scholarly journals Diagnosis, Screening and Treatment of Osteoporosis –A Review

2021 ◽  
Vol 14 (2) ◽  
pp. 567-575
Author(s):  
V. Chitra ◽  
Evelyn Sharon.S
Keyword(s):  
Bone Mineral Density ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Weight Bearing ◽  
Previous History ◽  
Fragility Fractures ◽  
Prevention Measures ◽  
Lifestyle Modifications ◽  
Mineral Density ◽  
Treatment Of Osteoporosis

Osteoporosis is the multifactorial skeletal disease that leads to fracture risk in individuals. It is characterized by a decrease in bone mineral density leading to increased fracture risk. It is often silent and only known when fractures occur in the elderly leading to death. The reason is that the disease is always underdiagnosed and not treated properly. It affects men and women, but women are more susceptible to it due to estrogen deficiency. Osteoporosis is diagnosed based on the fragility fractures, low bone mineral density assessed by DEXA scan. Pharmacological (anti-resorptive and anabolic drugs) and lifestyle modifications (dietary intake, weight-bearing exercise, hip protectors, and fall prevention measures) are helpful in the prevention and treatment of Osteoporosis. Clinicians must take proper measures in finding out the patients who are at higher risk of Osteoporosis and providing treatment by either diagnosing or by screening the previous history of fracture risk in the patients. This article provides an overview of the diagnosis, screening, and treatment of Osteoporosis.

scholarly journals Bone Mineral Density of the Tarsals and Metatarsals With Reloading

2008 ◽  
Vol 88 (6) ◽  
pp. 766-779 ◽  
Author(s):  
Mary Kent Hastings ◽  
Judy Gelber ◽  
Paul K Commean ◽  
Fred Prior ◽  
David R Sinacore
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Case Report ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Weight Bearing ◽  
Quantitative Computed Tomography ◽  
Case Description ◽  
Mineral Density ◽  
Lateral Column

Background and PurposeBone mineral density (BMD) decreases rapidly with prolonged non–weight bearing. Maximizing the BMD response to reloading activities after NWB is critical to minimizing fracture risk. Methods for measuring individual tarsal and metatarsal BMD have not been available. This case report describes tarsal and metatarsal BMD with a reloading program, as revealed by quantitative computed tomography (QCT).Case DescriptionA 24-year-old woman was non–weight bearing for 6 weeks after right talocrural arthroscopy. Tarsal and metatarsal BMD were measured with QCT 9 weeks (before reloading) and 32 weeks (after reloading) after surgery. A 26-week progressive reloading program was completed. Change scores were calculated for BMD before reloading and BMD after reloading for the total foot (average of all tarsals and metatarsals), tarsals, metatarsals, bones of the medial column (calcaneus, navicular, cuneiforms 1 and 2, and metatarsal 1), and bones of the lateral column (calcaneus, cuboid, cuneiform 3, and metatarsals 2–5). The percent differences in BMD between the involved side and the uninvolved side were calculated.OutcomesBefore reloading, BMD of the involved total foot was 9% lower than that on the uninvolved side. After reloading, BMD increased 22% and 21% for the total foot, 16% and 14% for the tarsals, 29% and 30% for the metatarsals, 14% and 15% for the medial column bones, and 28% and 26% for the lateral column bones on the involved and uninvolved sides, respectively. After reloading, BMD of the involved total foot remained 8% lower than that on the uninvolved side.DiscussionThe increase in BMD with reloading was not uniform across all pedal bones; the metatarsals showed a greater increase than the tarsals, and the lateral column bones showed a greater increase than the medial column bones.

scholarly journals O41 Percentage body fat as a predictor for fragility fracture: an observational study

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Dominic T Beith ◽  
Marwan Bukhari
Keyword(s):  
Bone Mineral Density ◽  
Fracture Risk ◽  
Body Mass ◽  
Body Fat ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
Statistical Significance ◽  
Fragility Fractures ◽  
Mineral Density ◽  
Percentage Body Fat

Abstract Background A body mass index (BMI) of less than 19 is a known risk factor for the development of osteoporosis and thus increases the propensity of one having a fragility fracture. Bone mineral density (BMD) referrals are aided by the FRAX™ tool, which contains BMI in order to calculate the ten-year fracture risk. We aimed to investigate the effect of percentage body fat on risk of fracture referred for BMD estimation. Methods Between June 2004 and October 2015, patients were referred for bone mineral density (BMD) estimation in a scanner in the North West of England. All patients were referred with all FRAX™ indications including rheumatoid arthritis, excess alcohol, steroids, family history of fracture and secondary osteoporosis. The cohort was divided into quintiles of ascending body mass percentage. Logistical regression was then applied before adjusting for age at scan, gender and total left BMD comparing patients with a fracture and those that had not. Results 35,759 patients were referred for scanning during the period. 22,765 (63.66%) were referred for BMD estimation and had body fat percentage measured. Mean age at scan was 63.16 (SD 12.86) and 18,961 (88.29%) of the cohort were females. 8,072 (35.46%) had a fracture. More fractures were seen in higher quintiles of percentage body fat, 1,693 (20.97%) compared to 1,580 (19.57%) in females (p = <0.05). Predictors shown in the Table 1 below adjusted for age at scan, gender and total left BMD. Logistical regression of the quintiles after adjustment shows statistical significance in quintiles 3, 4 and 5 as well as for age at scan and total left BMD. Other predictors did not shows statistical significance p > 0.05. Conclusion Our study of 22,765 patients referred for BMD estimations opposes current literature on the effect of BMI on fragility fractures. The data shows that increasing percentage body fat in associated with an increased propensity of fragility fractures in those with BMI as a FRAX™ indicator. Currently percentage body fact is not featured in the FRAX™ tool and further work needs to be done to show the relationship between fracture risk and percentage body fat. Disclosures D.T. Beith: None. M. Bukhari: None.

