483∗FNTscore+0.042∗HEIGHT). In our current longitudinal study, an algorithm predicting fracture occurrence over a period of 5 years was developed. It may find application in daily medical practice.
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Affiliation(s)
- P Adamczyk
- Department of Pediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland.
| | - A Werner
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, Gliwice, Poland
| | - M Bach
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, Gliwice, Poland
| | - J Żywiec
- Department of Internal Medicine, Diabetology and Nephrology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland
| | - A Czekajło
- Dialysis Station Fresenius NefroCare, Wodzisław, Poland
| | - W Grzeszczak
- Department of Internal Medicine, Diabetology and Nephrology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland
| | - B Drozdzowska
- Department of Pathomorphology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland
| | - W Pluskiewicz
- Department of Internal Medicine, Diabetology and Nephrology-Metabolic Bone Diseases Unit, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland
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Shu MM, Canhos AL, Ocampos GP, Plapler PG, Camargo OP, Rezende MUDE. PROFILE OF PATIENTS WITH OSTEOPOROTIC FRACTURES AT A TERTIARY ORTHOPEDIC TRAUMA CENTER. ACTA ORTOPEDICA BRASILEIRA 2018; 26:117-122. [PMID: 29983628 PMCID: PMC6032616 DOI: 10.1590/1413-785220182602185325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 09/15/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the profile of patients with osteoporotic fractures treated at a tertiary orthopedic hospital. METHODS Using questionnaires, 70 patients with osteoporotic fractures (OF) were compared with 50 outpatients with multiple osteoarthritis (OA) followed through an outpatient clinic. RESULTS The OF group was older (p <0.001), less heavy (p=0.003), had lower BMI (p=0.006), was more likely to be white (p=0.011), was less likely to be married (p=0.008), and had previous falls, previous fractures, old fractures (>1 year), falls in the last 12 months, fractures due to falls, and needed more assistance (p<0.05). They also had lower Lawton & Brody Instrumental Activities of Daily Living scores (p <0.05) and reported less lower limb disability, foot pathology, muscle weakness, hypothyroidism, and vitamin D intake than patients in the OA group. White race, previous falls, and previous fractures increase the risk of osteoporotic fractures by 10.5, 11.4, and 4.1 times, respectively. The chance of fracture dropped 29% for each one-unit increase in Lawton & Brody IADL score. Married participants had fewer fractures than participants with other marital status. CONCLUSION Together, race, marital status, previous falls, foot pathologies, previous fractures, and IADL scores define the profile of patients with osteoporotic fractures. Level of Evidence III; Case control study.
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Affiliation(s)
- Michael Minsu Shu
- . Osteometabolic Diseases Group, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - Andre Langes Canhos
- . Osteometabolic Diseases Group, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - Guilherme Pereira Ocampos
- . Osteometabolic Diseases Group, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - Perola Grimberg Plapler
- . Osteometabolic Diseases Group, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - Olavo Pires Camargo
- . Department of Orthopedics and Traumatology, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - Marcia Uchoa DE Rezende
- . Osteometabolic Diseases Group, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
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Tabor E, Kuźniewicz R, Zagórski P, Martela K, Pluskiewicz W. The Relationship of Knowledge of Osteoporosis and Bone Health in Postmenopausal Women in Silesia Osteo Active Study. J Clin Densitom 2018; 21:98-104. [PMID: 27618368 DOI: 10.1016/j.jocd.2016.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 08/06/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
Abstract
The Silesia Osteo Active Study was designed to assess osteoporosis-related knowledge and its relationships with skeletal status in an epidemiological population-based program. Participants were chosen randomly from postmenopausal women over 55 yr. The study group consisted of 388 patients (mean age 65 ± 7). All participants fulfilled medical and socioeconomic questionnaires and test concerning osteoporosis-related knowledge. They underwent proximal femur and lumbar spine densitometry. The mean level of osteoporosis knowledge was 7.3 ± 2.0 for 10 questions. Osteoporosis knowledge seems to have no influence on densitometry results in the population; nevertheless it improves femoral neck (FN) density in those without prior personal experience of osteoporosis (r = 0.15; p < 0.05). Higher knowledge of osteoporosis was connected with osteoporosis in family, hormone replacement therapy or smoking history, and higher educational degree. The level of knowledge was significantly better in younger than in older participants (7.4 vs 6.7; p < 0.01). Osteoporosis (T-score < -2.5) was established in 6.4%, 2%, and 33% for FN, total hip, and spine, respectively. As a conclusion, current study revealed a positive influence of the knowledge of osteoporosis on FN density in postmenopausal women without prior personal experience of the disease.
