Epidemiology of risk factors and estimating 10-year probability of osteoporotic fractures in the Russian Federation

Скрипникова, И. А.; Myagkova, M.A.; Shalnova, S. А.; Выгодин, В А; Balanova, Yu. A.; Kiselev, Anton R.; Drapkina, О. М.

doi:10.1007/s11657-022-01093-x

Cited by 5 publications

(6 citation statements)

References 22 publications

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“…Исследование, опубликованное И.А. Скрипниковой и соавт., продемонстрировало, что при использовании терапевтического порога вмешательства на основании оценки риска переломов с использованием калькулятора FRAX, в российской популяции только 7% мужчин и женщин в возрасте 40-69 лет имеют высокий риск переломов, при этом 16,3% перенесли перелом по анамнестическим данным [34]. По данным исследования, 42,2% популяции при использовании диагностического порога вмешательства нуждаются в проведении денситометрии для уточнения риска переломов.…”

Section: Discussionunclassified

The role and place of the FRAX calculator in initiation osteoporosis treatment: an analysis of the osteoporosis center registry

et al. 2022

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Background: The growing frequency of fractures associated with osteoporosis, the significant costs of their treatment, disability and increased mortality make it an important and urgent task to optimize the diagnosis and treatment of osteoporosis in the Russian Federation.Aim: The aim of this study was analyzed of using modern diagnostic criteria for osteoporosis by specialists when they making a clinical decision to initiate treatment for osteoporosis, including an estimate of the 10-year probability of fractures according to FRAX.Materials and methods: The study was conducted in the city consultative and diagnostic center for the prevention of osteoporosis, St. Petersburg. The register of the osteoporosis center for 2018–2021 was used to select patients for the study. Based on the analysis of registry data, a sample of 362 patients with newly diagnosed osteoporosis was obtained. In the resulting sample, the existing FRAX value was assessed on the therapeutic intervention threshold graph, all of them analyzed the primary medical documentation, as well as the available DXA densitometry data.Results: In this study, we assessed the place of FRAX 10-year risk of major osteoporotic fractures in the clinical decision of an osteoporosis specialist to start anti-osteoporosis therapy, in this case taken as the «gold standard». The study found that a positive FRAX score had a high predictive value of 100%. In contrast, the negative predictive value was very low (19.5%): a FRAX value below the intervention threshold did not guarantee a truly low fracture risk and no need to start osteoporosis treatment.Conclusion: Despite the fact that both densitometry and FRAX have significant limitations in use, and cannot identify all patients with a high risk of fractures, their combined use increases the prognostic value of the methods. FRAX technology in routine practice allows, in addition to clinical and instrumental methods for diagnosing high-risk fractures, to identify candidates for the treatment of osteoporosis, and should be used in accordance with clinical recommendations.

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Section: Discussionunclassified

The role and place of the FRAX calculator in initiation osteoporosis treatment: an analysis of the osteoporosis center registry

et al. 2022

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“…Перенесенные в анамнезе низкоэнергетические переломы являются серьёзным клиническим проявлением ОП, а также значимым фактором риска последующих остеопоротических переломов [5]. Установлено, что перенесенный в прошлом перелом при минимальной травме в 1,5 раза увеличивает риск последующих переломов (ОР 1,55, 95% ДИ 1,47-1,63) [6].…”

Section: рис 5 суточное потребление кальция с продуктами питанияunclassified

Prognostic Factors for the Development of Osteoporotic Fractures in Women of Different Ethnic Groups Over 50 Years Old Residing in the Transbaikal Region

