Frequency and localization of osteoporotic fractures depending on age, bone mineral density and trabecular bone score in postmenopausal women of Ukrainian cohort
Background. Low-trauma fractures are the important complications of systemic osteoporosis, which lead to reduced quality of life, increased morbidity, disability and mortality. Nowadays, bone mineral density (BMD) and trabecular bone score (TBS) measured by dual energy X-ray absorptiometry are two major parameters of bone strength. They are widely used when establishing the osteoporosis diagnosis. The purpose was to study the frequency and localization of different osteoporotic fractures in postmenopausal women depending on the age, BMD and TBS. Materials and methods. We have performed cross-sectional study and have examined 1,369 postmenopausal women aged 45–89 years. Patients were divided into groups depending on BMD according to the WHO criteria: normal bone (T-score > –1.0 standard deviation (SD)), osteopenia (≤ –1.0 T-score £ –2.5 SD), osteoporosis (T-score ≤ –2.5 SD), and depending on TBS (L1-L4) quartiles (groups): QI — the lowest quartile (0.36–1.08); QII — the lower quartile (1.08–1.20); QIII — the upper quartile (1.20–1.32); QIV — the highest quartile (1.32–1.79). BMD and TBS in lumbar spine (L1-L4) were measured using Prodigy densitometer (GE Medical systems, Lunar, model 8743, 2005). TBS was determined using the software TBS Insight (Med-Imaps, Bordeaux, France, 2006). Results. Our study found that risk of all types of osteoporotic fractures in females reliably increases with age (for vertebral fractures — by 1.97–4.26 times, non-vertebral — 1.96–5.45 times, combined fractures — 1.54–3.14 times). Additionally, we have revealed that osteoporotic fractures are present in all groups of females with different BMD: osteoporosis (45.5 %), osteopenia (26.9 %) and normal bone (18.1 %). The highest frequency of osteoporotic fractures was detected in osteoporosis (46.5 %), and, predominantly, in women with vertebral and combined fractures. Only 25.5 % of patients with non-vertebral fractures have osteoporosis. Low TBS was observed in 50.8 % of females with vertebral, 43.7 % — non-vertebral and 32.8 % — with combined (vertebral and non-vertebral) osteoporotic fractures. Conclusions. Osteoporotic fractures are partly associated with age, BMD and TBS. However, there are other significant factors, which influence the risk of fractures, and their combination requires further study.
Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res. 2007 Mar;22(3):465-75. doi: 10.1359/jbmr.061113.
Curtis EM, Moon RJ, Harvey NC, Cooper C. Reprint of: The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide. Int J Orthop Trauma Nurs. 2017 Aug;26:7-17. doi: 10.1016/j.ijotn.2017.04.004.
Fischer S, Kapinos KA, Mulcahy A, Pinto L, Hayden O, Barron R. Estimating the long-term functional burden of osteoporosis-related fractures. Osteoporos Int. 2017 Oct;28(10):2843-2851. doi: 10.1007/s00198-017-4110-4.
Povorozyuk VV, Grygorieva NV, Orlyk TV, et al. Osteoporosis in the practice of an internist-doctor. Кyiv; 2014. 198 p. (in Russian).
Czerwinski E, Badurski JE, Marcinowska-Suchowierska E, Osieleniac J. Current understanding of osteoporosis according to the position of the World Health Organization (WHO) and International Osteoporosis Foundation. Ortop Traumatol Rehabil. 2007 Jul-Aug;9(4):337-56.
Leslie WD, Lix LM, Langsetmo L, et al. Construction of a FRAX® model for the assessment of fracture probability in Canada and implications for treatment. Osteoporos Int. 2011 Mar;22(3):817-27. doi: 10.1007/s00198-010-1464-2.
ISCD. Official Positions 2015 ISCD - Adult and Pediatric. Available from: https://iscd.app.box.com/v/OP-ISCD-2015-Adult/. Accessed June 30, 2018.
Hans D, Barthe N, Boutroy S, Pothuaud L, Winzenrieth R, Krieg MA. Correlations between TBS, measured using antero-posterior DXA acquisition, and 3D parameters of bone micro-architecture: an experimental study on human cadavre vertebrae. J Clin Densitom. 2011 Jul-Sep;14(3):302-12. doi: 10.1016/j.jocd.2011.05.005.
Leslie WD, Pahlavan PS, Tsang JF, Lix LM; Manitoba Bone Density Program. Prediction of hip and other osteoporotic fractures from hip geometry in a large clinical cohort. Osteoporos Int. 2009 Oct;20(10):1767-74. doi: 10.1007/s00198-009-0874-5.
Harvey NC, Glüer CC, Binkley N, et al. Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice. Bone. 2015 Sep;78:216-24. doi: 10.1016/j.bone.2015.05.016.
Hans D, Goertzen AL, Krieg MA, Leslie WD. Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: The Manitoba study. J Bone Miner Res. 2011 Nov;26(11):2762-9. doi: 10.1002/jbmr.499.
Chuang M-H, Chuang T-L, Koo M, Wang Y-F. Trabecular Bone Score Reflects Trabecular Microarchitecture Deterioration and Fragility Fracture in Female Adult Patients Receiving Glucocorticoid Therapy: A Pre-Post Controlled Study. Biomed Res Int. 2017;2017:4210217. doi: 10.1155/2017/4210217.
Pothuaud L, Barthe N, Krieg M-A, Mehsen N, Carceller P, Hans D. Evaluation of the potential use of trabecular bone score to complement bone mineral density in the diagnosis of osteoporosis: a preliminary spine BMD-matched, case-control study. J Clin Densitom. 2009 Apr-Jun;12(2):170-6. doi: 10.1016/j.jocd.2008.11.006.
Rabier B, Héraud A, Grand-Lenoir C, Winzenrieth R, Hans D. A multicentre, retrospective case-control study assessing the role of trabecular bone score (TBS) in menopausal Caucasian women with low areal bone mineral density (BMDa): Analysing the odds of vertebral fracture. Bone. 2010 Jan;46(1):176-81. doi: 10.1016/j.bone.2009.06.032.
Copyright (c) 2018 PAIN. JOINTS. SPINE
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2018