Risk Factors for Fractures Identified in the Algorithm Developed in 5-Year Follow-Up of Postmenopausal Women From RAC-OST-POL Study

Adamczyk, Piotr; Werner, A.; Bach, Małgorzata; Żywiec, Joanna; Czekajło, Aleksandra; Grzeszczak, W; Drozdzowska, Bogna; Pluskiewicz, Wojciech

doi:10.1016/j.jocd.2017.07.005

Cited by 14 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, an important point is to identify early signs of osteoporosis—prior to the first osteoporotic fracture. Several clinical risk factors for osteoporosis have been identified and included in predictive models, available as online calculators, such as FRAX [ 1 ], the Garvan algorithm [ 2 , 3 ] and the Polish POL-RISK method [ 4 ], all of which are very helpful to assess the clinical condition and design an effective therapeutic programme. However, the data, which can be entered into a calculator formula, often do not fully reflect the actual patient’s health status.…”

Section: Introductionmentioning

confidence: 99%

Height loss in postmenopausal women—do we need more for fracture risk assessment? Results from the GO Study

2021

Self Cite

View full text Add to dashboard Cite

Summary Human body height loss of 3–4 cm or more may be considered a simple indicator of increasing fracture risk, where the information is very similar to the results from fracture risk assessments by available online calculators, all of them based on a multiple variable approaches. Introduction The aim of the study was to assess the relationship between body height loss (HL) and fracture risk in postmenopausal women from the Gliwice Osteoporosis (GO) Study. Methods The study sample included 1735 postmenopausal women, aged over 55 years and recruited at the Osteoporotic Outpatient Clinic. The mean age of the study participants was 68.15 ± 8.16 years. Fracture risk was established, using the fracture risk assessment tool (FRAX) (10-year probability of major and hip fractures), the Garvan calculator (any and hip fractures, 5 and 10 years) and the Polish (POL-RISK) algorithm, available at www. fracture - risk .pl (any fractures, 5 years). Bone densitometry at the femoral neck was performed, using a Prodigy device (Lunar, GE, USA). Body heights were measured before bone densitometry, using a wall stadiometer and compared with the maximum body heights, measured in early adulthood and reported by the study participants themselves. Results In 199 women, the body heights, measured during the study, did not change in comparison to their corresponding values in early adulthood, while being decreased in the other 1536 women. The mean height loss (HL) in the whole study group was 3.95 ± 3.24 cm. That HL correlated significantly with the calculated fracture risk (the r range from 0.13 to 0.39, p < 0.0001). In general, regarding the patients with fracture risk close to the recommended therapeutic thresholds, HL was around 3–4 cm, except of the values from the FRAX calculator for major fractures, where the commonly used therapeutic threshold (20%) was related to HL of approximately 6.5 cm. In subjects with HL between 3.5 and 4 cm ( n = 208), the FRAX value for major fractures was 6.83 ± 3.74. Conclusions Body height measurements, carried out to establish HL, provide an important information for clinical practice, where HL of 3–4 cm or more may be considered a simple indicator of increasing fracture risk.

show abstract

Section: Introductionmentioning

confidence: 99%

Height loss in postmenopausal women—do we need more for fracture risk assessment? Results from the GO Study

2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…The prevalence of new fractures was slightly higher than that in the general population of postmenopausal Korean women (30). Two factors explain this outcome: 1) the risk of fracture rises sharply with age, and 2) patients with a fracture history are more prone to experience subsequent fractures (31,32). The patients of our study were on average over 70 years old, and 37.0% of patients in Group 1 and 41.5% in Group 2 had a history of fracture.…”

Section: Discussionmentioning

confidence: 53%

Effects of Epidural Steroid Injections on Bone Mineral Density and Bone Turnover Markers in Patients Taking Anti-Osteoporotic Medications

