Capture the fracture - use of bone turnover markers in clinical practice

Vuksanovic, Miljanka; Beljić-Živković, Teodora

doi:10.2298/sarh1608450v

Cited by 4 publications

(1 citation statement)

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“…Women start to lose bone mass around the age of 35, which can lead to a 35%–50% decline across their lifetime ( 4 – 6 ). As bone resorption accelerates during menopause while bone formation is reduced ( 5 ), the imbalance between these processes leads to osteoporosis ( 7 ). Consequently, the risk of osteoporosis increases in women that enter menopause early ( 8 ), as the catabolic effect of estrogen deficiency contributes to bone loss ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Early Menopause and Risk of Fractures–A Preventable Gap

Minakovic¹,

Zvekic-Svorcan²,

Janković³

et al. 2023

ijph

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Background: Osteoporosis is a chronic disease that results in microarchitectural changes to the bone, thereby reducing its density and increasing the risk of fractures. This retrospective cross-sectional study aimed to examine the link between the risk of major osteoporotic fractures and hip fractures with the age of menopause onset, as well as the impact of menopause duration on fracture incidence. Methods: This retrospective cross-sectional study was conducted at the Special Hospital for Rheumatic Diseases, Novi Sad, Serbia. The data required for meeting the study objectives were obtained from patients’ medical records spanning the 2015-2018 period. The sample for the study comprised of 985 postmenopausal women aged ≥ 50 yr who underwent bone mineral densitometry examination and received a FRAX score for major osteoporotic fractures and hip fractures with and without bone mineral density. The obtained FRAX scores were compared across the subjects with respect to the age of menopause onset and menopause duration. Results: The group that entered into menopause before the age of 45 had a high risk of hip fracture (OR: 1,652; 95% CI: 1,138 - 2,399; P<.01) and a higher mean FRAX score for hip fracture compared to women in whom menopause started after the age of 45 (Me=1.60 vs. 1.30, P<.004). FRAX scores were also correlated with menopause duration, and the difference between the groups with the longest (over 20 yr) and the shortest (1–10 yr) duration was statistically significant at P<.001. Conclusion: As menopause duration could contribute to the prediction of fracture risk, its inclusion in the FRAX algorithm should be considered, while also taking into account the age of menopause onset.

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Section: Introductionmentioning

confidence: 99%

Early Menopause and Risk of Fractures–A Preventable Gap

Minakovic¹,

Zvekic-Svorcan²,

Janković³

et al. 2023

ijph

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A deep-learning system for automatic detection of osteoporotic vertebral compression fractures at thoracolumbar junction using low-dose computed tomography images

Niu

Yan

et al. 2022

Preprint

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Purpose: To develop a deep-learning system for automatic osteoporotic vertebral compression fractures (OVCF) detection at the thoracolumbar junction using low-dose computed tomography (CT) images. Materials and methods: 500 individuals were enrolled in this retrospective study, including 270 normal and 230 OVCF cases. The cases were divided into the training, validation, and test sets in the ratio of 6:2:2. First, a localization model using Faster R-CNN was trained to identify and locate the target thoracolumbar junction, then a 3D AnatomyNet model was trained to finely segment the target vertebrae in the localized image. Finally, 3D DenseNet model was applied for detecting OVCF on target vertebrae. Manual annotation by experienced radiologists and a clinically made diagnosis of OVCF were used as the gold standards. The performance of the detecting system was evaluated through the area under the curve (AUC) for receiver operating characteristic (ROC) analysis, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV). Results Our automated segmentation method achieved a mean Dice coefficient of 0.95 for vertebral bodies (T12-L2) segmentation on the testing dataset, with dice coefficients greater than 0.9 accounting for 96.6%. For the diagnostic performance of our system for OVCF, the AUC, sensitivity, specificity, PPV and NPV for the four-fold cross-validation on the testing dataset were 98.1%, 95.7%, 92.6%, 91.7% and 96.2%, respectively. Conclusions A deep-learning system has been developed to automatically segment vertebral bodies and accurately detect OVCF using low-dose CT.

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Diagnosis of osteoporosis and prevention of osteoporotic fractures

et al. 2022

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Introduction. Osteoporosis is a metabolic bone disease characterized by reduced bone mineral density and damage to the bone microarchitecture, which leads to bone fragility, thus increasing the risk of osteoporotic fractures. While different diagnostic methods can be employed for detecting bone mineral density decrement in a timely manner, dual energy X-ray absorptiometry remains the gold standard in research and clinical practice. Bone mineral density estimation methods. Osteoporosis can be diagnosed through conventional radiography, quantitative ultrasonography, quantitative computed tomography, and magnetic resonance. Nonetheless, dual energy X-ray absorptiometry is the gold standard in the diagnosis of osteoporosis on which further treatment and monitoring are based. The dual energy X-ray absorptiometry apparatus is equipped with the Fracture Risk Assessment Tool, which estimates the 10- year probability of a major fracture and hip fracture due to osteoporosis. The use and interpretation of osteoporosis diagnostic evaluation modalities is based on the International Society for Clinical Densitometry guidelines for diagnosing osteoporosis in adults and children. According to the International Society for Clinical Densitometry recommendations, the aforementioned quantitative visualization modalities should be used alongside laboratory analyses of bone metabolism markers to supplement diagnostics and monitor treatment efficacy in patients suffering from osteoporosis. Conclusion. Assessment of risk factors and early diagnosis are prerequisites for timely treatment and effective monitoring, which is necessary for arresting the progression of bone mineral density loss and preventing the occurrence of osteoporotic fractures.

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Capture the fracture - use of bone turnover markers in clinical practice

Cited by 4 publications

References 0 publications

Early Menopause and Risk of Fractures–A Preventable Gap

Early Menopause and Risk of Fractures–A Preventable Gap

A deep-learning system for automatic detection of osteoporotic vertebral compression fractures at thoracolumbar junction using low-dose computed tomography images

Diagnosis of osteoporosis and prevention of osteoporotic fractures

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