A study on prevalence of risk factors for osteoporosis in Postmenopausal women and the importance of Osteoporosis self- assessment tool (OST) in identifying osteoporotic risk

Osteoporosis is a highly prevalent health issue among postmenopausal women, which can be prevented if identified in the early stages. The use of Osteoporosis Self - assessment Tool (OST) will help in identifying the risk of osteoporosis and hence will allow the patients to seek the best treatment if required. In this study we assessed the prevalence of risk factors for osteoporosis in 400 Postmenopausal women and have measured the osteoporotic risk using OST. The risk factors and risk scores were correlated using spearman’s rho correlation analysis. As per the postmenopausal classification, 52% of the population belonged to the late stage. Average BMI of the population was found to be 19.5 that is borderline of the normal which indicates the risk for Osteoporosis. Attaining early menopause 243(60.75%) and history of fall 223(55.75%) was the most common risk factors found in the population. Using OST, 78 patients were identified with high risk. The correlation between OST and risk factors revealed that OST is positively significant with the progression of menopausal stage. Patient education regarding the use and interpretation of OST will help to identify risk of osteoporosis; this should be implemented within the primary gynecological care units for the better outcome. Keywords: Osteoporosis, postmenopausal women, risk factors, Osteoporosis Self - assessment Tool.

A Retrospective Review of Bone Health Screening of at-risk Children and Adolescents: A Single Center Experience

Background Bone health surveillance that includes laboratory tests and dual-energy x-ray absorptiometry (DXA) for patients with conditions that predispose them to a higher risk of osteoporosis is recommended. This study aimed to review current practice of such surveillance in a local tertiary referral centre. Methods Retrospective review of clinical data of patients who underwent DXA from 2013 to 2017 inclusive. Laboratory test results and presence of osteoporotic risk which was defined as bone mineral density (BMD) Z-score -2 SD or less were documented.Results This review consisted of 112 patients, 58 boys and age ranged from 1.1 to 20.3 years. Most referrals for DXA came from the subspecialty of nephrology (56.3%). Vitamin D status was rarely evaluated in this cohort of patients, only 17.9% of subjects had their vitamin D level checked. Overall, osteoporotic risk was demonstrated in 37% of the subjects. Thalassaemia, other haematological diseases like chronic ITP, osteogenesis imperfecta and inflammatory bowel disease accounted for majority of cases with high risk of osteoporosis.Conclusion DXA is underutilized in this center. Bone health surveillance and protection should be strengthened.

GENETIC DETERMINANTS OF OSTEOPOROTIC RISK IN CALCIUM-DEPENDENT DISEASES - CHRONIC PANCREATITIS AND HYPERTENSIVE DISEASE.

