Archives of Osteoporosis最新文献

The current study aimed to investigate the prevalence trends of osteoporosis from 2003 to 2022 using data from the largest tertiary care referral center hospital in Northeastern Thailand. We reviewed 36,306 bone mineral density measurements of community-dwelling individuals aged > 45 years from the medical record database of Srinagarind Hospital, Khon Kaen, Thailand, between 2003 and 2022. We observed a significant increase in the crude prevalence of osteoporosis from 2003 to 2022. Meanwhile, the age-standardized prevalence increased more gradually.

Purpose: To investigate the prevalence trends of osteoporosis from 2003 to 2022 using data from the largest tertiary care referral center in Northeastern Thailand.

Methods: Bone mineral density (BMD) measurements of community-dwelling individuals aged > 45 years were reviewed from the medical record database of Srinagarind Hospital, Khon Kaen, Thailand, between 2003 and 2022. Osteoporosis was defined by a T-score of ≤  - 2.5. For each year, crude and age-standardized prevalence rates for osteoporosis stratified by site of measurement were calculated. Trend analysis was performed using the joinpoint regression method.

Results: A total of 36,306 BMD measurements were identified between 2003 and 2022. The crude prevalence of femoral neck (FN) osteoporosis increased from 2.4% to 9.2% in men and from 2.5% to 11.2% in women, while the age-standardized prevalence increased less, from 2.6% to 8.3% in men, and slightly decreased from 8.7% to 7.6% in women. Trend analysis revealed increased crude and age-standardized prevalence rates of FN osteoporosis in men, with an annual percent change (APC) of 4.0 (95%CI: - 4.1 to 14.7) and 2.3 (95%CI: - 4.9 to 10.0), respectively. In women, the crude prevalence increased significantly from 2003 to 2011 (APC: 20.8, 95%CI: 5.8-249.3) and plateaued from 2011 to 2022 (APC: 0.8, 95%CI: - 30.3 to 5.9). The age-standardized prevalence was relatively unchanged (APC: 0.1, 95%CI: - 4.2 to 5.4).

Conclusion: We observed a significant increase in the crude prevalence of osteoporosis from 2003 to 2022 among individuals receiving BMD measurements in a tertiary care referral center in Northeastern Thailand. Meanwhile, the age-standardized prevalence increased more gradually.

This study aimed to describe the incidence of hospitalizations for osteoporotic fractures in patients aged 50 years and over in Belgium between 2010 and 2021. A declining trend in crude and age-adjusted hospitalization incidence was observed, however, the absolute number of hospitalisations for osteoporotic fractures increased due to demographic changes.

Purpose: The secular trends of hospitalizations for hip and other osteoporotic fractures between 2010 and 2021 in patients aged 50 years and over in Belgium are unknown. This study aimed to describe the incidence of hospitalizations for osteoporotic fractures in patients aged 50 years and over in Belgium between 2010 and 2021.

Methods: Population-based, retrospective study based on hospitalization data extracted by the national database NIHDI and demographical data retrieved from the Belgian Federal Bureau for Statistics. Data were combined to determine the crude and age-standardized hospitalization incidence of fractures of the hip, distal femur, pelvis, humerus, wrist, and spine (2010 as the reference year).

Results: A total of 445,234 hospitalizations for osteoporotic fractures were reported between 2010 and 2021 (excluding 2015). Hospitalizations increased by 5.8% between 2010 and 2021 (p = 0.013) with a higher increase in men (12.1%; p = 0.001) compared to women (4.1%; p = 0.041). The crude incidence of hospitalizations for all fractures per 100,000 persons per year decreased from 990 to 910 between 2010 and 2021 (p = 0.572). The age-standardized incidence for hospitalizations of any osteoporotic fracture in men declined from 5.30/1,000 to 4.42/1,000 (p = 0.010). In women, a similar decrease was observed (13.84/1,000 to 11.62/1,000; p = 0.003). Both age-standardized hospitalizations for hip and non-hip fractures showed a decrease in both sexes.

Conclusion: Although a declining trend in the crude incidence per 100,000 and in the age-adjusted incidence of hospitalizations for osteoporotic fractures was observed, the absolute number of hospitalizations for osteoporotic fractures increased due to the demographic change of an ageing population.

This study investigated the relationship between A body shape index (ABSI) and bone mineral density (BMD) in older Americans and found a negative linear association, which was particularly pronounced in diabetic population. An early focus on ABSI in the elderly population will help in the prevention of osteoporosis.

Objective: A body shape index (ABSI) is an abdominal obesity index developed based on epidemiological statistics and high ABSI indicates that waist circumference (WC) is higher than expected for a given height and weight and corresponds to a more central concentration of body volume. The objective of this study was to determine whether there is a linear or nonlinear relationship between ABSI and total femur bone mineral density (BMD) in older Americans and whether the relationship between the ABSI and total femur BMD varies across populations.