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Affiliation(s)
- E Tabor
- Doctoral Studies, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Poland.
| | - R Kuźniewicz
- Department and Clinic of Internal Diseases, Diabetology and Nephrology, School of Medicine with the Division of Dentistry, Metabolic Bone Diseases Unit, Medical University of Silesia in Katowice, Poland
| | - P Zagórski
- Department of Orthopaedic Surgery, Sports-Clinic, Żory, Poland
| | - K Martela
- Doctoral Studies, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Poland
| | - W Pluskiewicz
- Department and Clinic of Internal Diseases, Diabetology and Nephrology, School of Medicine with the Division of Dentistry, Metabolic Bone Diseases Unit, Medical University of Silesia in Katowice, Poland
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Rokicki W, Drozdzowska B, Czekajło A, Grzeszczak W, Wiktor K, Majewski W, Pluskiewicz W. Relationship between visual status and functional status and the risk of falls in women. The RAC-OST-POL study. Arch Med Sci 2016; 12:1232-1238. [PMID: 27904513 PMCID: PMC5108377 DOI: 10.5114/aoms.2015.55146] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 01/31/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Falls in elderly women producing fractures are a public health problem that could be largely preventable. The aim of this study was to determine the effect of visual impairment on functional status, falls and fractures in women. MATERIAL AND METHODS We examined 623 women aged ≥ 55 years in order to assess the association between visual status and functional status and the risk of falls and fractures. Distance, near visual acuity, and depth perception were examined. Functional status was assessed using the Instrumental Activities of Daily Living (IADL) and Timed Up and Go (TUG) tests. The history of falls in the last 12 months and prior osteoporotic fractures were recorded. RESULTS The mean age of participants was 66.01 ±7.76 years. Distance visual acuity was correlated (r = -0.13, p < 0.0001) with an increased number of falls. The most prognostic fall factor was IADL (Z = 3.19, p < 0.05), which showed a significant association with distance acuity (r = 0.27, p < 0.0001). The TUG test time significantly increased with diminishing visual acuity: 10.6 ±3.1 s for good, 12.8 ±6.1 s for moderate and 15.3 ±8.8 s for poor visual acuity (p < 0.0001, ANOVA 24.4). The IADL also differs significantly (p < 0.0001) in subgroups divided according to visual acuity (23.6 ±1.5, 22.6 ±2.9, 21.2 ±4.8 points, respectively). In multivariate logistic regression on probability of falls including IADL, TUG and visual acuity, IADL was found to be an independent prognostic factor (p = 0.025). The data revealed no association of refractive correction, depth perception, or near visual acuity with fall incidence or history of fractures. CONCLUSIONS Visual acuity influences functional status and number of falls in women aged over 55 years.
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Affiliation(s)
- Wojciech Rokicki
- Department and Clinic of Ophthalmology, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Bogna Drozdzowska
- Department of Pathomorphology, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland
| | | | - Władysław Grzeszczak
- Department and Clinic of Internal Diseases, Diabetology and Nephrology, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland
| | | | - Wojciech Majewski
- Radiotherapy Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland
| | - Wojciech Pluskiewicz
- Department and Clinic of Internal Diseases, Diabetology and Nephrology – Metabolic Bone Diseases Unit, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland
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Pluskiewicz W, Adamczyk P, Czekajło A, Grzeszczak W, Drozdzowska B. High fracture probability predicts fractures in a 4-year follow-up in women from the RAC-OST-POL study. Osteoporos Int 2015; 26:2811-20. [PMID: 26168766 DOI: 10.1007/s00198-015-3196-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 05/28/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED In 770 postmenopausal women, the fracture incidence during a 4-year follow-up was analyzed in relation to the fracture probability (FRAX risk assessment tool) and risk (Garvan risk calculator) predicted at baseline. Incident fractures occurred in 62 subjects with a higher prevalence in high-risk subgroups. Prior fracture, rheumatoid arthritis, femoral neck T-score and falls increased independent of fracture incidence. INTRODUCTION The aim of the study was to analyze the incidence of fractures during a 4-year follow-up in relation to the baseline fracture probability and risk. METHODS Enrolled in the study were 770 postmenopausal women with a mean age of 65.7 ± 7.3 years. Bone mineral density (BMD) at the proximal femur, clinical data, and fracture probability using the FRAX tool and risk using the Garvan calculator were determined. Each subject was asked yearly by phone call about the incidence