GENETIC DETERMINANTS OF OSTEOPOROTIC RISK IN CALCIUM-DEPENDENT DISEASES - CHRONIC PANCREATITIS AND HYPERTENSIVE DISEASEViun T.I., Pasieshvili L.M.Objectives: to determine the genetic determinants of osteoporotic risk in the comorbidity of calcium-dependent diseases - chronic pancreatitis and hypertensive desease. Subjects and methods: two groups of patients were formed for the study - the main one - 70 patients with chronic pancreatitis and hypertensive disease; and the comparison group - 40 persons with isolated course of chronic pancreatitis. The polymorphism of VDR, LCT and FDPS genes as well as the comparison of pathological alleles of these genes was investigated with the definition of the possible influence of these indices on the course of the disease and formation of complications. Results show that patients with a combined course of CP and HD have an increased risk of osteoporosis, which is expressed by an increase in the number of fractures compared with healthy people. As the genetic determinants of the development of osteopenic syndrome in these patients, there is the presence of the allele of the VR gene, the VDR gene and the SS allele of the FDPS gene. The presence of the LC allele of the LCT gene has no independent predictive value, but in combination with the identified variants of the genes, VDR and FDPS promote an increase in osteoporosis risk. Key words: chronic pancreatitis, hypertonic disease, osteoporosis, VDR gene polymorphism, LCT gene polymorphism, FDPS gene polymorphism. ГЕНЕТИЧНІ ДЕТЕРМІНАНТИ ОСТЕОПОРОТИЧНОГО РИЗИКУ ПРИ КАЛЬЦІЙЗАЛЕЖНИХ ЗАХВОРЮВАННЯХ – ХРОНІЧНОГО ПАНКРЕАТИТУ ТА ГІПЕРТОНІЧНОЇ ХВОРОБИ.В’юн Т. І., Пасієшвілі Л. М.Мета дослідження: визначити генетичні детермінанти остеопоротичного ризику при коморбідності кальційзалежних захворюваннях – хронічному панкреатиті та гіпертонічній хворобі. Матеріали та методи: для проведення дослідження було сформовано дві групи хворих - основна - 70 пацієнтів з хронічним панкреатитом та гіпертонічною хворобою; та група порівняння - 40 осіб з ізольованим перебігом хронічного панкреатиту. Досліджували поліморфізм генів VDR, LCT та FDPS, співставлення патологічних аллелей даних генів, з визначенням можливого впливу даних показників на перебіг захворювання та формування ускладнень. Результати показують, що пацієнти з поєднаним перебігом ХП та ГХ мають підвищений остеопоротичний ризик, який проявляється збільшенням кількості переломів порівняно зі здоровими особами. В якості генетичних детермінант розвитку остеопенічного синдрому у даних хворих є наявність алеля ВВ гена VDR і алеля СС гена FDPS. Наявність алеля CС гена LCT не має самостійного предиктивного значення, проте в комплексі з означеними варіантами генів VDR і FDPS сприяє збільшенню остеопоротичного ризику.Ключові слова: хронічний панкреатит, гіпертонічна хвороба, остеопороз, поліморфізм гена VDR, поліморфізм гена LCT, поліморфізм гена FDPS. ГЕНЕТИЧЕСКИЕ ДЕТЕРМИНАНТЫ ОСТЕОПОРОТИЧЕСКОГО РИСКА ПРИ КАЛЬЦИЙЗАВИСИМЫХ ЗАБОЛЕВАНИЯХ - ХРОНИЧЕСКИЙ ПАНКРЕАТИТ И ГИПЕРТОНИЧЕСКАЯ БОЛЕЗНЬ.Вьюн Т. И., Пасиешвили Л. М.Цель исследования: определить генетические детерминанты остеопоротического риска при коморбидности кальцийзависимых заболеваниях - хроническом панкреатите и гипертонической болезни. Материалы и методы: для проведения исследования были сформированы две группы больных: основная - 70 пациентов с хроническим панкреатитом и гипертонической болезнью; и группа сравнения - 40 человек с изолированным течением хронического панкреатита. Исследовали полиморфизм генов VDR, LCT и FDPS, сопоставление патологических аллелей данных генов, с определением возможного влияния данных показателей на течение заболевания и формирования осложнений. Результаты показывают, что пациенты с совокупным течением ХП и ГБ имеют повышенный остеопоротический риск, который проявляется увеличением количества переломов по сравнению со здоровыми лицами. В качестве генетических детерминант развития остеопенического синдрома у данных больных является наличие аллеля ВВ гена VDR и аллеля СС гена FDPS. Наличие аллеля CС гена LCT не имеет самостоятельного предиктивного значения, однако в комплексе с обозначенными вариантами генов VDR и FDPS способствует увеличению остеопоротические риска.Ключевые слова: хронический панкреатит, гипертоническая болезнь, остеопороз, полиморфизм гена VDR, полиморфизм гена LCT, полиморфизм гена FDPS.

Are other feasible options available for screening of risk assessment of osteoporosis in postmenopausal women at community level in Southern Coastal India

Background: Osteoporosis is a chronic debilitating condition which exhibits iceberg phenomenon. Identification at an early stage of disease will enable preventive measures to reduce the incidence of disease and complications. Owing to the cost of diagnostic test, this study, various screening tools such as WHO fracture risk assessment tool, osteoporosis self-assessment tool for Asians, simple calculated osteoporosis risk estimation and osteoporosis risk assessment instrument have been used for assessment, in order to screen postmenopausal women in the preliminary stages.Methods: A facility-based cross-sectional study was conducted among 107 postmenopausal women carried over a period of five months.Results: Prevalence of osteoporosis and osteopenia was 24.3% and 69.2%. The area under the curve for osteoporosis self-assessment tool for Asians (OSTA), simple calculated osteoporotic risk estimation (SCORE) and osteoporotic risk assessment instrument (ORAI) was 0.731, 0.407 and 0.172 respectively. OSTA proved to be effective in differentiating normal BMD from low BMD score (i.e., osteopenia and osteoporosis) with a cut off of 1.1, SCORE to be more effective in screening osteoporosis than the other tools because it had a higher positive probability with a cut off 22. FRAX tool predicted probability of five and three percent probability of major fracture and hip fracture risk in ten yearsConclusions: Various tools assessed in the studies can be utilized at community level for identifying high risk women in post-menopausal stage but with different cut offs. This will reduce the cost of screening and also facilitate non pharmacological measures to reduce the progression of disease.