Body mass index, height, and osteoporotic fracture risk in community-dwelling Japanese people aged 40–74 years

Nishikura, Toshi; Kitamura, Kaori; Watanabe, Yumi; Kabasawa, Keiko; Takahashi, Akemi; Saito, Toshiko; Kobayashi, Ryosaku; Oshiki, Rieko; Takachi, Ribeka; Tsugane, Shoichiro; Yamazaki, Osamu; Watanabe, Kei; Nakamura, Kazutoshi

doi:10.1007/s00774-023-01478-z

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…Likewise, the obese population had higher fracture risks after adjusting for BMD, and abdominal adiposity was associated with a high fracture rate [48]. In a Japanese cohort study followed-up with for 10 years, a U-shaped association between BMI and fractures was also observed, but only in the male population, not female, indicating sex-and ethnicitydependent differences [49]. In the present study, we also found a high BMI to be an independent risk fracture for GIOP fracture after adjusting for multiple variables, including BMD.…”

Section: Discussionmentioning

confidence: 94%

Development and Comparison of Treatment Decision Tools for Glucocorticoid-Induced Osteoporosis

Chen,

Yu,

Chiu

et al. 2024

Diagnostics

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Long-term Glucocorticoid (GC) use results in compromised bone strength and fractures, and several treatment recommendations have been developed to prevent fractures, but none have been validated in a real-world setting. This study aims to create a treatment decision tool and compares this tool to the treatment suggestions from the American College of Rheumatology (ACR), International Osteoporosis Foundation and European Calcified Tissue Society (IOF-ECTS), and GC-adjusted Fracture Risk Assessment Tool (GC-FRAX), above the intervention threshold. We utilized registry data gathered at Chang Gung Memorial Hospital at Kaohsiung, Taiwan, between September 2014 and April 2021. This research is a single-center, observational, and case-controlled study. We recruited participants using prednisone for at least 2.5 mg/day or the equivalent dose for over 3 months, excluding those younger than 40, those with malignancies, or those currently undergoing anti-osteoporosis therapy. The primary endpoint was new fragility fractures within 3 years, including morphometric vertebral fractures detected at baseline and with a follow-up thoracic–lumbar spine X-ray. Participants were randomly allocated into derivation and validation sets. We developed the Steroid-Associated Fracture Evaluation (SAFE) tool in the derivation cohort by assessing the weights of exploratory variables via logistic regression. Prediction performance was compared in the validation set by the receiver operating characteristic (ROC) curve, the area under the curve (AUC), and sensitivity and specificity. A total of 424 treatment-naïve subjects were enrolled, and 83 (19.6%) experienced new fractures within 3 years. The final formula of the SAFE tool includes osteoporosis (1 point), an accumulated GC dose ≥ 750 mg within 6 months (or equivalent prednisolone of ≥4.5 mg/day for 6 months) (1 point), a BMI ≥ 23.5 (1 point), previous fractures (1 point), and elderliness of ≥70 years (2 points). In the validation set, a treatment decision based on the SAFE ≥ 2 points demonstrated an AUC of 0.65, with a sensitivity/specificity/accuracy of 75.9/54.0/58.9, with an ACR of 0.56 (100.0/11.0/31.0), IOF-ECTS 0.61 (75.9/46.0/52.7), and GC-FRAX 0.62 (82.8/42.0/51.2). Among current GIOP recommendations, the SAFE score serves as an appropriate treatment decision tool with increased accuracy and specificity.

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Section: Discussionmentioning

confidence: 94%