Validation of the Thai Osteoporosis Foundation and Royal College of Orthopaedic Surgeons of Thailand Clinical Practice Guideline for bone mineral density measurement in postmenopausal women

A. Suwan,K. Panyakhamlerd,S. Chaikittisilpa,U. Jaisamrarn,P. Hawanond,T. Chaiwatanarat,S. Tepmongkol,E. Chansue,N. Taechakraichana 대한골다공증학회 2015 Osteoporosis and Sarcopenia Vol.1 No.2

Objective: The primary objective of this study was to determine the sensitivity, specificity, and predictive values of the Thai Osteoporosis Foundation (TOPF) and Royal College of Orthopaedic Surgeons of Thailand (RCOST) Clinical Practice Guideline for bone mineral density (BMD) measurement for the detection of postmenopausal osteoporosis. Its secondary objective was to find better indicators to detect postmenopausal osteoporosis. Methods: Postmenopausal women were enrolled in this study between June and December 2014. The clinical risk factors following TOPF and RCOST Clinical Practice Guideline for BMD measurement were collected. Bone mineral density was measured using dual energy X-ray absorptiometry. Results: Four hundred postmenopausal women were enrolled in the study. The mean age of the studied population was 66.16 ± 6.04 years. Twenty-seven percent of the participants had either osteoporosis of the lumbar spine, femoral neck, or total hip, of which 13.3% had osteoporosis at the lumbar spine, 21.3% had osteoporosis at the femoral neck, and 2.5% had osteoporosis of the total hip. The sensitivity and specificity for detecting osteoporosis of the whole TOPF and RCOST guideline were 96.2% and 16.7%, 98.8% and 18.7%, 90.0% and 15.1%, and 97.2% and 19.5% at the lumbar spine, femoral neck, total hip, and any sites, respectively. Multiple logistic regression analysis revealed that only OSTA ??1, osteopenia on X-ray and low trauma fracture after age of 40 years were significant clinical risk factors in the detection of postmenopausal osteoporosis. The Receiver Operating Characteristics (ROC) curve was used to obtain the optimum probability value of osteoporosis at any sites which revealed that the probability value of 0.2222236 would have a sensitivity of 67% and specificity of 62% as the optimal cut point to detect osteoporosis. A simple flow diagram of “OSTA ??1”, “Osteopenia on X-ray” and “A history of low trauma fracture after age of 40 years” was developed as a better trade-off guideline for BMD measurement. Conclusions: This study revealed that the TOPF and RCOST guideline for BMD measurement provided a high true positive rate of disease detection but with an expense of high false positive rate. The simple flow diagram was proposed as a more appropriate guideline for BMD measurement in postmenopausal women. © 2015 The Korean Society of Osteoporosis. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

대도시와 중소도시 여성의 골다공증에 대한 인식도

신욱태,권혁중,조동영 건국대학교 의과학연구소 2003 건국의과학학술지 Vol.13 No.-

As average lifespan in human increased, women's concerns about health promotion after postmenopause are increased. Osteoporosis causes the serious health problem in postmenopausal women. We investigated comparison between Seoul and Chungju for women's recognition about osteoporosis to utilize patient's education data. Information, concerning whether the osteoporosis was well understood, were gather 405 patients, who visited an university hospital from January 1 to April 30, 2001. The mean age of 201 women in Seoul is 46.39 years old, and mean age of 204 in Chungju is 46.35 years old. Among 201 women in Seoul, 43(21.4%) women answered "well known" osteoporosis, and 32(15.9%) women answered "unknown" osteoporosis. Among 204 women in Chungju, 24(11.8%) women answered "well known" osteoporosis, and 32(15.9%) women answered "unknown" osteoporosis. There were significant association between recognition of osteoporosis and their education level, but not significant related with their economic level. Subjective and objective recognition for osteoporosis in Seoul was relatively higher than women in Chungju, but compliance about doctor in Chungju was relatively higher than women in Seoul. But we found that recognition level of postmenopausal osteoporosis is low in Seoul and Chungju. We concluded that knowledge for osteoporosis was relatively low, seoul was relatively higher than in Chungju. Therefore, correct patient education for prevention and treatment of osteoporosis would be needed.

