Osteoporosis- Do We Need to Think Beyond Bone Mineral Density?
Journal Title: International Journal of Health Sciences and Research - Year 2017, Vol 7, Issue 10
Abstract
Introduction- Fracture is the most concerned clinical outcome of osteoporosis, but recently it has been found that most fragility fracture occurs in patients with either normal or osteopenic Bone Mineral Density (BMD) scans. This warrants us to look for factors beyond BMD alone for bone strength. Country specific WHO-Fracture Risk Assessment Tool (FRAX) has emerged as a promising and validated tool to assess probability of fragility fracture. Materials and Methods- In this Cross sectional study, eighty patients with BMD prescribed elsewhere or in our OPD were recruited. Ten were excluded on the basis of age being less than 40 years. Demographic data, BMD test report measured by DXA scan and risk factors included in WHO-FRAX tool were recorded for the remaining 70 patients. Ten year probability of major osteoporotic fracture and hip fracture was assessed using country specific WHO-FRAX tool. Results- Excel 2007 and STATA 14 were used for data analysis and curve comparison. Mean age was– 61.37± 11.06 years and male to female ratio was 1:3. Mean T score at Spine was 1.86±1.72 and Mean T score at Hip was 1.8± 1.12. Out of 15 patients showing normal BMD at hip, 4 (26.7%) had low BMD at spine and out of 55 subjects with low BMD at hip (osteopenia and osteoporosis), FRAX picked up only 2 cases at risk of major osteoporotic fracture in coming ten years. Discussion- To our knowledge, this is the first gender unbiased report of FRAX score of native Indian population. We found that FRAX is more sensitive to predict treatment threshold in osteoporotic hip rather than osteopenic hip and FRAX under-estimates ten year major osteoporotic fracture risk (including spine fracture) in Indian population. Conclusion- FRAX has a major role in predicting fracture risk but it has its inherent flaws. It does not replace good clinical judgment by health care practitioner. Besides FRAX, We should always look for other Clinical Risk Factors (CRFs) and guide our treatment accordingly.
Authors and Affiliations
Dr Preeti Soni
Keywords
Related Articles
- EP ID EP379187
- DOI -
- Views 88
- Downloads 0
Association of Blood Pressure and Biochemical Parameters with Adiposity in Women
Modifications in lifestyle have an impact on the incidence of metabolic disorders such as the development of type 2 diabetes, dyslipidemias and metabolic syndrome (MS) that aggravate the risk of developing cardiovascular...
Significance of 25 Hydroxy Vitamin D and Calcium in Pregnancy Induced Hypertension
Background: Pregnancy induced hypertension (PIH) is a common gestational disorder which complicates 7-10% of pregnancies globally and it is associated with maternal, fetal and neonatal morbidity and mortality. Yet the et...
Assessing the Quality of Vision Screening By Teachers among School Children in the Bibiani-Ahwianso-Bekwai District, Ghana
Background: An effective and efficient school vision screening program will lead to early detection and management of childhood vision impairment. Non health professionals specifically teachers can be utilized for vision...
Tracheostomy as an Independent Risk Factor of ICU Readmission
Readmission to Intensive Care Unit (ICU) is associated with poor patients’ outcomes. Prediction of risk of ICU readmission may help improve discharge decision making. Tracheostomies are increasing in ICU because of the s...
Existing State of Implementing Fall Preventing Strategies in Shahid Gangalal National Heart Centre, Nepal
Background: Fall is defined as a sudden, unexpected descent from standing, sitting, or horizontal position in which the person is found lying on the floor. Sometimes, fall in a sick patient can be disastrous. Nurses have...