Handgrip strength and 25OHD decrease with aging in postmenopausal women. The patients with lower 25OHD level had significantly lower BMD of femoral neck. The patients with lower handgrip strength had significantly lower BMD of lumbar spine, femoral neck, and total hip. Grip strength measurement is the simplest muscle strength measurement method. Our study confirmed that low grip strength was correlated with low BMD and was a strong risk factor for osteoporosis in postmenopausal women.

BackgroundVertebral fracture is the most common fragility fracture but it remains frequently unrecognized and is underdiagnosed worldwide. In this retrospective study, we examined the prevalence of moderate and severe vertebral fractures on chest radiographs of hospitalized female patients aged 50 years and older and determined missed diagnosis of vertebral fractures in the original radiology reports.Methods3216 female patients 50 years of age and older were enrolled in our study. The patients’ medical records including their original radiology reports and lateral chest radiographs were retrospectively reviewed by the study radiologists who had training certificates from the International Society for Clinical Densitometry (ISCD). Vertebral fractures between thoracic spine T4 and lumbar spine L1 were identified and classified using Genant’s semi-quantitative scale. The definition of vertebral fractures used in this study was Genant grade 2 or higher.ResultsThe study radiologists identified 295(9.2%) patients with grade 2 or 3 fractured vertebrae, total 444 vertebrae on 3216 chest radiographs. The prevalence of vertebral fracture was 2.4% in women aged 50-59 yrs., 8.9% in women aged 60–69 yrs., and 21.9% in women aged≥70 yrs. There were 213 patients with a single vertebral fracture, 49 patients with two vertebral fractures and 33 patients with ≥ three vertebral fractures. Fractured vertebrae were identified with greater frequency in thoracic spine T11,12 and lumbar spine L1. According to our statistics, 66.8% of patients with vertebral fractures found in this study were undiagnosed in the original radiology reports.ConclusionsVertebral fracture is common on chest radiographs but it is often ignored by radiologists. Genant’s semiquantitative assessment is a simple and effective method for detecting vertebral fracture. Because osteoporotic vertebral fracture increases the risk of new fractures, radiologists have an important role in accurately diagnosing vertebral fractures.

The aim of this study was to assess the influence of bone mineral density and hip geometry on the fragility fracture of femoral neck and trochanteric region. There were 95 menopausal females of age ≥ 50 years with fragility fracture of hip, including 55 cases of femoral neck fracture and 40 cases of trochanteric fracture. Another 63 non-fractured females with normal bone mineral density (BMD) were chosen as control. BMD, hip axis length, neck-shaft angle and structural parameters including cross surface area, cortical thickness and buckling ratio were detected and compared. Compared with control group, the patients with femoral neck fracture or trochanteric fractures had significantly lower BMD of femoral neck, as well as lower cross surface area and cortical thickness and higher buckling ratio in femoral neck and trochanteric region. There were no significant differences of BMD and structural parameters in the femoral neck fracture group and intertrochanteric fracture group. Hip axis length and neck-shaft angle were not significantly different among three groups. The significant changes of BMD and proximal femur geometry were present in the fragility fracture of femoral neck and trochanteric region. The different types of hip fractures cannot be explained by these changes.

