Research

12 pages, 1122 KiB

Open AccessArticle

Spine Fragility Fracture Prediction Using TBS and BMD in Postmenopausal Women: A Bayesian Approach

by Claudio Ripamonti, Lucia Lisi, Jacopo Ciaffi, Angela Buffa, Renata Caudarella and Francesco Ursini

Int. J. Environ. Res. Public Health 2022, 19(21), 14315; https://doi.org/10.3390/ijerph192114315 - 02 Nov 2022

Cited by 1 | Viewed by 1601

Abstract

The trabecular bone score (TBS) estimates bone microarchitecture and can be used to evaluate the risk of osteoporotic fractures independently of bone mineral density (BMD). In this retrospective case-control study, we tested and compared the ability of TBS and lumbar spine BMD (LS-BMD) [...] Read more.

The trabecular bone score (TBS) estimates bone microarchitecture and can be used to evaluate the risk of osteoporotic fractures independently of bone mineral density (BMD). In this retrospective case-control study, we tested and compared the ability of TBS and lumbar spine BMD (LS-BMD) to predict vertebral fragility fractures. The inclusion criteria were female sex, age range 50–90 years, menopause, and clinical risk factors for osteoporosis. Patients with secondary osteoporosis were excluded. LS-BMD and TBS were measured at the L1–L4 vertebral level. The ability of the two diagnostic systems in predicting vertebral fragility fractures was assessed by combining LS-BMD and TBS according to the Bayesian “OR rule” (the diagnosis is negative only for those negative for both tests, and it is positive for those who were positive for at least one test) or to the “AND rule” (the diagnosis is positive only for those positive to both tests and is negative for those negative for at least one test). Of the 992 postmenopausal women included, 86 had a documented vertebral fragility fracture. At the cutoff value used in the present study, the TBS and LS-BMD showed a similar diagnostic ability to predict vertebral fragility fractures, having positive predictive values (PPV) of, respectively, 13.19% and 13.24%. Negative predictive values (NPV) were, respectively, 95.40% and 94.95%. Compared to that of each single diagnostic system, the “OR-rule” significantly increased the NPV to 97.89%, while no statistically significant differences were found by using the “AND-rule”. In conclusion, the present study highlights the possibility that combining LS-BMD and TBS could improve their predictive ability in diagnosing vertebral fragility fractures, and that there is a significant probability of absence of fractures in women who test negative to both diagnostic systems. Full article

(This article belongs to the Special Issue Osteoporosis and Other Bone Tissue Disorders)

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Review

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10 pages, 1362 KiB

Open AccessReview

Increased Risk of Fractures and Use of Proton Pump Inhibitors in Menopausal Women: A Systematic Review and Meta-Analysis

by Thuila Ferreira da Maia, Bruna Gafo de Camargo, Meire Ellen Pereira, Cláudia Sirlene de Oliveira and Izonete Cristina Guiloski

Int. J. Environ. Res. Public Health 2022, 19(20), 13501; https://doi.org/10.3390/ijerph192013501 - 19 Oct 2022

Cited by 7 | Viewed by 2430

Abstract

Proton pump inhibitors (PPIs) can directly interfere with osteoclastic function, induce hypergastrinemia, and inhibit calcium absorption, leading to reduced bone mineral density (BMD), a measure of bone metabolism that may be associated with the risk of fractures. The current study involves a systematic [...] Read more.

Proton pump inhibitors (PPIs) can directly interfere with osteoclastic function, induce hypergastrinemia, and inhibit calcium absorption, leading to reduced bone mineral density (BMD), a measure of bone metabolism that may be associated with the risk of fractures. The current study involves a systematic review and meta-analysis aimed at assessing the relationship between prolonged use of PPI drugs and fractures in menopausal women. A systematic search and meta-analysis were performed on PubMed, Scopus, and Science Direct databases according to PRISMA guidelines. Two independent reviewers analyzed the articles. The five articles found in the databases, which met the eligibility criteria, covered participants who were menopausal women aged between 56 and 78.5 years, using or not using a PPI for a minimum of 12 months. All studies showed an increase in the rate of fractures related to using PPIs, as an outcome. Prolonged use of PPIs in menopausal women can affect bone metabolism and cause fractures. However, other factors, such as the use of other classes of drugs, obesity, low weight, poor diet, replacement hormones, and comorbidities, should also be considered for assessing the risk of fractures. Full article

(This article belongs to the Special Issue Osteoporosis and Other Bone Tissue Disorders)

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Other

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8 pages, 942 KiB

Open AccessCase Report

Difficult Therapeutic Decisions in Gorham-Stout Disease–Case Report and Review of the Literature

by Katarzyna Wojciechowska-Durczynska, Arkadiusz Zygmunt, Marta Mikulak, Marta Ludwisiak and Andrzej Lewinski

Int. J. Environ. Res. Public Health 2022, 19(18), 11692; https://doi.org/10.3390/ijerph191811692 - 16 Sep 2022

Cited by 4 | Viewed by 1883

Abstract

Gorham-Stout disease (GSD) is a very rare, life-threatening condition characterized by the proliferation of lymphatic vessels and osteolysis. Unfortunately, no standard treatment has been determined for management of GSD. The available therapies are not equally effective and carry substantial side-effects. We report a [...] Read more.

Gorham-Stout disease (GSD) is a very rare, life-threatening condition characterized by the proliferation of lymphatic vessels and osteolysis. Unfortunately, no standard treatment has been determined for management of GSD. The available therapies are not equally effective and carry substantial side-effects. We report a 42-year-old female with GSD manifested in multifocal osteolysis and chronic chylothorax and ascites. The combined treatment with sirolimus and zoledronic acid due to its synergism of action was introduced. To our knowledge, this is the first Polish case report of adult patients with Gorham-Stout disease. Full article

(This article belongs to the Special Issue Osteoporosis and Other Bone Tissue Disorders)

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