of fracture during the follow-up period. RESULTS Of the 770 women, 62 had a fracture during follow-up, and 46 had a major fracture. At baseline, BMD was significantly lower, and fracture probability and fracture risk were significantly higher in women who had a fracture. Among women with a major fracture, the percentage with a high baseline fracture probability (>10 %) was significantly higher than among those without a fracture (p < 0.01). Fracture incidence during follow-up was significantly higher among women with a high baseline fracture probability (12.7 % vs. 5.2 %) and a high fracture risk (9.2 vs. 5.3 %) so that the "fracture-free survival" curves were significantly different (p < 0.05). The number of clinical risk factors noted at baseline was significantly associated with fracture incidence (chi-squared = 20.82, p < 0.01). Prior fracture, rheumatoid arthritis, and femoral neck T-score were identified as significant risk factors for major fractures (for any fractures, the influence of falls was also significant). CONCLUSIONS During follow-up, fracture incidence was predicted by baseline fracture probability (FRAX risk assessment tool) and risk (Garvan risk calculator). A number of clinical risk factors and a prior fracture, rheumatoid arthritis, femoral neck T-score, and falls were independently associated with an increased incidence of fractures. [Corrected]
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Affiliation(s)
- W Pluskiewicz
- School of Medicine with the Division of Dentistry, Metabolic Bone Diseases Unit, Department and Clinic of Internal Diseases, Diabetology and Nephrology, Medical University of Silesia in Katowice, 3-Maja 13/15 street, 41-800, Zabrze, Poland.
| | - P Adamczyk
- School of Medicine with the Division of Dentistry, Department and Clinic of Pediatrics, Medical University of Silesia in Katowice, Zabrze, Poland
| | - A Czekajło
- Department of Nephrology, Wodzisław, Poland
| | - W Grzeszczak
- School of Medicine with the Division of Dentistry, Department and Clinic of Internal Diseases, Diabetology and Nephrology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - B Drozdzowska
- School of Medicine with the Division of Dentistry, Department of Pathomorphology, Medical University of Silesia in Katowice, Zabrze, Poland
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Factors affecting bone mineral density in postmenopausal women. Arch Osteoporos 2015; 10:15. [PMID: 25972061 DOI: 10.1007/s11657-015-0217-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 04/20/2015] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study aimed to determine the relationship between bone mineral density (BMD) and demographic, biochemical, and clinical features according to BMD measurement sites. The results indicated that BMD correlates negatively with menopause duration, parity, and history of fractures but positively correlates with obesity, physical activity, education, and serum ferritin. PURPOSE/INTRODUCTION Osteoporosis (OP) is an important cause of morbidity and mortality in the elderly people. The impacts of various factors on bone mineral density (BMD) differ across diverse population. We hypothesized that the influences of factors which affect BMD vary according to BMD measurement sites. The aim of this study was to determine the relationship between BMD in the femoral neck (FN) and lumbar spine (LS) with some common clinical, demographic, and biochemical parameters in postmenopausal women. METHODS In this cross-sectional case-control study, all postmenopausal women of the Amirkola Health and Ageing Project (AHAP) who performed bone densitometry were included. BMD at FN and LS was measured by DXA method. Data regarding clinical, demographic, and biochemical characteristics were provided. OP was diagnosed by the International Society for Clinical Densitometry criteria. Pearson correlation and multivariate regression analyses with simultaneous adjustment were performed to determine relationship. RESULTS Five hundred thirty-seven women with mean age of 67.9 ± 6.7 years and mean menopause duration (MD) of 15.8 ± 5.1 years were studied. MD correlated negatively with FN-BMD and LS-BMD g/cm(2) (r = -0.405, p = 0.001 and r = -0.217, p = 0.001). Body mass index (BMI) correlated positively with FN and LS-BMD g/cm(2) (r = 0.397, p = 0.001 and r = 0.311, p = 0.001). The association of MD with risk of FN-OP was stronger than LS-OP. Obesity and metabolic syndrome (MS) and higher serum ferritin reduced the risk of OP at both LS and FN similarly, whereas the impacts of parity, prior fracture, high level of education, and physical activity were significantly different across BMD measurement sites. CONCLUSION The results of this study indicated a significant association between OP and MD, obesity, parity, MS, history of fracture, serum ferritin, level of education, and physical activity. However, the direction and the strength of association varied across BMD measurement sites.
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