Role of low TSH levels and high fracture risk in postmenopausal osteopenia and osteoporosis patients

Bone ◽  
2011 ◽  
Vol 48 ◽  
pp. S199
Author(s):  
R. Pastore ◽  
P. Borboni ◽  
G. Vancieri ◽  
L. Chioma ◽  
G.V. Frajese
Keyword(s):  
Fracture Risk ◽  
High Fracture ◽  
Postmenopausal Osteopenia ◽  
Tsh Levels

scholarly journals Factors associated with initiation of bone-health medication among older adults in primary care in Ireland

2021 ◽  
Author(s):  
Mary E Walsh ◽  
Mari Nerdrum ◽  
Tom Fahey ◽  
Frank Moriarty
Keyword(s):  
Primary Care ◽  
Fracture Risk ◽  
Bone Health ◽  
Retrospective Cohort ◽  
Hormone Replacement ◽  
Inverse Association ◽  
High Fracture ◽  
Factors Associated ◽  
General Practices ◽  
Multimorbid Patients

Abstract Background Adults at high risk of fragility fracture should be offered pharmacological treatment when not contraindicated, however, under-treatment is common. Objective This study aimed to investigate factors associated with bone-health medication initiation in older patients attending primary care. Design This was a retrospective cohort study. Setting The study used data from forty-four general practices in Ireland from 2011–2017. Subjects The study included adults aged ≥ 65 years who were naïve to bone-health medication for 12 months. Methods Overall fracture-risk (based on QFracture) and individual fracture-risk factors were described for patients initiated and not initiated onto medication and compared using generalised linear model regression with the Poisson distribution. Results Of 36,799 patients (51% female, mean age 75.4 (SD = 8.4)) included, 8% (n = 2,992) were observed to initiate bone-health medication during the study. One-fifth of all patients (n = 8,193) had osteoporosis or had high fracture-risk but only 21% of them (n = 1,687) initiated on medication. Female sex, older age, state-funded health cover and osteoporosis were associated with initiation. Independently of osteoporosis and co-variates, high 5-year QFracture risk for hip (IRR = 1.33 (95% CI = 1.17–1.50), P < 0.01) and all fractures (IRR = 1.30 (95% CI = 1.17–1.44), P < 0.01) were associated with medication initiation. Previous fracture, rheumatoid arthritis and corticosteroid use were associated with initiation, while liver, kidney, cardiovascular disease, diabetes and oestrogen-only hormone replacement therapy showed an inverse association. Conclusions Bone-health medication initiation is targeted at patients at higher fracture-risk but much potential under-treatment remains, particularly in those >80 years and with co-morbidities. This may reflect clinical uncertainty in older multimorbid patients, and further research should explore decision-making in preventive bone medication prescribing.

scholarly journals Pharmacologic treatment of osteoporosis – 2011

2011 ◽  
Vol 152 (33) ◽  
pp. 1320-1326 ◽  
Author(s):  
Péter Lakatos
Keyword(s):  
Bone Loss ◽  
Fracture Risk ◽  
Hormone Replacement ◽  
Treatment Options ◽  
Osteoporotic Fractures ◽  
Cost Effective ◽  
Similar Efficacy ◽  
High Fracture ◽  
Efficient Treatment ◽  
Treatment Of Osteoporosis

Osteoporosis affects approximately 9% of the population in Hungary resulting in about 100 000 osteoporotic fractures annually. Thirty-five percent of patients with hip fractures due to osteoporosis will die within 1 year. Direct costs of osteoporosis exceed 25 billion forints per year. Apparently, cost-effective reduction of bone loss and consequent fracture risk will add up to not only financial savings but improvement in quality of life, as well. A number of pharmacological modalities are available for this purpose. The mainstay of the treatment of osteoporosis is the bisphosphonate group that includes effective anti-resorptive compounds mitigating bone loss and fragility. The recently registered denosumab exhibits similar efficacy by neutralizing RANK ligand, however, marked differences can be observed between the two drug classes. Strontium has a unique mechanism of action by rebalancing bone turnover, and thus, providing an efficient treatment option for the not fast bone losers who are at high fracture risk. The purely anabolic teriparatide is available for the extremely severe osteoporotic patients and for those who do not respond to other types of therapy. Older treatment options such as hormone replacement therapy, raloxifene, tibolone or calcitonin may also have a restricted place in the management of osteoporosis. Orv. Hetil., 2011, 152, 1320–1326.

scholarly journals Role of disc area and trabecular bone density on lumbar spinal column fracture risk curves under vertical impact

2018 ◽  
Vol 72 ◽  
pp. 90-98 ◽  
Author(s):  
Narayan Yoganandan ◽  
Jason Moore ◽  
Frank A. Pintar ◽  
Anjishnu Banerjee ◽  
Nicholas DeVogel ◽  
...  
Keyword(s):  
Bone Density ◽  
Fracture Risk ◽  
Trabecular Bone ◽  
Spinal Column ◽  
Trabecular Bone Density ◽  
Disc Area ◽  
Lumbar Spinal ◽  
Risk Curves ◽  
Vertical Impact

scholarly journals Cluster Analysis of Finite Element Analysis and Bone Microarchitectural Parameters Identifies Phenotypes with High Fracture Risk

2019 ◽  
Vol 105 (3) ◽  
pp. 252-262 ◽  
Author(s):  
Leo D. Westbury ◽  
Clare Shere ◽  
Mark H. Edwards ◽  
Cyrus Cooper ◽  
Elaine M. Dennison ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Cluster Analysis ◽  
Finite Element ◽  
Fracture Risk ◽  
High Fracture ◽  
Element Analysis
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