open access

Vol 72, No 3 (2021)
Original paper
Submitted: 2020-11-09
Accepted: 2021-01-21
Published online: 2021-02-02
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A cross-sectional comparison of selected anthropometric, laboratory, and densitometric parameters in postmenopausal osteoporotic women with and without vertebral compression fractures

Piotr Sawicki1, Marek Tałałaj2, Katarzyna Życińska13, Wojciech S. Zgliczyński4, Waldemar Wierzba56
·
Pubmed: 33619710
·
Endokrynol Pol 2021;72(3):191-197.
Affiliations
  1. Department of Rheumatology, Systemic Connective Tissue Diseases, and Rare Diseases, Central Clinical Hospital MSWiA, Warsaw, Poland
  2. Department of Geriatrics, Internal Medicine, and Metabolic Bone Diseases, Centre of Postgraduate Medical Education, Warsaw, Czerniakowska 231, 00-416 Warsaw, Poland
  3. Department of Family Medicine, Medical University of Warsaw, Warsaw, Poland
  4. School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
  5. Central Clinical Hospital MSWiA in Warsaw, Warsaw, Poland
  6. UHE Satellite Campus in Warsaw, University of Humanities and Economics in Łódź, Warsaw, Poland

open access

Vol 72, No 3 (2021)
Original Paper
Submitted: 2020-11-09
Accepted: 2021-01-21
Published online: 2021-02-02

Abstract

Introduction: Osteoporosis leads to an increased risk of vertebral compression fractures (VCFs). Most of them are spontaneous, which makes early diagnosis difficult. The aim of the study was to find parameters that distinguish osteoporotic women with and without vertebral compression fractures.

Material and methods: A total of 437 women with postmenopausal osteoporosis were enrolled to the study. Based on the results of densitometric vertebral fracture assessment, patients were divided into 2 groups: with (n = 193) and without (n = 244) VCFs. Then selected anthropometric, laboratory, and densitometric parameters as well as questionnaire data were compared.

Results: The following distinguishing factors were found among patients with VCFs in comparison to patients without such fractures: older age — 73.93 years vs. 69.63 years [p(1) < 0.001, p(2) < 0.001], shorter height — 1.56 m vs. 1.58 m [p(4) < 0.001], lower value of glomerular filtration rate (GFR) according to Cockcroft-Gault formula — 58.22 mL/min. vs. 66.25 mL/min. [p(1) < 0.025, p(2) = 0.002], lower peripheral blood haemoglobin and serum albumin concentration (OR = 1.24, 95% CI: 1.02–1.51, p(5) = 0.03; OR = 2.29, 95% CI: 1.09–4.80, p(5) = 0.03, respectively), and higher 10-year risk of major osteoporotic fracture (FRAX MOF) –12.01% vs. 9.69% [p(1) < 0.01, p(2) < 0.001] and hip fracture (FRAX HIP) — 3.85% vs. 2.55% [p(1) < 0.01, p(2) < 0.001]. In addition, among patients with VCFs a greater severity of back pain was found in the 11-grade scale of pain intensity — 6.12 vs. 4.29 [p(1) < 0.001, p(2) < 0.001, p(3) < 0.001]. The bone mineral content (BMC) and bone mineral density (BMD) of the hip were lower in patients with VCFs — 25.25 vs. 26.2 g and 0.72 g/cm2 vs. 0.75 g/cm2, respectively [p(4) = 0.04 and p(4) < 0.001, respectively].

Conclusions: Patients with VCFs were characterised by greater back pain intensity, higher fracture risk according to the FRAX calculator, and lower values of the following: GFR according to Cockcroft-Gault formula, peripheral blood haemoglobin and serum albumin concentration, and BMD of the hip. Further studies are required to validate the FRAX calculator to assess not only the risk of future fractures but also unrecognised VCFs. 

Abstract

Introduction: Osteoporosis leads to an increased risk of vertebral compression fractures (VCFs). Most of them are spontaneous, which makes early diagnosis difficult. The aim of the study was to find parameters that distinguish osteoporotic women with and without vertebral compression fractures.

Material and methods: A total of 437 women with postmenopausal osteoporosis were enrolled to the study. Based on the results of densitometric vertebral fracture assessment, patients were divided into 2 groups: with (n = 193) and without (n = 244) VCFs. Then selected anthropometric, laboratory, and densitometric parameters as well as questionnaire data were compared.