Methods: This cross-sectional study was based on data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Weighted multiple linear regression, restricted cubic spline (RCS) curves, subgroup analysis, and interaction tests were used to examine the association between ABSI and total femur BMD.

Results: This study included 2505 older adults. This study found a negative linear correlation between ABSI and total femur BMD (β = -3.2, 95%CI: -5.0, -1.4, p < 0.001). When participants were grouped according to quartiles of ABSI, those in the upper quartile had lower total femur BMD compared to those in the bottom quartile of ABSI. This negative association remained consistent across gender, age, education level, smoking, physical activity and BMI subgroups. However, in the diabetes subgroup, ABSI showed a stronger negative association with total femur BMD.

Conclusions: The study shows a negative linear association between ABSI and total femur BMD in older Americans, with this negative association being stronger in the diabetic population.

We investigated the risk factors for hip fracture in 48,533 European older adults for 8 years from 2013 onward. We identified female gender, age above 80, low handgrip strength, and depression as significant risk factors for hip fracture. Our findings may help identify high-risk populations for hip fractures in pre-clinical settings.

Objectives: Hip fracture is a major cause of functional disability, mortality, and health costs. However, the identification and characterization of its causative factors remain poor.

Methods: We investigated demography, handgrip strength (HGS), depression, and multiple age-associated comorbidities for predicting future hip fracture in individuals aged 50 or above from 15 European countries (n = 48,533). All participants were evaluated from 2013 to 2020 using four successive waves of the Survey of Health, Aging, and Retirement in Europe (SHARE).

Results: Altogether, 1130 participants developed hip fractures during the study period. We identified female gender, an advancing age from quinquagenarians onward, and a poor socioeconomic status as critical risk factors for future hip fracture. Having mobility difficulty, a low HGS (< 27 kg in men, < 16 kg in women) and higher scores on Euro-D depression scales were also significant risk factors for hip fracture. Summated scales of hypertension, diabetes mellitus, cancer, Alzheimer's disease, and stroke did not appear as risk factors.

Conclusion: Collectively, we report advancing age, female gender, low HGS, and depression as independent risk factors for hip fracture. Our findings are useful in identifying high-risk populations for hip fractures in pre-clinical settings before rigorous evaluation and treatment in clinics.

Introduction: This systematic review and meta-analysis was conducted as part of the update of Moroccan recommendations for the management of postmenopausal osteoporosis. Its aim was to estimate the prevalence of postmenopausal osteoporosis in Morocco, based on available bibliographic data.

Methods: We conducted a systematic search of the Medline/PubMed, Scopus, and Embase databases to identify articles published between January 2000 and January 2024. We included all observational studies reporting the prevalence of osteoporosis in postmenopausal women in Morocco. Two reviewers independently contributed to the study selection and data extraction. We assessed the risk of bias in the included studies using the Joanna Briggs Institute tool. Statistical analyses were performed using Stata with the Freeman-Tukey double arcsine transformation. Heterogeneity was assessed using the I² test statistic. Meta-regression analysis was used to investigate the effect of the date on the prevalence. Publication bias was assessed by DOI plots and the LFK index.

Results: An electronic search found a total of 161 citations from the databases. After excluding the irrelevant articles, 17 eligible studies were included. This meta-analysis included 5097 postmenopausal women. The pooled prevalence of postmenopausal osteoporosis was 32% (95% CI 28-36). Heterogeneity was statistically significant (I² = 89.67%). There was no significant difference between subgroup analyses performed by risk of bias and sample size. The prevalence rate was significantly higher in 2006-2012 (36%; 95% CI 31-42; I² = 88.7%; p < 0.001) than in 2013-2019 (27%; 95% CI 22-32; I² = 85.9%; p < 0.001). Meta-regression showed that the prevalence of osteoporosis decreases very slightly (0.016% per year). This decrease becomes nonsignificant if only studies with a low risk of bias are included in the meta-regression (coefficient - 7.77, p = 0.667, I² 0%). No publication bias was detected in this meta-analysis.

Conclusion: Our results indicate that postmenopausal osteoporosis is prevalent in Morocco, which is a developing country; however, the prevalence of this disease is aligned with that of industrialized countries.

The SPAH study is a population-based prospective cohort of Brazilian community-dwelling elderlies with higher fracture risk than observed in the studies used to construct the Brazilian FRAX model. In this study, the FRAX tool was a good fracture predictor within this high-risk elderly cohort, especially when calculated without bone density.

Purpose: To determine the performances of FRAX and age-dependent intervention thresholds according to National Osteoporosis Guideline Group (NOGG) guidelines with and without bone mineral density (BMD) regarding fracture prediction in community-dwelling elderly Brazilians.

