Pub Date : 2024-03-01DOI: 10.1016/j.afos.2023.12.004
Worapong Sucharitpongpan
Objectives
The World Health Organization developed the Fracture Risk Assessment Tool (FRAX) to assess the risk of having fragility fractures in the next 10 years. The FRAX tool is different by country, race, gender, and age. This study is a community-based study aiming to identify the optimal cut-off values of FRAX for the identification of older individuals who are at high risk of osteoporosis fractures in both genders.
Methods
This cross-sectional, analytic study was conducted by using health screening data of the older adults aged 60–90 living in the 3 biggest districts of Nan province, Thailand. Validity and optimal FRAX major osteoporotic fracture (MOF) and hip fracture (HF) cut-off values in both genders were determined.
Results
Of 36,042 older adults included in the study, 1624 older people had a history of fragility fractures. Older females were 3.2 and 2.5 times more likely to have fragility fractures and hip fractures than males, respectively. The optimal cut-off values of FRAX MOF for predicting fragility fractures were 3.0% for males and 6.3% for females. The optimal cut-off values of FRAX HF for predicting hip fractures were 1.1% for males and 3.3% for females.
Conclusions
A simple screening tool like the FRAX which is available in the annual health screening activities has the potential to be used to predict the risk of developing fragility fractures in rural areas of Thailand. Different cut-off values should be used in females and males because the risk of MOF and HF of both genders is significantly different.
{"title":"The optimal cut-off values of FRAX without BMD for predicting osteoporosis fracture risk in the older adults at Nan, Thailand","authors":"Worapong Sucharitpongpan","doi":"10.1016/j.afos.2023.12.004","DOIUrl":"10.1016/j.afos.2023.12.004","url":null,"abstract":"<div><h3>Objectives</h3><p>The World Health Organization developed the Fracture Risk Assessment Tool (FRAX) to assess the risk of having fragility fractures in the next 10 years. The FRAX tool is different by country, race, gender, and age. This study is a community-based study aiming to identify the optimal cut-off values of FRAX for the identification of older individuals who are at high risk of osteoporosis fractures in both genders.</p></div><div><h3>Methods</h3><p>This cross-sectional, analytic study was conducted by using health screening data of the older adults aged 60–90 living in the 3 biggest districts of Nan province, Thailand. Validity and optimal FRAX major osteoporotic fracture (MOF) and hip fracture (HF) cut-off values in both genders were determined.</p></div><div><h3>Results</h3><p>Of 36,042 older adults included in the study, 1624 older people had a history of fragility fractures. Older females were 3.2 and 2.5 times more likely to have fragility fractures and hip fractures than males, respectively. The optimal cut-off values of FRAX MOF for predicting fragility fractures were 3.0% for males and 6.3% for females. The optimal cut-off values of FRAX HF for predicting hip fractures were 1.1% for males and 3.3% for females.</p></div><div><h3>Conclusions</h3><p>A simple screening tool like the FRAX which is available in the annual health screening activities has the potential to be used to predict the risk of developing fragility fractures in rural areas of Thailand. Different cut-off values should be used in females and males because the risk of MOF and HF of both genders is significantly different.</p></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"10 1","pages":"Pages 11-15"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405525524000013/pdfft?md5=26ec65c1dc2730e0b698d2b8e46608b9&pid=1-s2.0-S2405525524000013-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139638450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.afos.2024.01.001
Huy G. Nguyen , Hoa T. Nguyen , Linh T.T. Nguyen , Thach S. Tran , Lan T. Ho-Pham , Sai H. Ling , Tuan V. Nguyen
Objectives
Vertebral fracture is both common and serious among adults, yet it often goes undiagnosed. This study aimed to develop a shape-based algorithm (SBA) for the automatic identification of vertebral fractures.
Methods
The study included 144 participants (50 individuals with a fracture and 94 without a fracture) whose plain thoracolumbar spine X-rays were taken. Clinical diagnosis of vertebral fracture (grade 0 to 3) was made by rheumatologists using Genant's semiquantitative method. The SBA algorithm was developed to determine the ratio of vertebral body height loss. Based on the ratio, SBA classifies a vertebra into 4 classes: 0 = normal, 1 = mild fracture, 2 = moderate fracture, 3 = severe fracture). The concordance between clinical diagnosis and SBA-based classification was assessed at both person and vertebra levels.