Results: The following distinguishing factors were found among patients with VCFs in comparison to patients without such fractures: older age — 73.93 years vs. 69.63 years [p(1) < 0.001, p(2) < 0.001], shorter height — 1.56 m vs. 1.58 m [p(4) < 0.001], lower value of glomerular filtration rate (GFR) according to Cockcroft-Gault formula — 58.22 mL/min. vs. 66.25 mL/min. [p(1) < 0.025, p(2) = 0.002], lower peripheral blood haemoglobin and serum albumin concentration (OR = 1.24, 95% CI: 1.02–1.51, p(5) = 0.03; OR = 2.29, 95% CI: 1.09–4.80, p(5) = 0.03, respectively), and higher 10-year risk of major osteoporotic fracture (FRAX MOF) –12.01% vs. 9.69% [p(1) < 0.01, p(2) < 0.001] and hip fracture (FRAX HIP) — 3.85% vs. 2.55% [p(1) < 0.01, p(2) < 0.001]. In addition, among patients with VCFs a greater severity of back pain was found in the 11-grade scale of pain intensity — 6.12 vs. 4.29 [p(1) < 0.001, p(2) < 0.001, p(3) < 0.001]. The bone mineral content (BMC) and bone mineral density (BMD) of the hip were lower in patients with VCFs — 25.25 vs. 26.2 g and 0.72 g/cm2 vs. 0.75 g/cm2, respectively [p(4) = 0.04 and p(4) < 0.001, respectively].

Conclusions: Patients with VCFs were characterised by greater back pain intensity, higher fracture risk according to the FRAX calculator, and lower values of the following: GFR according to Cockcroft-Gault formula, peripheral blood haemoglobin and serum albumin concentration, and BMD of the hip. Further studies are required to validate the FRAX calculator to assess not only the risk of future fractures but also unrecognised VCFs. 

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Keywords

 osteoporosis; spinal fractures; back pain; cross-sectional studies

About this article
Title

A cross-sectional comparison of selected anthropometric, laboratory, and densitometric parameters in postmenopausal osteoporotic women with and without vertebral compression fractures

Journal

Endokrynologia Polska

Issue

Vol 72, No 3 (2021)

Article type

Original paper

Pages

191-197

Published online

2021-02-02

Page views

1114

Article views/downloads

531

DOI

10.5603/EP.a2021.0011

Pubmed

33619710

Bibliographic record

Endokrynol Pol 2021;72(3):191-197.

Keywords

 osteoporosis
spinal fractures
back pain
cross-sectional studies

Authors

Piotr Sawicki
Marek Tałałaj
Katarzyna Życińska
Wojciech S. Zgliczyński
Waldemar Wierzba