Methods: Seven hundred and five older adults (447 women; 258 men) were followed for 4.3 ± 0.8 years. FRAX risk for hip and major osteoporotic fractures with and without BMD was calculated at baseline. The bivariate analysis investigated the associations between the absolute probability of fracture (FRAX), as well as the age-dependent intervention thresholds (NOGG), and the incidence of vertebral fracture (VF), non-vertebral fracture (NVF), and major osteoporotic fractures (MOF), segregated by sex. Age-adjusted Poisson's multiple regression and ROC curves were constructed to determine FRAX and NOGG's accuracies as fracture predictors.

Results: Fractures occurred in 22% of women and 15% of men. FRAX with and without BMD was higher in women with all types of fractures (p < 0.001). Only NOGG risk classification without BMD was associated with NVF (p = 0.047) and MOF (p = 0.024). FRAX was associated with NVF in the multiple regression, regardless of BMD. ROC curves of FRAX with and without BMD had AUCs of 0.74, 0.64, and 0.61 for NVF, VF, and MOF, respectively. The most accurate risk cutoffs for FRAX were 8% for MOF and 3% for hip fractures. No statistically significant associations were found in men.

Conclusion: FRAX predicted NVF more accurately than VF or MOF in elderlies, regardless of BMD. These results reiterate that FRAX may be used without BMD, even considering that Brazilian elderlies have known higher fracture risk.

The present study includes the longest period of analysis with the highest number of hip fracture episodes (756,308) described in the literature for Spain. We found that the age-adjusted rates progressively decreased from 2005 to 2018. We believe that this is significant because it may mean that measures such as prevention and treatment of osteoporosis, or programs promoting healthy lifestyles, have had a positive impact on hip fracture rates.

Purpose: To describe the evolution of cases and rates of hip fracture (HF) in patients 65 years or older in Spain from 2001 to 2018 and examine trends in adjusted rates.

Methods: Retrospective, observational study including patients ≥65 years with acute HF. Data from 2001 to 2018 were obtained from the Spanish National Record of the Minimum Basic Data Set of the Ministry of Health. We analysed cases of HF, crude incidence and age-adjusted rates by sex, length of hospital stay (LOS) and in-hospital mortality, and used joinpoint regression analysis to explore temporal trends.

Results: We identified 756,308 HF cases. Mean age increased 2.5 years, LOS decreased 4.5 days and in-hospital mortality was 5.5-6.5%. Cases of HF increased by 49%. Crude rate per 100,000 was 533.3 (95% confidence interval [CI], 532.1-534.5), increasing 14.0% (95%CI, 13.7-14.2). Age-adjusted HF incidence rate increased by 6.9% from 2001 (535.7; 95%CI, 529.9-541.5) to 2005 (572.4; 95%CI, 566.7-578.2), then decreased by 13.3% until 2017 (496.1, 95%CI, 491.7-500.6). Joinpoint regression analysis indicated a progressive increase in age-adjusted incidence rates of 1.9% per year from 2001 to 2005 and a progressive decrease of -1.1% per year from 2005 to 2018. A similar pattern was identified in both sexes.

Conclusions: Crude incidence rates of HF in Spain in persons ≥65 years from 2001 to 2018 have gradually increased. Age-adjusted rates show a significant increase from 2001 to 2005 and a progressive decrease from 2005 to 2018.

In a Norwegian youth cohort followed from adolescence to young adulthood, bone mineral density (BMD) levels declined at the femoral neck and total hip from 16 to 27 years but continued to increase at the total body indicating a site-specific attainment of peak bone mass.

Purpose: To examine longitudinal trends in bone mineral density (BMD) levels in Norwegian adolescents into young adulthood.

Method: In a prospective cohort design, we followed 980 adolescents (473 (48%) females) aged 16-19 years into adulthood (age of 26-29) on three occasions: 2010-2011 (Fit Futures 1 (FF1)), 2012-2013 (FF2), and 2021-2022 (FF3), measuring BMD (g/cm²) at the femoral neck, total hip, and total body with dual x-ray absorptiometry (DXA). We used linear mixed models to examine longitudinal BMD changes from FF1 to FF3.

Results: From the median age of 16 years (FF1), femoral neck BMD (mean g/cm² (95% CI)) slightly increased in females from 1.070 (1.059-1.082) to 1.076 (1.065-1.088, p = 0.015) at the median age of 18 years (FF2) but declined to 1.041 (1.029-1.053, p < 0.001) at the median age of 27 years (FF3). Similar patterns were observed in males: 16 years, 1.104 (1.091-1.116); 27 years, 1.063 (1.050-1.077, p < 0.001); and for the total hip in both sexes (both p < 0.001). Total body BMD increased from age 16 to 27 years in both sexes (females: 16 years, 1.141 (1.133-1.148); 27 years, 1.204 (1.196-1.212), p < 0.001; males: 16 years, 1.179 (1.170-1.188); 27 years, 1.310 (1.296-1.315), p < 0.001).

