Bone mineral density and fracture in postmenopausal women

Park

Geriatr Orthop Surg Rehabil

et al. 2020

Introduction: The aims of this study were to investigate (1) whether demographic factors would be risk factors for severe proximal humerus fracture (PHF), (2) relationship of radiological parameters with bone mineral density (BMD), deltoid tuberosity index (DTI), or severe PHF, and (3) correlation between DTI and BMD. Methods: We conducted a cross-sectional study based on radiographs and medical records taken during admission or the visit to the orthopedic clinic. We reviewed consecutive 100 adult patients who were diagnosed with PHF in our hospital from March 2014 to December 2016. Three- and 4-part fractures were regarded as severe PHFs. Univariable and multivariable logistic regression analyses were performed to evaluate risk factors for severe PHF. Also, we investigated the correlation between BMD and DTI using the additional BMD data of the patients who underwent shoulder surgeries. Results: This study included 62 nonsevere PHFs and 38 severe PHFs. There were 30 male and 70 female patients with a mean age of 66.4 ± 16.4 years. Mean T score of BMD was −2.5 ± 0.9 at the time of injury. Logistic regression analyses showed that age (odds ratio: 1.044, range: 1.011-1.079, P = .009) and sex (odds ratio of females: 3.763, range: 1.236-11.459, P = .020) were related to severe PHF. The group satisfying the radiological parameter criteria had significantly higher rates of severe PHF. The correlation coefficient (r) between DTI and T score was 0.555 ( P < .001). Discussion and Conclusion: Older age and female were the independent risk factors for severe PHF. Conversely, BMD and other medical comorbidities were not risk factors for severe PHF. Deltoid tuberosity index showed significantly high intraclass correlation coefficient and a strong correlation with the T score of BMD. Therefore, DTI may be useful for screening osteoporosis in PHF patients. Level of Evidence: Level IV, Cross-sectional study.

Section: Introductionmentioning

confidence: 99%

Risk Factors for Severe Proximal Humerus Fracture and Correlation Between Deltoid Tuberosity Index and Bone Mineral Density

Park

Geriatr Orthop Surg Rehabil

et al. 2020

Am. J. Phys. Anthropol.

“…Bone loss in this disorder is attributable to increased resorption that is most pronounced in the trabecular component. Because of the high proportion of trabecular bone in the vertebrae, type I osteoporosis is associated with vertebral crush fractures (Elders et al, 1988;Meltzer et al, 1989). Collapse of the vertebral body may be symmetrical or may occur as wedging with the ventral (anterior) aspect of the cortex collapsing while the dorsal aspect remains intact.…”

Section: Osteoporosis: Definitions and Etiologiesmentioning

confidence: 99%

“Osteoporosis”: Etiologies, prevention, and treatment

Stini

1990

W-ith the steady increase in life expectancies occurring in industrialized countries have come major changes in the causes of morbidity and mortality. The greatest burden on the health care delivery systems in these countries has shifted from the treatment of infectious diseases to extended care of degenerative conditions. One such condition of increasing widespread concern is osteoporosis. Chronic bone loss leading to fractures and secondary infections has become a major problem in the United States, and has been estimated to cost $6 to $8 billion annually.The etiology of osteoporosis is complex, depending upon the interaction of nutritional, endocrinological, and local factors that are subject to a variety of genetic and environmental influences. The stringent requirement of maintaining calcium homeostasis places heavy demands on the primary reservoir of calcium, the skeleton, when intake andlor absorption are inadequate. Inactivity, depriving bone of its weight-bearing function, also initiates bone resorption. Under normal circumstances in the young adult, bone is maintained through continual, balanced turnover of mineral and calcium. When this balance is upset, loss of bone can be slow or rapid, reversible or irreversible. The trabecular compartment with its high surface-to-volume ratio is most rapidly mobilized, but cortical bone is ultimately resorbed as well.Involationaf osteoporosis is conventionally designated as either type i I postmenopauqali or type I1 senile:. Women are affected by both and, because of a generally less-robust skeleton, experience risk of fracture earlier than men on the average. The hormonal and physiological factors involved in the regulation of normal bone physiology and the factors leading to loss of bone mass constitute a n area of active research that is casting light on the fundamental mechanisms underlying bone growth and maintenance in the search for new avenues of prevention and treatment of osteoporosis.Currently the fastest growing segment of the population of the United States is the age group 85 years old and older (United Nations, 1986). The increasing numbers of elderly citizens of both sexes have changed the country's demographic profile but the proportion of women living to advanced age has had singular impact. In North America in 1984, males outnumbered females by about 1 million (29 million to 28 million) up to the age of 15 years, but in the age group 65 years old and older, females outnumbered males by 6 million (18 million women, 12 million men) (Stini, 1987). Beyond age 65 years, the disparity in survival continues to grow. In the age group 80 to 84 years, the death rate is currently 107.0 per 1,000 for males and 66.9 per 1,000 for females. Thus, the population of the United States 0 1990 Wiley-Liss, Inc.

Journal of Bone and Mineral Research

Noninvasive assessment of ulnar bending stiffness in women

McCabe

Zhou

Steele

et al. 1991

The load-carrying capacity of cortical bone is closely related to its geometry and to its fundamental material properties, including mineral content (BMC). Together these determine the bending stiffness EI, where I is the cross-sectional moment of inertia and E is Young's modulus of elasticity. To assess the relationship of BMC and bone width (BW) to EI in healthy women, we used mechanical response tissue analysis (MRTA), a noninvasive method that involves analysis of tissue responses to ulnar vibration. A total of 48 healthy women were enrolled into an older (64 +/- 1y, n = 25) and a younger (25 +/- 0.6y, n = 23) group. BMC and BW of the dominant ulna were measured by single-photon absorptiometry (SPA). EI was determined by MRTA. BMC (0.75 +/- 0.02 versus 0.63 +/- 0.02 g/cm), BMC/BW (0.75 +/- 0.02 versus 0.63 +/- 0.02 g/cm2), and EI (27.7 +/- 1.3 versus 21.3 +/- 1.1 N.m2) were significantly greater (p less than 0.005) in the young subjects. BW did not change with age (1.00 +/- 0.01 versus 1.01 +/- 0.01 cm). In young women, simple correlations of BMC and BW with EI were both significant. By multiple regression analysis only BW independently predicted EI (EI = -0.35 + 39.1 x BMC, R2 = 0.52). In older women BMC and BW correlated with EI, but in multiple regression only BMC was significant (EI = -34.5 + 62.1 x BW; R2 = 0.45). When this analysis of older women included only those whose BMC values were within 2 SD of the young mean, BMC remained the only significant predictor of EI.(ABSTRACT TRUNCATED AT 250 WORDS)