Association between age at menopause and fracture risk: a systematic review and meta-analysis

Anagnostis, Panagiotis; Siolos, Pavlos; Gkekas, Nifon K; Kosmidou, Nikoletta; Artzouchaltzi, Aikaterini-Maria; Christou, Konstantinos; Paschou, Stavroula Α.; Potoupnis, Michael; Kenanidis, Eustathios; Tsiridis, Eleftherios; Lambrinoudaki, Ιrene; Stevenson, John C.; Goulis, Dimitrios G.

doi:10.1007/s12020-018-1746-6

Cited by 64 publications

(58 citation statements)

References 47 publications

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“…For young adult males, this is associated with an increasing risk of high‐energy trauma, such as traffic accidents, falls from height, and serious crashes, which, in turn, lead to serious tibial plateau fractures with a high risk of being accompanied by intercondylar eminence fractures. The phenomenon of peak age delay for females may be due to the high prevalence of osteoporosis among women, especially following menopause. Osteoporosis causes bones to become brittle, which can often be accompanied by comminuted fractures, when compared with young adults with the same trauma.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Study of Tibial Plateau Fractures Combined with Intercondylar Eminence Fractures

Zhang

Chen

et al. 2020

Orthopaedic Surgery

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Objective: To investigate the epidemiological characteristics of tibial plateau fractures combined with intercondylar eminence fractures and identify the risk factors.Methods: This retrospective study enrolled patients with tibial plateau fractures who were treated in the third hospital of Hebei Medical University from January 2015 to December 2018; 1020 patients (693 [68%] men and 327 [32%] women) meeting the inclusion and exclusion criteria had a mean age of 45.2 AE 13.8 years. In total, 506 (50%) cases were left injuries, 495 (48%) were right injuries, and 19 (2%) were bilateral injuries. Among them, 458 (44.9%) with a mean age of 47.0 AE 13.9 years had intercondylar eminence fractures, including 324 men and 134 women. A total of 562 (55.1%) patients were identified without intercondylar eminence fractures, including 369 (65.7%) men and 193 (34.3%) women with an average age of 43.8 AE 13.6 years. The distribution characteristics of tibial plateau fractures with intercondylar eminence involved were identified. The potential associations among fractures and various other factors, such as age, gender, occupation, and mechanism of injury, were explored.Results: The highest proportion age group of tibial plateau fractures included the ages 35-54 years, with more men than women for both age groups. For males, the highest proportion age group was 35-44 years, and for females, it was 55-64 years (χ 2 = 71.336, P < 0.01). According to Schatzker classification, type IV tibial plateau fractures had the highest risk of intercondylar eminence being involved (70.6%) without significance with type V (69.5%) and VI (68.2%) but with greater significance with types I (11.9%), II (39.2%), and III (9.4%, χ 2 = 280.187, P < 0.01). Multiple analysis showed that simple fractures, including types I, II, and III (OR 0.108, 95% CI: 0.080-0.145), were less likely to involve intercondylar eminence fractures than complex fractures, including types IV, V, and VI. Patients aged >74 years were more likely to have intercondylar eminence fractures compared with other age groups. Retired patients (OR 4.332, 95% CI: 1.147-16.362) were more likely to have fractured intercondylar eminence. Conclusion:The current study revealed the characteristics of tibial plateau fractures, especially those involving intercondylar eminence fractures, as well as their proportion, distribution, and risk factors, which can be used as reference data for clinical assessment and surgical protocol selection.

