Assessment of the use of different risk algorithms for osteoporotic fractures in women in the practice of a family doctor

Keywords: osteoporosis, osteopenia, ultrasound densitometry, FRAX, Q-Fracture, osteoporotic fractures, risk factors

Abstract

Object of research: Women in whom the risk of osteoporotic fractures was assessed using the FRAX, Q-Fracture algorithms, and the risk factors for osteoporosis and their role in the development of osteoporotic fractures were studied.

Investigated problem: the use of various algorithms in the practice of a family doctor to assess the 10-year risk of osteoporotic fractures.

Main scientific results: A decrease in bone mineral density was found in 51.4 % of the surveyed women, of whom osteopenia was in 48.7 %, osteoporosis in 2.9 % of women. The risk of fractures according to all algorithms was higher in women of the age group 70–79 years: FRAX Total – 8.87±3.2, FRAX Hip – 4.03±3.1, Q fracture total – 12.87±1.5, Q fracture Hip – 7.97±2.7, FRAX Total without BMD – 11.9±5.5, FRAX Hip without BMD – 6.3±4.8. Age correlates negatively with the T score (r=–0.47, p=0.007) and positively with the FRAX Total algorithms without BMD (r=–0.47, p=0.003), FRAX Hip without BMD (r=0.78, p=0.006), Q fracture total (r=0.86, p=0.007), Q fracture Hip (r=0.92, p=0.008), FRAX Hip with BMD (r=0.55, p=0.009). No statistically significant difference was found with FRAX Total with BMD (r=0.21, p=0.345).

Risk factors: 14.3 % of women had fractures of various localization; fractures in parents were noted by 37.1 % of respondents; a decrease in height by 3 cm during life occurred in 13.3 %. Early menopause (up to 45 years old) occurred in 11.4 % of women. Physical activity less than 30 minutes a day was noted by 68.6 %.

The area of practical use of the research results: the primary level of medical care.

Innovative technological product: early identification of risk factors for osteoporosis and calculation of the risk of fractures will reduce the medical and social consequences of complications in osteoporosis.

Scope of application of the innovative technological product: in the clinical practice of general practitioners.

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Author Biography

Yevheniia Lukianets, Bogomolets National Medical University

Department of General Practice (Family Medicine)

References

Johnell, O., Kanis, J. A. (2006). An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis International, 17 (12), 1726–1733. doi: http://doi.org/10.1007/s00198-006-0172-4

Hernlund, E., Svedbom, A., Ivergård, M., Compston, J., Cooper, C., Stenmark, J. et. al. (2013). Osteoporosis in the European Union: medical management, epidemiology and economic burden. Archives of Osteoporosis, 8 (1-2). doi: httpsdoi.org/10.1007/s11657-013-0136-1

Kovalenko, V. N., Bortkevych, O. P. (2010). Yssledovanye rasprostranennosty faktorov ryska osteoporoza y poysk optymalnoi profylaktyky perelomov u zhenshchyn v vozraste starshe 50 let. Ukrainskyi revmatolohichnyi zhurnal, 3, 15–20.

Assessment of fracture risk and its application to screening for postmenopausal osteoporosis (1994). Technical Support Series. No. 843. Geneva: WHO.

Holm, J. P., Hyldstrup, L., Jensen, J.-E. B. (2016). Time trends in osteoporosis risk factor profiles: a comparative analysis of risk factors, comorbidities, and medications over twelve years. Endocrine, 54 (1), 241–255. doi: http://doi.org/10.1007/s12020-016-0987-5

Kanis, J. A., Cooper, C., Rizzoli, R., Reginster, J.-Y. (2018). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International, 30 (1), 3–44. doi: http://doi.org/10.1007/s00198-018-4704-5

Lakatos, P., Balogh, Á., Czerwinski, E., Dimai, H. P., Hans, D. et. al. (2011). New considerations on the management of osteoporosis in Central and Eastern Europe (CEE): summary of the “3rd Summit on Osteoporosis–CEE”, November 2009, Budapest, Hungary. Archives of Osteoporosis, 6 (1-2), 1–12. doi: http://doi.org/10.1007/s11657-010-0048-2

Ito, M. (2015). Bone mineral density measurement. Nihon Rinsho. Japanese journal of clinical medicine, 73 (10), 1659–1663.

