Archives of Osteoporosis最新文献

Brief rationale: To evaluate the utility of forearm-DXA in differentiating postmenopausal osteoporosis and to explore its relationship with clinical features of PHPT.

Main result: Forearm-DXA was useful for differential diagnosis and independently associated with calcium in PHPT. Significance of the paper: This is the first study demonstrating these findings.

Purpose: To evaluate the utility of forearm dual-energy X-ray absorptiometry (DXA) measurement in differentiating primary postmenopausal osteoporosis from primary hyperparathyroidism (PHPT) related osteoporosis and to examine its association with clinical features of PHPT.

Methods: This retrospective study included 246 women with PHPT (153 postmenopausal and 93 premenopausal) and 100 postmenopausal controls with osteopenia/osteoporosis. DXA measurements of the lumbar spine, hip, and one-third distal radius, together with clinical and biochemical data, were compared between postmenopausal patients with PHPT and controls, as well as between postmenopausal and premenopausal PHPT groups. Associations between DXA measurements and clinical findings were also analyzed in PHPT.

Results: Postmenopausal PHPT and controls were matched for age and body-mass index (BMI), osteoporosis was more frequent in PHPT (p = 0.001), with the distal radius most affected (p < 0.001). Multivariate regression confirmed an independent association between distal radius T-scores and PHPT [OR 1.88, 95% CI: 1.44-2.47]. In postmenopausal patients with osteoporosis by lumbar spine or hip DXA, ROC analysis showed that distal radius scores had excellent discriminatory value (AUC > 0.80) for differentiating PHPT from primary postmenopausal osteoporosis; optimal cutoffs were T-score < -2.4 (80.0% sensitivity, 63.6% specificity) and Z-score < -1.0 (81.5% sensitivity, 63.6% specificity). In premenopausal PHPT, calcium was independently associated with the distal radius T-score [(B = -0.594 (95% CI: -1.027 to -0.160)].

Conclusion: This is the first study to show the utility of forearm DXA in differentiating primary postmenopausal osteoporosis from PHPT-related osteoporosis as well as its independent association with calcium in PHPT. Although the diagnosis of PHPT is primarily biochemical, a predominant reduction in distal radius BMD should prompt evaluation for a parathyroid disorder. Moreover, our data may provide clues to help distinguish whether osteoporosis-identified as a surgical indication in PHPT-observed in postmenopausal individuals with PHPT is primarily attributable to PHPT or to menopause.

This study aimed to describe the level of knowledge about osteoporosis prevention among health science students and to identify influencing factors. Results show a low level of knowledge regarding osteoporosis 13.27 ± 3.67 out of 32. Also influencing factors were such as gender (p = 0.007), age (p = 0.003), living environment (p = 0.009) and educational level (p = 0.017).

Purpose: The Purpose of this study was to describe the level of knowledge about osteoporosis prevention among health science students and to identify influencing factors.

Methods: A descriptive correlational study was conducted among 524 health science students enrolled at the Higher School of Health Sciences and Techniques of Sousse (HSHSTS) and the Higher Institute of Nursing Sciences of Sousse (HINSS), Tunisia. Data were collected using a validated, self-administered questionnaire based on the revised Osteoporosis Knowledge Test (OKT). The OKT included two subscales assessing knowledge of osteoporosis prevention through physical activity and nutrition. Each correct response was awarded one point, while incorrect or "unknown" answers received zero points. The questionnaire also gathered sociodemographic information, including gender, age, living environment, and educational level.

Results: The participants had a mean age of 20.5 ± 1.4 years. Overall, 71.8% of students demonstrated a low level of knowledge regarding osteoporosis. The mean total knowledge score was 13.27 ± 3.67 out of 32. Female students scored significantly higher on the overall OKT compared to males (p = 0.007). Physical activity subscale scores were significantly associated with gender (p = 0.005), age (p = 0.003), living environment (p = 0.009), and education level (p = 0.010). Similarly, nutrition-related knowledge showed significant associations with gender (p < 0.001), age (p = 0.001), living environment (p = 0.033), and education level (p = 0.002).

Conclusion: Key limitations include the cross-sectional design, possible participation bias from differing response rates between institutions, and a markedly imbalanced sex ratio, which may limit generalizability. These findings highlight the need for targeted educational interventions and early integration of osteoporosis content into university curricula to improve knowledge.

A population study to understand the characteristics of osteoporotic (OP) hip fractures in Chile. Incidence has decreased slightly over time, but absolute numbers are increasing. A low rate of surgery stands out with higher in-hospital mortality among men and those not treated surgically. Management improvements are required.

Introduction: Osteoporotic hip fractures are prevalent among older adults, particularly women, and are associated with significant morbidity andmortality.

Purpose: To analyze the epidemiological characteristics, surgeries, and in-hospital case fatality rates (CFR) of patients aged ≥ 50 years hospitalized for OP fractures in Chile.