ObjectiveTo study the effect of anti‐osteoporosis therapies on mortality after hip fracture.MethodsThis retrospective study was carried out in the Second Affiliated Hospital of Fujian Medical University and enrolled 690 patients 50 years of age and older who were admitted with hip fractures between 2010 and 2015. The patients were followed in 2017: 690 patients aged was from 50 to 103 years. There were 456 women and 234 men. There were 335 patients with fractures of the femoral neck and 355 patients with intertrochanteric fractures of the femur. There were 444 (64.35%) patients who also had internal diseases. The Charlson comorbidity index was 0–6. The anti‐osteoporosis medications were classified into no anti‐osteoporosis medication, calcium + vitamin D supplementations, non‐bisphosphonate medication, and bisphosphonate medication. The physicians followed the patients or family members by personal visit and telephone. Multivariable Cox regression analyses were done with known risk factors for mortality of hip fracture, such as gender, age, number of combined internal diseases, fracture type, place of residence, and Charlson comorbidity index, to show which anti‐osteoporosis medications had significant effects on mortality after adjustment for these variables.ResultsOut of 690 patients with hip fractures, 149 patients received no anti‐osteoporosis medication, 63 patients received calcium +vitamin D supplementations, 398 patients received non‐bisphosphonate medication, and 80 patients received bisphosphonate medication. The patients were followed between 7 months and 52 months, with the average of 28.53 ± 9.75 months. A total of 166 patients died during the follow‐up period. Of 166 deaths, 43 occurred within 3 months, 65 within 6 months, and 99 within 1 year after the hip fracture. In this study, fracture type, place of residence, and Charlson comorbidity index were not associated with the mortality, and the male gender, age > 75 years, and ≥ 2 combined internal diseases were the independent factors for deaths post‐hip fracture. The cumulative mortality was 36.24% in the patients receiving no anti‐osteoporosis medication. The hazard ratio for mortality after hip fracture with bisphosphonate medication, non‐bisphosphonate medication, and calcium/vitamin D supplementation was 0.355 (95% CI, 0.194–0.648), 0.492 (95% CI, 0.347–0.699) and 0.616 (95% CI, 0.341–1.114), respectively, as compared with no anti‐osteoporosis group. Bisphosphonate and non‐bisphosphonate medications for osteoporosis were significantly associated with the reduction of cumulative mortality post‐hip fracture (P < 0.01).ConclusionsBisphosphonate and non‐bisphosphonate medications for osteoporosis were significantly associated with decreased mortality after fragility hip fracture.

Objective To investigate the effects of age, body mass index (BMI), bone mineral density (BMD), and levels of serum 25‐hydroxyvitamin D (25OHD) on hip fracture on the condition of the bone density of femoral neck having reached the threshold of osteoporosis. Methods A total of 252 postmenopausal women patients, whose bone density had reached the threshold of osteoporosis and age ≥50 years (50–98 years), collected from the Second Affiliated Hospital of Fujian Medical University from January 2015 to December 2018, were performed by retrospective analysis. According to whether or not they had a hip fracture, including femoral neck fracture or intertrochanteric fracture, the patients were divided into two groups, including 117 cases (50–84 years old) in the non‐hip fracture group and 135 cases (57–98 years old) in the hip fracture group. BMD was measured by Hologic Discovery A DXA bone mineral densitometer. Levels of serum 25OHD were detected by ROCHE detection instrument. Comparisons of age, BMI, bone density of femoral neck, and levels of serum 25OHD between the two groups were performed by using the Student's t‐test. Furthermore, the statistically significant factors were analyzed by multiple regression analysis to investigate the independent risk factors of hip fracture. Results The group without hip fracture: 117 cases; average age: 67.4 ± 8.5 years; BMI: 22.3 ± 3.2 kg/m2; bone density of femoral neck: (0.504 ± 0.067) g/cm2; T‐value of femoral neck: −3.1 ± 0.6; levels of serum 25OHD: (24.9 ± 8.5) ng/mL. The group with brittle hip fracture: 135 cases; average age: 80.7 ± 7.6 years; BMI: 20.3 ± 3.5 kg/m2; bone density of femoral neck: (0.426 ± 0.077) g/cm2; T‐value of femoral neck: −3.8 ± 0.7; levels of serum 25OHD: (15.9 ± 8.9) ng/mL. Age, BMI, bone density of femoral neck, and 25OHD level of the group without hip fracture were markedly lower than hip fracture group (P < 0.05). The results of logistic regression analysis suggested that age, bone density of femoral neck, and levels of serum 25OHD were independent risk factors for fragile hip fracture on the condition of the bone density of femoral neck having reached the threshold of osteoporosis. Conclusion Higher age, lower levels of bone density and 25OHD are the main risk factors of hip fracture on the condition of the bone density of femoral neck having reached the threshold of osteoporosis.