Nah

Lee

2018

Pain Phys

View full text Add to dashboard Cite

Background: Glucocorticoids adversely affect bone mineral density (BMD) and increase the risk of fracture. Yet, the cause-and-effect relationship between epidural steroid injection (ESI) and BMD has not been thoroughly investigated, and available results are inconsistent. This is probably a consequence of differences in the dose of steroids and follow-up duration. Objective: This study aimed to evaluate changes in BMD and the risk of fracture according to duration of the follow-up and amount of steroids used for ESI. Setting: Department of Orthopedic Surgery at Seoul Metropolitan Government Seoul National University (SMG-SNU) Boramae Medical Center, Korea. Methods: We retrospectively reviewed the medical records of postmenopausal patients who underwent dual-energy x-ray absorptiometry (DEXA) at least 3 times in 5 years. Patients were divided into 2 groups. Group 1 consisted of 73 patients who received ESI, whereas Group 2 consisted of 294 patients who did not receive ESI. All patients took anti-osteoporotic medications. BMD measurements were performed in 4 different regions, and levels of bone turnover markers (BTMs) were measured. In Group 1, BMD and BTMs levels were measured before the last ESI and 1 and 2 years after. A sub-analysis was conducted in Group 1 to compare BMD values in sub-groups with different doses of steroids. Results: In Group 1, the absolute values of BMD of the spine were decreased at the 1-year follow-up, but by the 2-year follow-up they recovered and approached the values in Group 2. In Group 2, BMD increased both at the 1- and 2-year follow-ups. There was an increase in occurrence of osteoporosis during the first year after ESI, but the prevalence of osteoporosis declined remarkably during the second year. The levels of BTMs increased at the 1-year followup and decreased at the 2-year follow-up in Group 1. Higher cumulative doses of steroids induced greater decreases in BMD. However, the changes in spine BMD in the sub-analysis were insignificant. Limitations: This was a retrospective study. Additionally, administration of anti-osteoporotic medication might have prevented accurate evaluation of the effects of ESI. Conclusions: ESI adversely affects BMD in postmenopausal women, especially that of the spine, and the adverse effects increase with the dose of steroids. Gradual reduction of the effect of steroids one year after the cessation of ESI resulted in recovery of BMD to a level similar to that in the control group. Key words: Epidural steroid injection, bone mineral density, osteoporosis, postmenopausal women, glucocorticoids, bone turnover markers, osteoporotic fracture

show abstract

“…For Polish postmenopausal women population at Upper Silesia area, 5 years risk of fractures assessment calculator was developed, but the study to create useful 10 year risk estimation tool is still ongoing. The results that would be obtained in the future could be compared with the results of our study because both groups come from Upper Silesia and the groups are at similar age [ 29 ]. 10% FRAX-BMD is a cut-off point value from which the guidelines for Polish patients recommends the implementation the therapy for osteoporosis [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

High rates of undiagnosed and untreated osteoporosis in postmenopausal women receiving medical services in the area of Upper Silesia

Hachuła

Pietrzyk

Gruszka

et al. 2020

View full text Add to dashboard Cite

Introduction High social cost and high risk of disability make postmenopausal osteoporosis one of major public health problem in the 21 st century. The aim of this study was to assess frequency of undiagnosed and untreated osteoporosis in postmenopausal women in the Upper Silesia Region of Poland. Additionally, we compare estimation of the 10-year probability of major osteoporotic fractures (MOF) and hip fractures (HF) based on fracture risk assessment tool (FRAX) with and without bone mineral density (BMD). Material and methods The survey included 450 postmenopausal women (age 65 ±11 years). A detailed questionnaire included demographic and anthropometric data, comorbidity, history of previous low-energy fractures, family medical history, and treatment for osteoporosis. The FRAX calculator was used to estimate the risk of MOF and HF. Results Osteoporosis was previously diagnosed in 23.7% women. Of those 70.2% were receiving vitamin D, 27% calcium preparations, 33% bisphosphonates, and 22% were untreated. Only 42.2% women with previous fractures had been diagnosed with osteoporosis and 42.8% received any treatment. 12.5% women with FRAX-BMD ≥ 10% had no risk factors of osteoporosis and < 10% risk of MOF and HF in FRAX without BMD. Conclusions Osteoporosis often remains undiagnosed and untreated in postmenopausal women. There is a great need to popularize FRAX without BMD calculator among physicians, especially GPs, as the risk calculation justify the implementation of antiosteoporotic therapy. Women with burden of risk factors of fractures and borderline FRAX without BMD values, should be referred to a densitometry examination, as having greater risk of fracture than shown by FRAX without BMD.

show abstract

Risk Factors for Fractures Identified in the Algorithm Developed in 5-Year Follow-Up of Postmenopausal Women From RAC-OST-POL Study

Cited by 14 publications

References 12 publications

Height loss in postmenopausal women—do we need more for fracture risk assessment? Results from the GO Study

Height loss in postmenopausal women—do we need more for fracture risk assessment? Results from the GO Study

Effects of Epidural Steroid Injections on Bone Mineral Density and Bone Turnover Markers in Patients Taking Anti-Osteoporotic Medications

High rates of undiagnosed and untreated osteoporosis in postmenopausal women receiving medical services in the area of Upper Silesia

Contact Info

Product

Resources

About