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Section: Discussionmentioning

confidence: 99%

Epidemiological Study of Tibial Plateau Fractures Combined with Intercondylar Eminence Fractures

Zhang

Chen

et al. 2020

Orthopaedic Surgery

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“…Women with premature ovarian insufficiency or early menopause from natural or surgical causes experience more profound bone loss and are at higher risk of fracture during their life. 2 Several other medical, genetic, and surgical conditions also either decrease peak bone mass or accelerate bone loss. These include medications such as glucocorticoids (> 5 mg for > 3 months) and lifestyle factors such as smoking and being underweight (ie, body mass index < 18 kg/m 2 ).…”

Section: ■ Bone Mineral Density Declines With Age and Menopausementioning

confidence: 99%

To scan or not to scan? DXA in postmenopausal women

DeSapri

Brook

2020

CCJM

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Fracture is a major cause of morbidity and death in postmenopausal women. Dual-energy x-ray absorptiometry (DXA) measures bone mineral density, which helps in estimating fracture risk and in identifying those who may benefi t from treatment. Although screening guidelines differ somewhat for postmenopausal women under age 65, in general, DXA is indicated if the patient has a high risk for fracture. KEY POINTSBone is lost with aging and declining estrogen and testosterone levels, particularly after menopause.Advanced age, prior fragility fracture, and low T scores (< -3.0) are the greatest risks factors for fracture.DXA is considered the therapeutic standard for measuring bone mineral density.In younger postmenopausal women, guidelines recommend DXA only in those who have a substantial risk of fracture based on clinical factors.

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“…Premature ovarian insu ciency (POI) is a clinical syndrome de ned by loss of ovarian activity before the age of 40 years [1].The incidence of spontaneous POI, typically assumed to occur in approximately 1% of adult women [2], has increased to 2.4-2.8% in recent years [3,4]. As a consequence of being exposed to lower estrogen for a longer period, women with POI have an increased risk of premature morbidity and mortality [5], cardiovascular and cerebrovascular diseases [6,7], osteoporosis [8,9], impaired cognition [10], and diminished sexual health [11]. However, the etiologies of POI are largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Knowledge of Iatrogenic Premature Ovarian Insufficiency Among Chinese Obstetricians and Gynecologists: A National Questionnaire Survey

Wang

Zou

Wang

et al. 2020

Preprint

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Background: With increasing cases of iatrogenic premature ovarian insufficiency (POI), more clinicians are required to counsel patients regarding the gonadotoxic effects of iatrogenic treatments. This survey aims to explore obstetricians and gynecologists’ knowledge regarding iatrogenic POI. A national online questionnaire survey was conducted across China. Respondents were asked to select the iatrogenic condition(s) that can cause POI based on their experience and knowledge.Results: Of the 5,523 returned questionnaires, 4,995 were analyzed. Among tumor therapies causing POI, most respondents agreed that radiotherapy (73.5% of respondents) and chemotherapy (64.1%) are risk factors for POI. While only 6.5% and 7.8% of the gynecological oncologists believed tumor immunotherapy and tumor-targeting therapy, respectively, may cause ovarian impairment, 31.8% and 22.2% of the non-gynecologic oncologists believed that these therapies could affect ovarian health. Most respondents believed that ovarian cystectomy (54.4%) was a risk factor for POI, while only a few respondents believed that hysterectomy with bilateral salpingectomy (39.6%) and uterine artery embolization (33.5%) could cause ovarian impairment. Only 30.5% respondents believed that immunosuppressants increased the risk of POI. Views differed with experience and hospital setting.Conclusions: The knowledge of gonadal toxicity due to traditional tumor treatments is generally high among Chinese obstetricians and gynecologists. A misunderstanding may exist in primary care hospitals and general gynecologists regarding a link between novel tumor treatments and POI, owing to the lack of convincing evidence. Knowledge of POI caused by hysterectomy and immunosuppressants should be improved.

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Association between age at menopause and fracture risk: a systematic review and meta-analysis

Abstract: This is the first meta-analysis showing that EM is associated with increased fracture risk compared with normal age at menopause, without any distinct effect on the site of the fracture.

Cited by 64 publications

References 47 publications

Epidemiological Study of Tibial Plateau Fractures Combined with Intercondylar Eminence Fractures

Epidemiological Study of Tibial Plateau Fractures Combined with Intercondylar Eminence Fractures

To scan or not to scan? DXA in postmenopausal women

Knowledge of Iatrogenic Premature Ovarian Insufficiency Among Chinese Obstetricians and Gynecologists: A National Questionnaire Survey

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