Postmenopausal Osteoporosis Is Associated with Serum Chemerin and Irisin but Not with Apolipoprotein M Levels

( Yaprak Engin-ustun ),( Emel Kıyak Caglayan ),( Ayse Yesim Gocmen2 ),( Muhammed Fevzi Polat ) 대한폐경학회 2016 대한폐경학회지 Vol.22 No.2

Objectives: The objective of this study was to describe the levels of chemerin, irisin and apolipoprotein M (apoM) in women with postmenopausal osteoporosis. Methods: The study included 88 women with postmenopausal osteoporosis. Based on World Health Organization criteria, women with a T-score of ≤ -2.5 were defined as osteoporotic. In this case-control study, postmenopausal women with T-score > -1 were selected as controls (n = 88) and case-matched in a 1:1 ratio based on age (within 2 years) and body mass index (BMI) (within 1.0 kg/m²). ApoM, irisin and chemerin levels were determined by a commercially available enzyme-linked immunosorbent assay (ELISA) kit. Results: There were no significant differences in age, BMI, parity, cholesterol and apoM levels between the two groups. C-reactive protein levels were significantly increased in women with osteoporosis. Serum chemerin levels (240.1 ± 46.1 vs. 261.5 ± 50.8 ng/ mL) were significantly lower in the women with osteoporosis, as compared to the controls (P = 0.004). Serum irisin levels were also decreased in women with osteoporosis (0.7 ± 0.2 vs. 0.8 ± 0.2 ng/mL; P = 0.007). Conclusions: In the present study, osteoporosis was associated with decreased levels of circulating chemerin and irisin. These findings suggested that adipokines might play a role in the pathogenesis of osteoporosis. (J Menopausal Med 2016;22:76-79)

Effect of Alkaline Drinking Water on Bone Density of Postmenopausal Women with Osteoporosis

( Sanaz Fasihi ),( Siavash Fazelian ),( Farinaz Farahbod ),( Fateme Moradi ),( Morteza Dehghan ) 대한폐경학회 2021 대한폐경학회지 Vol.27 No.2

Objectives: Postmenopausal women are predisposed to osteoporosis, and those on acidic diets are at a higher risk, because it has been demonstrated that such diets have adverse effects on bone health. In this study, the effect of alkaline drinking water on bone mineral density was evaluated in postmenopausal women with osteoporosis. Methods: One hundred postmenopausal women with osteoporosis (T-score ≤ -2.5) were equally divided into an intervention group and a control group (n = 50 each). The intervention group received calcium D (daily), alkaline drinking water (1.5 L daily with pH 8.6 ± 0.3), and Osteofos tablet (70 mg weekly), whereas the control group received only calcium D and Osteofos tablet for 3 months. T-scores of the femur and spine bones were obtained using bone densitometry before and 3 months after the intervention. Results: After the intervention, the mean T-scores of the femur and spine bones significantly increased in both the control and intervention groups (P < 0.05). However, the mean changes in the spine T-score were significantly higher in the intervention group (0.39 ± 0.07) than in the control group (0.08 ± 0.01) (P < 0.05). No significant differences were observed in the mean changes in the femur T-score between the two groups. Conclusions: Our findings demonstrate that drinking alkaline water improves spine T-scores in postmenopausal women with osteoporosis. Hence, alkaline water can be used to treat osteoporosis due to increased bone density in postmenopausal women. Longterm interventions are necessary to confirm the effects of alkaline water on femur density.

가족 구조에 따른 골다공증 인지율 영향요인-50세 이상 골다공증 폐경여성

김지영(Kim Ji Young),박영례(Park Youngrye) 한국기초간호학회 2021 Journal of korean biological nursing science Vol.23 No.4

Purpose: The purpose of this study was to investigate the factors influencing osteoporosis awareness depending on the family structure in postmenopausal women aged over 50 years with osteoporosis. Methods: The study was a cross-sectional study that used secondary data. Postmenopausal women with osteoporosis aged over 50 years (n=567) from the National Health Nutrition Survey of the 5th (2010, 2011) were selected for analysis. Data were analyzed by complex sampling design multiple regression analysis. Results: Among the patients with osteoporosis, the osteoporosis awareness was very low at 29.0%, and 32.5% for single households and 28.1% for household with spouses. There were significant differences in the factors influencing osteoporosis awareness depending on the family structure. For single household, factors that influenced osteoporosis awareness included sleeping for more than 9 hours (OR, 4.32), anxiety and depression (OR, 3.21), a history of fracture (OR, 0.29), and a family history of osteoporosis (OR, 0.29). In the household with a spouse, osteoporosis awareness was highest in women in their 60 seconds (OR, 3.45), unhealthy group (OR, 2.27), and underweight group (OR, 5.31). Other factors that influenced osteoporosis awareness included pain/discomfort (OR, 2.31), smoking (OR, 7.71), and a history of fracture (OR, 0.36). Conclusion: It is necessary to improve osteoporosis awareness for effective osteoporosis management through osteoporosis screening and counseling, and continuous osteoporosis education programs.