References (50)
  1. Kanis JA, Cooper C, Rizzoli R, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis Int. 2018; 30(1): 3–44.
  2. Yoo JH, Moon SH, Ha YC, et al. Osteoporotic Fracture: 2015 Position Statement of the Korean Society for Bone and Mineral Research. J Bone Metab. 2015; 22(4): 175–181.
  3. Lorenc R, Głuszko P, Franek E, et al. Guidelines for the diagnosis and management of osteoporosis in Poland : Update 2017. Endokrynol Pol. 2017; 68(5): 604–609.
  4. Curtis EM, Moon RJ, Harvey NC, et al. The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide. Bone. 2017; 104: 29–38.
  5. Alseddeeqi E, Bashir N, AlAli KF, et al. Characteristics of patients with low-trauma vertebral fractures in the United Arab Emirates: a descriptive multi-center analysis. Endocr J. 2020; 67(7): 785–791.
  6. Gonzalez-Rodriguez E, Aubry-Rozier B, Stoll D, et al. Sixty spontaneous vertebral fractures after denosumab discontinuation in 15 women with early-stage breast cancer under aromatase inhibitors. Breast Cancer Res Treat. 2020; 179(1): 153–159.
  7. Kammerlander C, Zegg M, Schmid R, et al. Fragility fractures requiring special consideration: vertebral fractures. Clin Geriatr Med. 2014; 30(2): 361–372.
  8. Balasubramanian A, Zhang J, Chen L, et al. Risk of subsequent fracture after prior fracture among older women. Osteoporos Int. 2019; 30(1): 79–92.
  9. Kendler DL, Chines A, Brandi ML, et al. The risk of subsequent osteoporotic fractures is decreased in subjects experiencing fracture while on denosumab: results from the FREEDOM and FREEDOM Extension studies. Osteoporos Int. 2019; 30(1): 71–78.
  10. Pluskiewicz W, Adamczyk P, Franek E, et al. The efficacy of pharmacotherapy in postmenopausal osteoporosis: a longitudinal observational study. Endokrynol Pol. 2019; 70(6): 473–477.
  11. Song LJ, Wang LL, Ning L, et al. A modification and validation of quantitative morphometry classification system for osteoporotic vertebral compressive fractures in mainland Chinese. Osteoporos Int. 2018; 29(11): 2495–2504.
  12. Jones LD, Pandit H, Lavy C. Back pain in the elderly: a review. Maturitas. 2014; 78(4): 258–262.
  13. Paolucci T, Morone G, Iosa M, et al. Efficacy of group-adapted physical exercises in reducing back pain in women with postmenopausal osteoporosis. Aging Clin Exp Res. 2014; 26(4): 395–402.
  14. Ramanathan S, Hibbert P, Wiles L, et al. What is the association between the presence of comorbidities and the appropriateness of care for low back pain? A population-based medical record review study. BMC Musculoskelet Disord. 2018; 19(1): 391.
  15. Francis RM, Aspray TJ, Hide G, et al. Back pain in osteoporotic vertebral fractures. Osteoporos Int. 2008; 19(7): 895–903.
  16. Moretti A, Gimigliano F, Di Pietro G, et al. Back pain-related disability and quality of life in patients affected by vertebral fractures: data from baseline characteristics of population enrolled in Denosumab In Real Practice (DIRP). Aging Clin Exp Res. 2015; 27 Suppl 1: S3–S9.
  17. Liu-Ambrose T, Eng JJ, Khan KM, et al. The influence of back pain on balance and functional mobility in 65- to 75-year-old women with osteoporosis. Osteoporos Int. 2002; 13(11): 868–873.
  18. Clark EM, Hutchinson AP, McCloskey EV, et al. Lateral back pain identifies prevalent vertebral fractures in post-menopausal women: cross-sectional analysis of a primary care-based cohort. Rheumatology (Oxford). 2010; 49(3): 505–512.
  19. Kanis JA, Glüer CC. An update on the diagnosis and assessment of osteoporosis with densitometry. Committee of Scientific Advisors, International Osteoporosis Foundation. Osteoporos Int. 2000; 11(3): 192–202.
  20. Li Y, Yan L, Cai S, et al. The prevalence and under-diagnosis of vertebral fractures on chest radiograph. BMC Musculoskelet Disord. 2018; 19(1): 235.
  21. Vokes TJ, Gillen DL, Pham AT, et al. Risk factors for prevalent vertebral fractures in black and white female densitometry patients. J Clin Densitom. 2007; 10(1): 1–9.
  22. Bijlsma AY, Meskers CGM, Westendorp RGJ, et al. Chronology of age-related disease definitions: osteoporosis and sarcopenia. Ageing Res Rev. 2012; 11(2): 320–324.
  23. Pietschmann P, Rauner M, Sipos W, et al. Osteoporosis: an age-related and gender-specific disease--a mini-review. Gerontology. 2009; 55(1): 3–12.
  24. Yoh K, Kuwabara A, Tanaka K. Detective value of historical height loss and current height/knee height ratio for prevalent vertebral fracture in Japanese postmenopausal women. J Bone Miner Metab. 2014; 32(5): 533–538.
  25. Siminoski K, Jiang G, Adachi JD, et al. Accuracy of height loss during prospective monitoring for detection of incident vertebral fractures. Osteoporos Int. 2005; 16(4): 403–410.
  26. Cangussu-Oliveira LM, Porto JM, Freire Junior RC, et al. Association between the trunk muscle function performance and the presence of vertebral fracture in older women with low bone mass. Aging Clin Exp Res. 2020; 32(6): 1067–1076.
