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  • Osteoporosis  (3)
  • Longitudinal studies  (2)
  • Risk factors  (2)
  • 1
    Digitale Medien
    Digitale Medien
    Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women (1993)
    Springer
    Osteoporosis international 3 (1993), S. 120-126 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Bone density ; Prospective studies ; Risk factors ; Vertebral fracture incidence
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We evaluated the ability of bone density and vertebral fractures at baseline to predict vertebral fracture incidence in a cohort of postmenopausal women with osteoporosis. The study population was 380 postmenopausal women (mean age 65 years) treated for osteoporosis in a randomized, placebo-controlled, clinical trial of the bisphosphonate etidronate at seven geographic centers in the United States. Baseline measurements of bone mineral density were obtained in 1986 by quantitative computed tomography at the spine and dual-photon absorptiometry at the lumbar spine and hip. Vertebral fractures were documented on serial spine radiographs. Proportional hazards models were used to evaluate the ability to predict the risk of subsequent fractures during an average of 2.9 years of follow-up. Presence of one or two fractures increased the rate of new vertebral fractures 7.4-fold (95% confidence interval = 1.0 to 55.9). Additional fractures at baseline further increased the fracture rate. A decrease of 2 standard deviations in spinal bone density by absorptiometry was associated with a 5.8-fold increase in fracture rate (95% confidence interval = 2.9 to 11.6). The lowest and highest quintiles of bone density had absolute fracture rates of 120 and 6 cases per 1000 patient-years, respectively. In general, the simultaneous use of two predictors (bone density and prevalent fractures or two bone density measurements) improved fracture prediction, compared with the use of a single predictor. We conclude that both bone density and prevalent vertebral fractures are strong, complementary predictors of vertebral fracture risk. The results suggest that physicians can use bone density and prevalent vertebral fractures, individually or in combination, as risk factors to identify patients at greatest risk of new fractures.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01623272
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  • 2
    Digitale Medien
    Digitale Medien
    When should bone density measurements be repeated? (1994)
    Springer
    Calcified tissue international 55 (1994), S. 243-248 
    Details
    ISSN: 1432-0827
    Schlagwort(e): Osteoporosis ; Bone density ; Longitudinal studies ; Statistical models ; Decision models
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin , Physik
    Notizen: Abstract We calculated how long to wait before repeating bone mineral density (BMD) measurements to reassess fracture risk. Correlation results from serial measurements of 495 postmenopausal Japanese-American women were used to estimate 95% confidence intervals (CI) for future BMD. After 7 years of follow-up, BMD correlations with the initial measurement ranged between 0.81 and 0.94, depending on age group and measurement site. In this analysis, the period between measurements was defined as the time required for the lower 95% CI to fall below the BMD value corresponding to doubling of fracture risk. Progressive bone loss causes fracture risk to double after 10 years, on average. However, the 95% CIs indicate that a second BMD measurement will detect risk doubling after only 2 or 3 years for some women. For untreated, early postmenopausal women, the period between measurements was approximately 2–5 years for the radius and 4–6 years for the calcaneus, depending on the initial BMD level. The period was approximately 1 year longer for women age 60 and older. Treatments that halve the bone loss rate would increase the period by 1–3 years. In the absence of a second measurement of BMD, the CI will continue to expand with time, corresponding to a wider range in risk between individuals, and a greater proportion of women will be at increased fracture risk. Obtaining a second BMD measurement pinpoints the patient's status within the precision of the measurement. We conclude that repeated BMD measurements will provide a more accurate estimate of fracture risk than a single, baseline measurement.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00310399
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  • 3
    Digitale Medien
    Digitale Medien
    Evaluation of adverse health outcomes associated with vertebral fractures (1991)
    Springer
    Osteoporosis international 1 (1991), S. 134-140 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Osteoporosis ; Pain and disability ; Psychosocial problems ; Risk analysis ; Statistical methods ; Vertebral fractures