폐경기 여성의 골다공증에 관한 조사

이종석,백지선,구은수,배철영,신동학 大韓家庭醫學會 1994 Korean Journal of Family Medicine Vol.15 No.2-3

춘천지역 폐경 후 여성의 골다공증 유병률과 관련 요인: 한림노년연구

장숙랑,최영호,최문기,강성현,정진영,최용준,김동현,Jang, Soong-Nang,Choi, Young-Ho,Choi, Moon-Gi,Kang, Sung-Hyun,Jeong, Jin-Young,Choi, Yong-Jun,Kim, Dong-Hyun 대한예방의학회 2006 예방의학회지 Vol.39 No.5

Objectives: A community-based, cross-sectional survey was conducted to determine theprevalence of osteoporosis and to evaluate the effects of body composition, health behaviors and reproductive history on bone density in postmenopausal women. Methods: The study subjects were 362 postmenopausal women, aged 45 years old or over, who were invited to the hospital. Information on their socio-demographic characteristics and the potential risk factors such as their past medical history, smoking, alcohol intake, exercise, diet and menstrual/reproductive histories were collected by trained interviewers. Weight, height, the body mass index ($kg/m^{2}$), and body composition variables were measured. Bone mineral density of the lumbar spine was measured by dual energy X-ray absorptiometry (DXA). Results: The prevalence of osteoporosis was 30.6% in the $45{\sim}64$ years old women, 52.5% in the elderly women aged $65{\sim}74$, and 68.7% in the women aged 75 years or over. After adjustment for the effect of potential covariates, those women in the highest 25% (4th quartile) of the lean body mass are less likely to have osteoporosis (aOR=0.31, 95% CI=0.12-0.76), compared with the lowest quartile group. More parity also had significantly detrimental effects on osteoporosis. Conclusions: These findings suggest that the prevalence of osteoporosis in postmenopausal women increased with age from 46.3% of those aged 45-64 to 68.7% for those aged 75 and over. Lean body mass and parity appeared significant contributor to bone mineral density in postmenopausal women in this population.

Resorption Level of Edentulous Alveolar Bone in Normal, Osteopenia and Osteoporosis Postmenopausal Women

Muslita Indrasari,Lindawati S. Kusdhany,Henni Koesmaningati 대한예방치과학회 2012 International Journal of Clinical Preventive Denti Vol.8 No.3

Introduction: Estrogen hormone deficiency in postmenopausal women results in a reduction of bone density. In this condition, estrogen hormone level decreases and bone density is less than normal, known as osteopenia and osteoporosis. Decreasing bone density becomes a risk factor of alveolar bone resorption in edentulous ridge. Objective: The aim of this study was to provide a description of alveolar bone resorption level in normal, osteopenia and osteoporosis postmenopausal women. This study provided information about bone density and postmenopausal condition in order to lower the failure of denture treatment. Methods: Data was collected cross sectionally on June 2009, in East Bekasi, West Java, Indonesia, on 312 postmenopausal women age 41∼82 years old. Bone density was measured by Ultrasound Densitometer. Alveolar bone height in edentulous ridge was measured by mouth mirror size 3 on buccal side of the edentulous ridge. Results: The result of this study showed that the resorption level of edentulous alveolar bone in women with normal bone density was lower than those of women with osteopenia and osteoporosis. Conclusion: Postmenopausal osteoporosis women had higher level of alveolar bone resorption compared to normal density and osteopenia.

폐경후 골다공증 환자에서 체질량지수에 따른 Alendronate의 효과

조영석,나소영,이효진,홍우정,김군순,김도희,구본정,송민호,김영건,노흥규 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