Methods: A retrospective, population-based study utilizing national hospital discharge data for individuals aged ≥ 50 years diagnosed with hip fractures.

Results: Over the 19 years studied (2001-2019), there were 119,145 discharges for OP fractures (89,502 women/29,643 men). The age-standardized incidence rates per 100,000 population were 181.8 for women and 92.6 for men. Incidence increased markedly with age, being 110 times higher in women and 35 times higher in men aged ≥ 80 years compared to those aged 50-54 years. The female-to-male incidence ratio was 2:1. Of all the patients, 66.1% underwent surgery during hospitalization. The overall in-hospital CFR was 2.54%, higher in men (2.93%) than in women (2.41%), and increased with advancing age.

Conclusions: This is the largest study in Chile using event data of the general population aged 50 years and older. Chile exhibits an intermediate incidence of OP fractures compared to other countries, with absolute numbers rising over time. Despite only 2/3 of the patients undergoing surgery, the overall in-hospital CFR was rather low. These findings underscore the need for enhanced strategies to ensure timely and effective care for this growing patient population.

A country-specific FRAX® model for Costa Rica was developed using national hip fracture data from 2015-2019. Hip fracture incidence increased with age, was consistently higher in women, and exceeded rates reported in neighboring Latin American countries. Costa Rica also demonstrated higher 10-year major osteoporotic fracture probabilities at older ages compared with regional FRAX® models. An estimated 3,176 hip fractures occurred in 2020, with projections indicating an increase to 9,946 cases by 2050. These findings underscore the growing burden of hip fractures in Costa Rica and the need for targeted prevention strategies.

Objective: To describe the epidemiology of hip fractures in Costa Rica and to develop a country-specific FRAX® model calibrated with national fracture and mortality data.

Methods: All hip fractures (ICD-10 S72.0, S72.1, S72.2) recorded in the Caja Costarricense de Seguro Social registry from 2015-2019 were included. Age- and sex-specific incidence rates were combined with United Nations mortality data to construct a Costa Rica-specific FRAX® model. Ten-year fracture probabilities were estimated and compared with those from other Latin American countries with calibrated FRAX® models. National projections for hip fracture burden in 2020 and 2050 were derived using United Nations population forecasts. Age-specific FRAX® assessment and intervention thresholds were developed following established international methodology.

Results: Hip fracture incidence increased with age and was consistently higher in women than in men. Compared with other Latin American countries, Costa Rica demonstrated higher age-specific hip fracture rates and higher 10-year major osteoporotic fracture probabilities at older ages. An estimated 3,176 hip fractures occurred in adults aged ≥ 50 years in 2020, with a projected increase to 9,946 by 2050. Age-specific FRAX® threshold curves showed widening separation with advancing age, reflecting increasing fracture probability in older age groups.

Conclusion: Costa Rica exhibits a comparatively high burden of hip fractures and fracture risk, which is expected to rise substantially with population aging. The newly developed Costa Rica-specific FRAX® model provides an essential tool for improving fracture risk assessment and guiding evidence-based osteoporosis management in clinical practice.

This cross-sectional study of 300 older adults (aged ≥ 50 years) found that less education, lower income, and health care card ownership are associated with reduced bone, muscle, and physical function measures. This underscores the need for targeted preventive strategies for osteoporosis and sarcopenia that address socioeconomic-related disparities.

Purpose: The prevalence of chronic diseases follows a social gradient, although this is unclear in musculoskeletal conditions. This study aims to examine the association between social disadvantage and diagnostic measures of osteoporosis and sarcopenia in community-dwelling older adults.

Methods: A single-centre, cross-sectional study was conducted in adults (≥ 50 years) residing in the metropolitan region of Melbourne, Australia. Data on socio-demographic variables were collected via self-reported questionnaires. Social disadvantage variables included education, income, employment status, health care card ownership, and area-level socioeconomic status. Outcomes of interest were bone mineral density (BMD), appendicular lean body mass (ALM/h²), hand grip strength, lower limb strength, and physical performance (gait speed; short physical performance battery; leg power). Multivariable linear regression was used to analyse associations between social disadvantage and outcome measures.

Results: A total of 300 participants were recruited (mean age: 66.8 years; 61.7% female). Post-secondary education was associated with higher BMD (β = 0.29; 95% CI: 0.01-0.58), ALM/h² (β = 0.29; 95% CI: 0.08-0.51), handgrip strength (β = 2.25; 95% CI: 0.57-4.52), gait speed (β = 0.08; 95% CI: 0.01-0.15), and leg power (β = 41.7; 95% CI: 11.3-71.9). Positive associations in these outcomes were also correlated with higher income and not having a health care card. Employment status and area-level socioeconomic status showed limited associations with most outcomes.

Conclusion: This study demonstrates that social disadvantage is associated with poorer bone, muscle, and physical function in older adults. Targeted interventions that address socioeconomic-related disparities may support effective prevention of osteoporosis and sarcopenia later in life.