Blackie, R. (2020). Diagnosis, assessment and management of osteoporosis. Prescriber, 31 (1), 14–19. doi: http://doi.org/10.1002/psb.1815

Nayak, S., Edwards, D. L., Saleh, A. A., Greenspan, S. L. (2015). Systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for osteoporosis or low bone density. Osteoporosis International, 26 (5), 1543–1554. doi: http://doi.org/10.1007/s00198-015-3025-1

Chan, M. Y., Nguyen, N. D., Center, J. R., Eisman, J. A., Nguyen, T. V. (2012). Quantitative ultrasound and fracture risk prediction in non-osteoporotic men and women as defined by WHO criteria. Osteoporosis International, 24 (3), 1015–1022. doi: http://doi.org/10.1007/s00198-012-2001-2

Kauppi, M., Stenholm, S., Impivaara, O., Mäki, J., Heliövaara, M., Jula, A. (2014). Fall-related risk factors and heel quantitative ultrasound in the assessment of hip fracture risk: a 10-year follow-up of a nationally representative adult population sample. Osteoporosis International, 25 (6), 1685–1695. doi: http://doi.org/10.1007/s00198-014-2674-9

Kanis, J. A., Harvey, N. C., Cooper, C., Johansson, H., Odén, A., McCloskey, E. V. (2016). A systematic review of intervention thresholds based on FRAX. Archives of Osteoporosis, 11 (1). doi: http://doi.org/10.1007/s11657-016-0278-z

Kanis, J. A., Johansson, H., Harvey, N. C., McCloskey, E. V. (2018). A brief history of FRAX. Archives of Osteoporosis, 13 (1). doi: http://doi.org/10.1007/s11657-018-0510-0

McCloskey, E. V., Johansson, H., Harvey, N. C., Compston, J., Kanis, J. A. (2016). Access to fracture risk assessment by FRAX and linked National Osteoporosis Guideline Group (NOGG) guidance in the UK – an analysis of anonymous website activity. Osteoporosis International, 28 (1), 71–76. doi: http://doi.org/10.1007/s00198-016-3696-2

Povorozniuk, V. V., Hryhorieva, N. V., Kanis, J. A., McCloskey, E. V., Johansson, H. (2016). Ukrainska versiia FRAX: vid stvorennia do validyzatsii. News of Medicine and Pharmacy, 16 (596), 3–5.

Kanis, J. A., Harvey, N. C., Johansson, H., Odén, A., Leslie, W. D., McCloskey, E. V. (2015). FRAX and fracture prediction without bone mineral density. Climacteric, 18 (sup2), 2–9. doi: http://doi.org/10.3109/13697137.2015.1092342

Osteoporosis: assessing the risk of fragility fracture. London: National Institute for Health and Care Excellence (UK) (2017). NICE Clinical Guidelines, No. 146. Available at: https://www.ncbi.nlm.nih.gov/books/NBK554920/

Burden, A. M., Tanaka, Y., Xu, L., Ha, Y.-C., McCloskey, E., Cummings, S. R., Glüer, C. C. (2020). Osteoporosis case ascertainment strategies in European and Asian countries: a comparative review. Osteoporosis International, 32 (5), 817–829. doi: http://doi.org/10.1007/s00198-020-05756-8


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Published
2021-06-30
How to Cite
Lukianets, Y. (2021). Assessment of the use of different risk algorithms for osteoporotic fractures in women in the practice of a family doctor. ScienceRise, (3), 34-39. https://doi.org/10.21303/2313-8416.2021.001921
Section
Innovative technologies in healthcare