  27. Takata S, Yasui N. Effects of constitution, atraumatic vertebral fracture and aging on bone mineral density and soft tissue composition in women. J Med Invest. 2002; 49(1–2): 18–24.
  28. Di Monaco M, Castiglioni C, Bardesono F, et al. Sarcopenia, osteoporosis and the burden of prevalent vertebral fractures: a cross-sectional study of 350 women with hip fracture. Eur J Phys Rehabil Med. 2020; 56(2): 184–190.
  29. Wang WF, Lin CW, Xie CN, et al. The association between sarcopenia and osteoporotic vertebral compression refractures. Osteoporos Int. 2019; 30(12): 2459–2467.
  30. Crivelli M, Chain A, da Silva ITF, et al. Association of Visceral and Subcutaneous Fat Mass With Bone Density and Vertebral Fractures in Women With Severe Obesity. J Clin Densitom. 2020 [Epub ahead of print].
  31. Yendt ER, Cohanim M, Jarzylo S, et al. Reduced creatinine clearance in primary osteoporosis in women. J Bone Miner Res. 1993; 8(9): 1045–1052.
  32. Prasad B, Ferguson T, Tangri N, et al. Association of Bone Mineral Density With Fractures Across the Spectrum of Chronic Kidney Disease: The Regina CKD-MBD Study. Can J Kidney Health Dis. 2019; 6: 2054358119870539.
  33. Elliott MJ, James MT, Quinn RR, et al. Estimated GFR and fracture risk: a population-based study. Clin J Am Soc Nephrol. 2013; 8(8): 1367–1376.
  34. Chung DJ, Choi HJ, Chung YS, et al. The prevalence and risk factors of vertebral fractures in Korean patients with type 2 diabetes. J Bone Miner Metab. 2013; 31(2): 161–168.
  35. Jackson RD, LaCroix AZ, Gass M, et al. Women's Health Initiative Investigators. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006; 354(7): 669–683.
  36. Marwaha RK, Tandon N, Gupta Y, et al. The prevalence of and risk factors for radiographic vertebral fractures in older Indian women and men: Delhi Vertebral Osteoporosis Study (DeVOS). Arch Osteoporos. 2012; 7: 201–207.
  37. Bauer DC, Black DM, Bouxsein ML, et al. Foundation for the National Institutes of Health (FNIH) Bone Quality Project. Treatment-Related Changes in Bone Turnover and Fracture Risk Reduction in Clinical Trials of Anti-Resorptive Drugs: A Meta-Regression. J Bone Miner Res. 2018; 33(4): 634–642.
  38. Gom I, Fukushima H, Shiraki M, et al. Relationship between serum albumin level and aging in community-dwelling self-supported elderly population. J Nutr Sci Vitaminol (Tokyo). 2007; 53(1): 37–42.
  39. van der Jagt-Willems HC, van Hengel M, Vis M, et al. Why do geriatric outpatients have so many moderate and severe vertebral fractures? Exploring prevalence and risk factors. Age Ageing. 2012; 41(2): 200–206.
  40. Jørgensen L, Skjelbakken T, Løchen ML, et al. Anemia and the risk of non-vertebral fractures: the Tromsø Study. Osteoporos Int. 2010; 21(10): 1761–1768.
  41. Valderrábano RJ, Lee J, Lui LY, et al. Osteoporotic Fractures in Men (MrOS) Study Research Group. Older Men With Anemia Have Increased Fracture Risk Independent of Bone Mineral Density. J Clin Endocrinol Metab. 2017; 102(7): 2199–2206.
  42. Lee EAe, Shin DW, Yoo JH, et al. Anemia and Risk of Fractures in Older Korean Adults: A Nationwide Population-Based Study. J Bone Miner Res. 2019; 34(6): 1049–1057.
  43. Goerss JB, Kim CH, Atkinson EJ, et al. Risk of fractures in patients with pernicious anemia. J Bone Miner Res. 1992; 7(5): 573–579.
  44. Hohman EE, McCabe GP, Peacock M, et al. Validation of urinary calcium isotope excretion from bone for screening anabolic therapies for osteoporosis. Osteoporos Int. 2014; 25(10): 2471–2475.
  45. Lajlev SE, Rejnmark L, Harsløf T. T-score differences and nonprogression in lumbar vertebrae as predictors of vertebral fractures. Clin Endocrinol (Oxf). 2019; 91(1): 58–62.
  46. Lee JE, Kim KM, Kim LK, et al. Comparisons of TBS and lumbar spine BMD in the associations with vertebral fractures according to the T-scores: A cross-sectional observation. Bone. 2017; 105: 269–275.
  47. Johansson L, Sundh D, Zoulakis M, et al. The Prevalence of Vertebral Fractures Is Associated With Reduced Hip Bone Density and Inferior Peripheral Appendicular Volumetric Bone Density and Structure in Older Women. J Bone Miner Res. 2018; 33(2): 250–260.
  48. Lopes JB, Danilevicius CF, Takayama L, et al. Prevalence and risk factors of radiographic vertebral fracture in Brazilian community-dwelling elderly. Osteoporos Int. 2011; 22(2): 711–719.
  49. Donaldson MG, Palermo L, Ensrud KE, et al. FRAX and risk of vertebral fractures: the fracture intervention trial. J Bone Miner Res. 2009; 24(11): 1793–1799.
  50. Cano A, Baró F, Fernández C, et al. Evaluation of the risk factors of asymptomatic vertebral fractures in postmenopausal women with osteopenia at the femoral neck. Maturitas. 2016; 87: 95–101.

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