Conclusion: BMD levels increased from 16 to 18 years at the femoral and total hip sites in young Norwegian females and males, and a small decline was observed at the femoral sites when the participants were followed up to 27 years. Total body BMD continued to increase from adolescence to young adulthood.

This study examined low bone mineral density (BMD) prevalence and associated factors among Chinese people living with HIV (PLWH), uncovering a persistent high BMD risk in older individuals, even after adjusting for age and body mass index (BMI). Notably, lopinavir/ritonavir (LPV/r) therapy was linked to reduced BMD, highlighting the imperative need for regular BMD monitoring and interventions in older PLWH.

Purpose: HIV infection and antiretroviral therapy (ART) have been shown to contribute to lower BMD, resulting in an increased susceptibility to osteopenia and osteoporosis. However, there is limited knowledge about the prevalence of reduced BMD and its associated factors among Chinese PLWH. In this cross-sectional study, we aimed to investigate the prevalence and factors associated with low BMD among PLWH in China.

Methods: We retrospectively enrolled PLWH and non-HIV volunteers who underwent dual-energy X-ray absorptiometry (DXA) scans to measure bone density. Demographic information, laboratory test results, ART regimens, and treatment duration were collected. Univariate and multiple regression analyses were performed to identify factors influencing abnormal bone mass in PLWH.

Results: A total of 829 individuals were included in this study, comprising the HIV group (n = 706) and the non-HIV group (n = 123). The prevalence of low BMD among all PLWH was found to be 13.88% (98 out of 706). However, among PLWH aged 50 years and above, the prevalence increased to 65.32% (81 out of 124). In contrast, control subjects in the same age group had a prevalence of 38.21% (47 out of 123). After adjusting for age and BMI, older PLWH still demonstrated a higher prevalence of low BMD compared to the non-HIV group (68.24% vs 34.94%, P < 0.001). Multivariate analysis revealed that older age was strongly associated with a higher risk of low BMD among PLWH, with an odds ratio (OR) of 6.28 for every 10-year increase in age in the ART-naïve population (95% confidence intervals [CIs], 3.12-12.65; P < 0.001) and OR of 4.83 in the ART-experienced population (3.20-7.29, P < 0.001). Within the ART-experienced group, current LPV/r treatment was associated with an increased risk of low BMD (OR = 3.55, 1.24-10.14, P < 0.05), along with lower BMI (OR = 0.84, 0.75-0.95, P < 0.05), and elevated alkaline phosphatase (OR = 1.02, 1.01-1.03, P < 0.01).

Conclusion: The prevalence of low BMD is higher among PLWH aged 50 years and above compared to non-HIV individuals. The use of LPV/r for ART is associated with reduced BMD. These findings emphasize the importance of regular monitoring of BMD in older PLWH and the need for appropriate interventions to mitigate the risks of osteopenia and osteoporosis in this population.

Trends toward more favorable improvement of the cortical bone parameters by once-weekly (56.5 μg once a week) and twice-weekly teriparatide (28.2 μg twice a week), and that of the trabecular bone parameters by once-daily (1/D) teriparatide (20 μg/day once a day) were shown.

Purpose: To examine the effects of differences in the amount of teriparatide (TPTD) per administration and its dosing frequency on the bone structure in the proximal femur by dual-energy X-ray absorptiometry (DXA)-based 3D-modeling (3D-SHAPER software).

Methods: This was a multicenter retrospective study. Patients aged 50 years or older with primary osteoporosis who continuously received once-/twice-weekly (1・2/W, n = 60) or 1/D TPTD (n = 14) administration for at least one year were included in the study. Measurement regions included the femoral neck (FN), trochanter (TR), femoral shaft (FS), and total proximal hip (TH). Concurrently, the bone mineral density (BMD) and Trabecular Bone Score (TBS) were measured.

Results: The cross-sectional area, cross-sectional moment of inertia, and section modulus in the FS were significantly improved in the 1・2/W TPTD group, as compared to the 1/D TPTD group. However, significant improvement of the cortical thickness and buckling ratio in the FN was observed in the 1/D TPTD group, as compared to the 1・2/W TPTD group. Trabecular BMD values in the FS and TH were significantly increased in the 1/D TPTD group, as compared to the 1・2/W TPTD group, while the cortical BMD values in the TR, FS, and TH were significantly increased in the 1・2/W TPTD group, as compared to the 1/D TPTD group.

Conclusion: Trends toward more favorable improvement of the cortical bone by 1・2/W TPTD and that of the trabecular bones by 1/D TPTD were observed.