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Little is known about the frequency or degree to which vertebral fractures cause pain and physical disability. The purpose of this investigation was to examine the advantages of risk analysis over other statistical techniques (e.g., correlation analysis) for quantifying relationships between vertebral fractures and outcomes such as pain and disability. Subjects who volunteered to participate in studies of osteoporosis were asked about pain and disability. The number and degree of vertebral deformities were assessed from radiographs. Strong associations were observed between the most severe vertebral deformities and the risk of high pain or disability scores, while weaker associations were observed for moderate deformities. There did not appear to be any association between vertebral deformity and risk of moderate levels of pain or disability. Because of the potential for bias in cross-sectional studies such as this, the magnitude of these findings must be considered tentative. We conclude that risk analysis is an appropriate method for quantifying the relationship of vertebral fractures with pain and disability, but that prospective studies are now needed.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01625442
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  • 4
    Digitale Medien
    Digitale Medien
    Spine fracture risk is predicted by non-spine fractures (1994)
    Springer
    Osteoporosis international 4 (1994), S. 1-5 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Bone mass ; Bone density ; Fracture incidence ; Fracture prevalence ; Longitudinal studies ; Risk factors
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A prospective cohort study of 1098 postmenopausal Japanese-American women evaluated the relationship between baseline non-spine fractures and new (incident) spine fractures. At the baseline examination in 1981, prevalent non-spine fractures were ascertained by interview, and prevalent spine fractures by radiograph. Bone mass measurements of the distal radius, proximal radius, calcaneus (1981), the lumbar spine (1984) were obtained and repeated at 1- to 2-year intervals. Women with existing non-spine fractures have a threefold greater risk of subsequent spine fractures, independent of bone mass, and independent of the known association between prevalent spine fractures and subsequent spine fractures. Women with both a prevalent non-spine fracture and low bone mass (50th percentile or lower) have an eightfold greater risk of new spine fractures compared with women above the 50th percentile of bone mass and no prevalent fractures. In addition to low bone mass, both prevalent spine fractures and prevalent non-spine fractures are strong risk factors for subsequent spine fracture. These data suggest that not all osteoporotic risk factors are expressed via bone mass, and that other, unmeasured risk factors, such as bone quality defects, may explain these results. In clinical terms, women with both prevalent fractures and low bone mass should be recognized as being at extremely high risk, and treatment potency should be commensurate with this level of risk.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02352253
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  • 5
    Digitale Medien
    Digitale Medien
    Relation of height and weight to the regional variations in bone mass among Japanese-American men and women (1995)
    Springer
    Osteoporosis international 5 (1995), S. 234-238 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Anthropometry ; Bone mass ; Height ; Osteoporosis ; Weight
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We examined the magnitude of regional variations in bone mass among elderly, Japanese-American men and women. All subjects had bone measurements at the calcaneus, and at the distal and proximal radius sites. A subset of the women had, in addition, spine bone mass measurements. To provide a common measurement scale, the bone measurements were converted to age- and sex-specificZ-scores. TheZ-scores between pairs of bone sites were then subtracted to yield the differences in bone mass between bone sites (expressed inZ-score units). For most individuals the differences were less than 1.0Z-score; however, 12%–20% of the differences were at least 1Z-score apart. The most similar sites were the distal and proximal radius: different regions within the same bone. Among the other bone pairs, the calcaneus and spine were the most similar to one another. The magnitudes of the differences in bone mass were associated with height and weight. Heavier subjects, for instance, had greater calcaneus than radius bone mass measurements, and greater spine than radius measurements. The spine and calcaneus are more weight-bearing than the radius sites. Associations were observed up to 0.25Z-score per 10 kg difference in weight. Height was associated with bone mass differences in an opposite direction to weight. Taller subjects had greater bone mass at the radius sites than expected from their calcaneus or spine bone measurements (0.1 to 0.2Z-score difference per 5 cm difference in height). Bone width partly explained the associations with height; that is, adjusting the radius widths reduced the associations with height. Overall, our results indicate that small to moderate differences between bone sites were common among our study population, and that the magnitudes of the differences were associated with height and weight.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01774012
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