scholarly journals Association between polymorphisms in GGPS1 and RANKL genes and postmenopausal osteoporosis in Romanian women

2019 ◽  
Vol 10 (Vol.10, No.3) ◽  
pp. 252-258
Author(s):  
Alina Deniza CIUBEAN ◽  
Laszlo IRSAY ◽  
Rodica Ana UNGUR ◽  
Viorela Mihaela CIORTEA ◽  
Ileana Monica BORDA ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Fracture Risk ◽  
Postmenopausal Osteoporosis ◽  
Bone Mineral ◽  
Strong Association ◽  
Fragility Fractures ◽  
Mineral Density ◽  
Density Values ◽  
Study Participants ◽  
The Relationship

Objectives: This study aimed to assess the relationship between bone mineral density, fragility fractures, fracture risk and polymorphisms of two osteoporosis-candidate genes (GGPS1 and RANKL) in Romanian women with postmenopausal osteoporosis. Methods: An analytical, prospective, transversal, observational, case-control study on 364 postmenopausal women, of which 228 were previously diagnosed with osteoporosis, was carried out between June 2016 and August 2017 in Cluj Napoca, Romania. Clinical data and blood samples were collected from all study participants. Polymorphisms in GGPS1 and RANKL genes were genotyped using TaqMan SNP Genotyping assays, run on a QuantStudio 3 real-time PCR machine. Results: The CT genotype in GGPS1 rs10925503 was associated with significant lower bone mineral density values at lumbar spine and femoral neck sites and a higher fracture risk compared to controls. No significant association was found between genotypes of RANKL rs2277439 with bone mineral density or fracture risk compared to the healthy controls. Conclusions: Our study showed a strong association between low bone mineral density and genotype CT of GGPS1 rs10925503 polymorphisms. No association was found for RANKL rs2277439 polymorphism.

scholarly journals Relationship between bone mineral density and fragility fracture risk: a case-control study in Changsha, China

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hong-Li Li ◽  
Yi Shen ◽  
Li-Hua Tan ◽  
Song-bo Fu ◽  
Ru-Chun Dai ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
Cox Regression ◽  
Fragility Fractures ◽  
Control Group ◽  
Reference Database ◽  
Mineral Density ◽  
Cox Regression Analysis

Abstract Background Fragility fracture is associated with bone mineral density (BMD), and most databases used in related researches are instrument-matched. Little is known about the relationship between BMD and fragility fracture risk of native Chinese, especially using local databases as reference databases. Objective To investigate relationship between BMD and risk of fragility fracture in native China. Methods 3,324 cases, including 2,423 women (67.7 ± 8.9 years) and 901 men (68.4 ± 11.6 years) having radiological fragility fractures and 3,324 age- and gender-matched controls participated in the study. We measured BMD at posteroanterior spine and hip using dual-energy X-ray absorptiometry (DXA), calculated BMD measurement parameters based on our own BMD reference database. Results BMDs and mean T-scores were lower in case group (with clinical fragility) than in control group (without clinical fragility). In patients with fragility fractures, prevalence of lumbar osteoporosis, low bone mass, and normal BMD were 78.9 %, 19.3 %, and 1.8 %, respectively, in women, and 49.5, 44.8 %, and 5.7 %, respectively, in men. In hip, these prevalence rates were 67.2 %, 28.4 %, and 4.4 % in females, and 43.2 %, 45.9 %, and 10.9 % in males, respectively, showing differences between females and males. Multivariate Cox regression analysis showed that after adjusting age, height, weight, and body mass index, fracture hazard ratio (HR) increased by 2.7–2.8 times (95 % CI 2.5–3.1) and 3.6–4.1 times (95 %CI 3.0–5.1) for women and men respectively with decreasing BMD parameters. In both sexes, risk of fragility fracture increased approximately 1.6–1.7 times (95 % CI 1.5–1.8) for every 1 T-score reduction in BMD. Conclusions Risk of clinical fragility fracture increases with decreasing BMD measurement parameters and anthropometric indicators in native China, and fracture HR varies from gender and site.

Fracture risk among men, in relation to osteopenia and osteoporosis defined by areal bone mineral density

2013 ◽  
Author(s):  
Julie Pasco ◽  
Stephen Lane ◽  
Sharon Brennan ◽  
Elizabeth Timney ◽  
Gosia Bucki-Smith ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Areal Bone Mineral Density ◽  
Mineral Density

scholarly journals DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

Endocrine ◽  
2021 ◽  
Author(s):  
Enisa Shevroja ◽  
Francesco Pio Cafarelli ◽  
Giuseppe Guglielmi ◽  
Didier Hans
Keyword(s):  
Bone Mineral Density ◽  
Trabecular Bone ◽  
Bone Mineral ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Fragility Fractures ◽  
Endocrine Disorders ◽  
Mineral Density ◽  
Increased Risk

AbstractOsteoporosis, a disease characterized by low bone mass and alterations of bone microarchitecture, leading to an increased risk for fragility fractures and, eventually, to fracture; is associated with an excess of mortality, a decrease in quality of life, and co-morbidities. Bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA), has been the gold standard for the diagnosis of osteoporosis. Trabecular bone score (TBS), a textural analysis of the lumbar spine DXA images, is an index of bone microarchitecture. TBS has been robustly shown to predict fractures independently of BMD. In this review, while reporting also results on BMD, we mainly focus on the TBS role in the assessment of bone health in endocrine disorders known to be reflected in bone.

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