Results
At the person level, the SBA achieved a sensitivity of 100% and specificity of 62% (95% CI, 51%–72%). At the vertebra level, the SBA achieved a sensitivity of 84% (95% CI, 72%–93%), and a specificity of 88% (95% CI, 85%–90%). On average, the SBA took 0.3 s to assess each X-ray.
Conclusions
The SBA developed here is a fast and efficient tool that can be used to systematically screen for asymptomatic vertebral fractures and reduce the workload of healthcare professionals.
{"title":"Development of a shape-based algorithm for identification of asymptomatic vertebral compression fractures: A proof-of-principle study","authors":"Huy G. Nguyen , Hoa T. Nguyen , Linh T.T. Nguyen , Thach S. Tran , Lan T. Ho-Pham , Sai H. Ling , Tuan V. Nguyen","doi":"10.1016/j.afos.2024.01.001","DOIUrl":"10.1016/j.afos.2024.01.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Vertebral fracture is both common and serious among adults, yet it often goes undiagnosed. This study aimed to develop a shape-based algorithm (SBA) for the automatic identification of vertebral fractures.</p></div><div><h3>Methods</h3><p>The study included 144 participants (50 individuals with a fracture and 94 without a fracture) whose plain thoracolumbar spine X-rays were taken. Clinical diagnosis of vertebral fracture (grade 0 to 3) was made by rheumatologists using Genant's semiquantitative method. The SBA algorithm was developed to determine the ratio of vertebral body height loss. Based on the ratio, SBA classifies a vertebra into 4 classes: 0 = normal, 1 = mild fracture, 2 = moderate fracture, 3 = severe fracture). The concordance between clinical diagnosis and SBA-based classification was assessed at both person and vertebra levels.</p></div><div><h3>Results</h3><p>At the person level, the SBA achieved a sensitivity of 100% and specificity of 62% (95% CI, 51%–72%). At the vertebra level, the SBA achieved a sensitivity of 84% (95% CI, 72%–93%), and a specificity of 88% (95% CI, 85%–90%). On average, the SBA took 0.3 s to assess each X-ray.</p></div><div><h3>Conclusions</h3><p>The SBA developed here is a fast and efficient tool that can be used to systematically screen for asymptomatic vertebral fractures and reduce the workload of healthcare professionals.</p></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"10 1","pages":"Pages 22-27"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405525524000025/pdfft?md5=63ec61beb3f370b70218acffa5705aba&pid=1-s2.0-S2405525524000025-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139825246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.afos.2024.02.001
Ta-Wei Tai , Hsuan-Yu Chen , Chien-An Shih , Chun-Feng Huang , Eugene McCloskey , Joon-Kiong Lee , Swan Sim Yeap , Ching-Lung Cheung , Natthinee Charatcharoenwitthaya , Unnop Jaisamrarn , Vilai Kuptniratsaikul , Rong-Sen Yang , Sung-Yen Lin , Akira Taguchi , Satoshi Mori , Julie Li-Yu , Seng Bin Ang , Ding-Cheng Chan , Wai Sin Chan , Hou Ng , Chih-Hsing Wu
Objectives
This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition. The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach.
Methods
A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and antiresorptive agents in sequential therapy approaches.
Results
The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to antiresorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for individuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment.
Conclusions
This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.