배경 : 폐경후 골다공증은 심각한 문제로 대두되고 있다. 현재 Alendronate는 폐경후 골다공증의 치료제로서 널리 쓰이고 있다. 저자는 Alendronate의 골밀도에 효과를 알아보고 골다공증의 위험인자에 따른 Alendronate의 반응 정도를 평가하기 위하여 본 연구를 수행하였다. 방법 : Alendronate를 평균 12개월간 복용한 35명의 폐경후 골다공증환자에서 체질량지수와 폐경후 기간에 따른 치료효과를 조사하였다. 결과 : 전체 대상군에서 Alendronate 10㎎을 12개월간 투여한후 골밀도의 평균 변화율은 요추와 대퇴골 경부에서 각각 7.83±7.39%와 2.99±9.22%이었다. 과체중군에서 평균변화율은 요추와 대퇴골 경부에서 각각 7.15±4.5%와 3.05±2.86%였다. 양군간에 통계적 유의성이 있는 차이는 없었다. 폐경후 7년이 경과되지 않은 군에서의 평균변화율은 요추와 대퇴골 경부에서 각각 6.9±5.3%와 5.71±0.08%였다. 양군간에 통계적인 유의성이 있는 차이는 없었다. 결론 : 마른체형이 골다공증의 발병에는 영향이 있으나, Alendronate 치료효과의 차이는 없는 것을 확인할 수 있었다. 더불어 폐경이 있고 7년이 초과된 군과 년이 경과되지 않은 군에서의 Alendronate 치료효과의 차이는 없는 것을 확인할수 있었다. 이는 골흡수가 상당히 진행된 상태에서도 Alendronate가 치료효과를 가지고 있음을 반영한다고 할 수 있겠다. Postmenopausal osteoporosis is a serious health problem. The aminophosphonate Alendronate is widely used for treatment of postmenopausal osteoporosis. We studied the effect of l0㎎ of alendronate given daily for mean 12 months on bone mineral density in 35 women(mean age 61yrs. mean BMI 23.24㎏/m^(2)) with osteoporosis. An over weight group is defined such that BMI was above 23㎏/m^(2). All the women received 1500㎎ calcium carbonate daily. The bone mineral density of L-spine and femoral neck was measured by dual-energy X-ray absorptiometry. Alendronate increased BMD at mean 12 months at the L-spine (7.15±4.5%) and femoral neck(3.05±2.86%) in normal women. Alendronate increased bone mineral density at 12 months at the L-spine(6.00±5.3%) and femoral neck(4.17±4.87%) in overweight women. There was no difference between two groups. In the less than 7 years group of postmenopausal duration. alendronate increased bone mineral density at 12 months at the L-spine(6.9±4.9%) and femoral neck(3.18±7.1%). In the more than 7 years group of postmenopausal duration, alendronate increased hone mineral density at 1% months at the L-spine(6.5±5.3%) and femoral neck(5.71±0.08%). There was no difference between two groups. In postmenopausal women with osteoporosis, therapy with alendronate produced significant increases in BMD of the L-spine and femoral neck in both group. There was no difference between normal and over-weight groups. and between less than 7 years group and more than 7 years group of postmenopausal duration.

Investigation of Comorbidity, Trauma History, and Osteoporotic Fractures in the Postmenopausal Population: A Nationwide, Observational, and Cross-Sectional Study of Korean Orthopedic Outpatient Clinics

조민준,Seoung-Hwan Moon,Ji-Ho Lee,Jae Hyup Lee 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.5

Study Design: A nationwide, observational, and cross-sectional study targeting postmenopausal patients from 62 orthopedic outpatient clinics in Korea between October 2010 and February 2011. Purpose: This study was carried out to investigate comorbidity, trauma history, and the status of osteoporotic fracture treatment in Korean postmenopausal women. Overview of Literature: There has been little reports on the comorbidity, family history, trauma history, and treatment status of osteoporotic fractures in patients visiting the orthopedic outpatient clinics in Korea. Methods: A total of 1,255 postmenopausal women between the ages of 50 and 80 years were enrolled in the study and the population distribution was reflected by region. Comorbidity, familial history of osteoporosis, familial history of osteoporotic fracture, history of falls, and status of osteoporotic fracture management were evaluated using an interview and questionnaire. The relationship between family history of osteoporosis and bone mineral density was analyzed. Results: A number of patients (23%) had a family history of osteoporosis and 16.5% had a family history of fractures. Most (64.7%) of the patients had one or more comorbidities, including 58.8% exhibiting a chronic disease and 16.4% suffering from diseases that restrict exercise or walking. The results of the questionnaire indicated that 21.8% of these fracture patients had experienced a fracture previously and that the most common type of fracture was that of the spine. Lumbar spine bone mineral density was found to be lower in the presence of family history of osteoporosis. Conclusions: Postmenopausal women are liable to have osteoporotic fractures due to the high prevalence of osteoporosis, a history of falling, and the comorbidity with diseases that restrict ambulation. A better understanding of postmenopausal women in the orthopedic outpatient settings is important to the management of osteoporotic fractures.