Incidence of vertebral fractures in calcium and vitamin D-supplemented postmenopausal Brazilian women with osteopenia or osteoporosis: data from Arzoxifene Generations Trial

Abstract

Objective: Vertebral fracture is the most common osteoporotic fracture, affecting quality of life and increasing mortality. Epidemiological data on incidence of vertebral fracture are scarce in Brazil and throughout Latin America. Our aim was to determine vertebral fracture incidence and risk factors in a female Brazilian population. Subjects and methods: Postmenopausal women with low bone mass were studied from the Brazilian placebo group of Arzoxifene Generations Trial (n = 974), followed for up to 5 years. The primary endpoint was new vertebral fractures, detected by X-Ray. Experimental design defined two strata: A. Osteoporosis or previous vertebral fracture with osteopenia; B. Osteopenia without previous fracture. Previous fracture, T-score, ionized calcium, alkaline phosphatase, creatinine and glucose were analyzed at baseline. Crude and adjusted incidence rates of vertebral fractures were estimated and Poisson regression model was used. Results: Incidence rate was 7.7 (95% CI of 5.4 to 10.9) per 1,000 person-years (PY), increasing as a function of age. Women with new vertebral fractures had higher prevalence of previous nonvertebral fracture after menopause, were older and had lower lumbar spine (LS) T-score. Fracture risk increased by 46% for each unit reduction in LS T-score. Variables correlated with new vertebral fracture were age (p = 0.034), LS T-score, stratum A (p = 0.001 for both) and previous nonvertebral fracture after menopause (p = 0.019). In the final model, LS T-score was the strongest predictor. Conclusions: Incidence rate of vertebral fracture of 7.7 per 1,000 PY. Age and previous fractures were associated with new vertebral fracture, but LS T-score was the most important predictor. Arch Endocrinol Metab. 2016;60(1):54-9

Crucial Role of Vitamin D in the Musculoskeletal System

“…Osteoporosis, a skeletal disease, is characterized by a decrease in bone mass and pathological changes of the microarchitecture due to a low serum level of 25(OH)D, leading to an elevated risk of osteoporotic fractures ( Figure 2 ) [ 42 , 54 , 55 , 56 ]. According to the findings of Shane et al , the existence of two single nucleotide polymorphisms (rs4355801 on chromosome 8 and rs3736228 on chromosome 11) constitutes a genetic predisposition which is associated with low bone mineral density (BMD) and a resulting increased risk of fractures [ 57 ].…”

“…Jackson and colleagues came to similar results when analyzing the results from the Women’s Health Initiative [ 58 ]. The diagnosis of osteoporosis is confirmed by measuring bone mineral density in the lumbar spine or femoral neck by dual-energy X-ray absorptiometry (DXA) [ 54 , 57 ]. In case of osteopenia, the T-score is between −2.5 and −1.…”

Die Hybridstabilisierung und geriatrische Komplexbehandlung in der Therapie von A-Frakturen der Wirbelsäule

“…Dabei steigt das Risiko deutlich bei Patienten höheren Alters und weiblichen Geschlechts. Einen wesentlichen Einfluss bei den geriatrischen Wirbelfrakturen hat die begleitende Osteoporose [5]. Sie erhöht nicht nur die Inzidenz auf über 300/100.000 Personenjahre, sondern auch das Risiko weiterer Frakturen sowie die Sterblichkeit und sie verringert die Lebensqualität [6][7][8].…”

“…Sie erhöht nicht nur die Inzidenz auf über 300/100.000 Personenjahre, sondern auch das Risiko weiterer Frakturen sowie die Sterblichkeit und sie verringert die Lebensqualität [6][7][8]. Damit einhergehend erhöhen sich auch die individuellen Krankheitskosten [5,8]. Mehrere Arbeiten zeigten, dass eine mobilitätserhaltende und schonende Therapie nicht nur der konservativen Therapie überlegen ist, sondern auch das Outcome der Patienten nach stattgehabter Wirbelfrakturen nicht wesentlich verschlechtert [9,10].…”

A Review of the Role of Vitamins in Psoriasis in Pregnancy

“…Recent studies have shown that vitamin D is associated with many different diseases, including obesity and cancer [63][64][65][66][67][68][69]. Vitamin discusses the relationship between vitamin D and female and male fertility [72][73][74].…”