{"title":"Asia-Pacific consensus on long-term and sequential therapy for osteoporosis","authors":"Ta-Wei Tai , Hsuan-Yu Chen , Chien-An Shih , Chun-Feng Huang , Eugene McCloskey , Joon-Kiong Lee , Swan Sim Yeap , Ching-Lung Cheung , Natthinee Charatcharoenwitthaya , Unnop Jaisamrarn , Vilai Kuptniratsaikul , Rong-Sen Yang , Sung-Yen Lin , Akira Taguchi , Satoshi Mori , Julie Li-Yu , Seng Bin Ang , Ding-Cheng Chan , Wai Sin Chan , Hou Ng , Chih-Hsing Wu","doi":"10.1016/j.afos.2024.02.001","DOIUrl":"10.1016/j.afos.2024.02.001","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition. The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach.</p></div><div><h3>Methods</h3><p>A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and antiresorptive agents in sequential therapy approaches.</p></div><div><h3>Results</h3><p>The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to antiresorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for individuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment.</p></div><div><h3>Conclusions</h3><p>This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.</p></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"10 1","pages":"Pages 3-10"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240552552400030X/pdfft?md5=c83fcb63cbef3c9efee429fd07c917e2&pid=1-s2.0-S240552552400030X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.afos.2024.03.002
Daisuke Inoue
{"title":"Diagnosis and treatment of adult hypophosphatasia: Still a big challenge?","authors":"Daisuke Inoue","doi":"10.1016/j.afos.2024.03.002","DOIUrl":"10.1016/j.afos.2024.03.002","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"10 1","pages":"Pages 1-2"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405525524000347/pdfft?md5=f3444628830c78cadd2a0c70e087d8d5&pid=1-s2.0-S2405525524000347-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.afos.2023.11.036
Tien-Ching Lee , Chen-Yu Hung , Chung-Hwan Chen , Pei-Shan Ho
{"title":"Effects of the adherence of denosumab on the kidney function and all-cause mortality in type 2 diabetic patients","authors":"Tien-Ching Lee , Chen-Yu Hung , Chung-Hwan Chen , Pei-Shan Ho","doi":"10.1016/j.afos.2023.11.036","DOIUrl":"10.1016/j.afos.2023.11.036","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"9 4","pages":"Page S12"},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143298386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.afos.2023.11.006
Chor-Wing Sing , K.H. Chan , Patrick KC. Chiu , Xiaowen Zhang , Kathryn CB. Tan , Ching-Lung Cheung
{"title":"Nitrogen-containing bisphosphonate was associated with a lower risk of dementia in patients with fragility fractures: A population-based cohort study in Hong Kong","authors":"Chor-Wing Sing , K.H. Chan , Patrick KC. Chiu , Xiaowen Zhang , Kathryn CB. Tan , Ching-Lung Cheung","doi":"10.1016/j.afos.2023.11.006","DOIUrl":"10.1016/j.afos.2023.11.006","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"9 4","pages":"Page S2"},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143298369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.afos.2023.11.043
Jhong-You Li , Chung-Hwan Chen , Sung-Yen Lin , Yen-Zung Wu , Je-Ken Chang
{"title":"Percutaneous screw stabilization facilitates rapid pain relief and functional recovery for fragility fractures of pelvis with lateral compression type fracture: a retrospective observational study","authors":"Jhong-You Li , Chung-Hwan Chen , Sung-Yen Lin , Yen-Zung Wu , Je-Ken Chang","doi":"10.1016/j.afos.2023.11.043","DOIUrl":"10.1016/j.afos.2023.11.043","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"9 4","pages":"Page S14"},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143353710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.afos.2023.11.032
Wen-Tung Hsieh , Tom Maarten Groot , Hung-Kuan Yen , Chen-Yu Wang , Ming-Hsiao Hu , Olivier Q. Groot , Ping-Ying Yu , Shau-Huai Fu
{"title":"How do ten osteoporosis screening tools perform in a rural area in Taiwan? An external validation study","authors":"Wen-Tung Hsieh , Tom Maarten Groot , Hung-Kuan Yen , Chen-Yu Wang , Ming-Hsiao Hu , Olivier Q. Groot , Ping-Ying Yu , Shau-Huai Fu","doi":"10.1016/j.afos.2023.11.032","DOIUrl":"10.1016/j.afos.2023.11.032","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"9 4","pages":"Pages S10-S11"},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143290940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.afos.2023.11.026
Ya-Lien Teng , Yi-Ming Chen , Shu-Hui Yang , Shih-Yi Lin
{"title":"Higher secondary fracture rate among male elderly veterans: A single veterans hospital-based analysis.","authors":"Ya-Lien Teng , Yi-Ming Chen , Shu-Hui Yang , Shih-Yi Lin","doi":"10.1016/j.afos.2023.11.026","DOIUrl":"10.1016/j.afos.2023.11.026","url":null,"abstract":"","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"9 4","pages":"Pages S8-S9"},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143297573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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