Verkhoturova,

Gorbunov,

Tsarenok

et al. 2024

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The aim of the research. To study prognostically unfavorable risk factors of the occurrence osteoporotic fractures in women over 50 years old in Trans-Baikal Region.Materials and methods. 121 women with OP (67 Russian and 54 Buryat nationalities, average age 63.5 years) and 145 healthy women of the same age were examined. The genetic polymorphisms VDR, LCT and COL1A1 were studied by PCR. The concentrations of bone tissue metabolism markers in the blood serum of 80 women were studied.Results. Homozygous TT of LCT 13910 C>T and recessive allele A VDR - Bsm1 c.IVS7 G>A were associated with increased risk of osteoporosis in women over 50 years of age living in the Trans-Baikal Territory. Heterozygous GА of VDR Bsm1 c.IVS7G>A, homozygous TT of LCT 13910 C>T were associated with increased risk of osteoporosis in Russian women. Homozygous АА of VDR Bsm1 c.IVS7G>A were associated with osteoporosis risk in Buryat women. The content of pyridinoline is increased in the blood serum of Russian women compared to Buryats. Independent predictors of the development of fractures were established: the TT genotype of the LCT and a high concentration of the ß-CrossLaps in Russian women, an increase in the level of pyridinoline and ß-CrossLaps in the blood serum of Buryats.Conclusion. The study of genetic polymorphism of bone tissue metabolite genes and markers of bone resorption in blood serum can be used as an early preclinical diagnosis of low-energy fractures in women over 50 years old living in the Trans-Baikal region.

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“…Исследование проводилось на основе кластерного принципа, когда случайным образом отбирались поликлиники, затем территориальные врачебные участки, а после -отдельные домохозяйства или индивидуумы, которые письменно приглашались на обследование. Отклик составил 80% [13,15].…”

Section: анализ порогов вмешательстваunclassified

“…При этом еще 12% мужчин были классифицированы как имеющие высокий риск на основании факта перенесенных ранее переломов при FRAX ниже порога вмешательства [12]. Многоцентровое эпидемиологическое исследование «Эпидемиология сердечно-сосудистых заболеваний в регионах РФ» (ЭССЕ-РФ), проведенное среди жителей в возрасте 40-69 лет, продемонстрировало наличие высокого риска переломов у 1,9% мужчин (в сравнении с 9,4% у женщин) [13]. Среди мужчин с хронической обструктивной болезнью легких подсчет FRAX с последующим сравнением результата с порогом вмешательства позволил обнаружить высокий риск только у 1,1% мужчин (но у 22,7% женщин) [14].…”

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FRAX-based intervention thresholds for men in the Russian Federation: Expert consensus of the Russian association on osteoporosis

Gladkova

Nikitinskaya²,

Скрипникова³

et al. 2023

Naučno-praktičeskaâ revmatologiâ

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According to the European guidelines for osteoporosis, the same FRAX intervention threshold is suggested for men as for women. At the same time, in the Russian Federation, according to research data, an extremely low proportion of identified men who are subject to the initiation of osteoporosis therapy. The female intervention threshold identifies only 1.1 to 4% of men for treatment. Aim – to develop and evaluate various options for the intervention threshold using the FRAX calculator for men in the Russian Federation and adopt the most acceptable intervention threshold by consensus. Material and methods. Delphi voting was conducted among 18 Russian experts who have publications and personal reports about their experience with the FRAX calculator. For discussion, 5 intervention threshold options with the corresponding rationale based on the literature reference were presented, as well as the proportion of men of different ages to be initiated in each of the options (based on several Russian population-based studies). Anonymous voting was carried out using the Delphi method with questionnaire placed in the Google form. It was proposed to evaluate all options for intervention thresholds on a 9-point Likert scale. Consensus was considered reached if the intervention threshold reached a Likert score of 7 or more points in 80% or more of the experts. The rating of each intervention threshold option was expressed as mean and standard deviations. Results. In the first round of voting, the maximum rating and percentage of agreement is reached for the 9% fixed interference threshold option based on the FRAX calculation. The rating was 7.72±1.6 points, the percentage of experts’ agreement was 88.9%. A fixed threshold of 9% determined 13–19.5% of men aged 50 years and older to be treated for osteoporosis, while their proportion increased to 26–38% at the age of 85 years and older. Conclusion. The consensus of experts of the Russian association on osteoporosis suggests initiating treatment of osteoporosis in Russian men with a 10-year probability of major osteoporotic fractures according to FRAX of 9% or higher.

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Epidemiology of risk factors and estimating 10-year probability of osteoporotic fractures in the Russian Federation

Cited by 5 publications

References 22 publications

The role and place of the FRAX calculator in initiation osteoporosis treatment: an analysis of the osteoporosis center registry

The role and place of the FRAX calculator in initiation osteoporosis treatment: an analysis of the osteoporosis center registry

Prognostic Factors for the Development of Osteoporotic Fractures in Women of Different Ethnic Groups Over 50 Years Old Residing in the Transbaikal Region

FRAX-based intervention thresholds for men in the Russian Federation: Expert consensus of the Russian association on osteoporosis

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