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  • 11
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    Timing of Repeat BMD Measurements: Development of an Absolute Risk‐Based Prognostic Model
    Wiley ; 2009
    In:  Journal of Bone and Mineral Research Vol. 24, No. 11 ( 2009-11), p. 1800-1807
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 24, No. 11 ( 2009-11), p. 1800-1807
    Abstract: This study attempted to address the following questions: for an individual who is at present nonosteoporotic, given their current age and BMD level, what is the individual's risk of fracture and when is the ideal time to repeat a BMD measurement? Nonosteoporotic women ( n = 1008) and men ( n = 750) over the age of 60 in 1989 from the Dubbo Osteoporosis Epidemiology Study were monitored until one of the following outcomes occurred: (1) BMD reached “osteoporosis” level (i.e., T‐scores ≤ −2.5) or (2) an incident fragility fracture. During the follow‐up period (average, 7 yr), 346 women (34%) and 160 men (21%) developed osteoporosis or sustained a low‐trauma fracture. The risk of osteoporosis or fracture increased with advancing age (women: RR/10 yr, 1.3; 95% CI, 1.1–1.6; men: RR/10 yr, 2.3; 95% CI, 1.7–2.9) and lower BMD levels (women: RR per −0.12 g/cm 2 , 3.2; 95% CI, 2.6–4.1; RR per −0.12 g/cm 2 , 2.6; 95% CI, 2.0–3.3). Using the predicted risk (of osteoporosis or fracture) of 10% as a cut‐off level for repeating BMD measurement, the estimated time to reach the cut‐off level varied from 1.5 (for an 80‐yr‐old woman with a T‐score of −2.2) to 10.6 yr (for a 60‐yr‐old man with a T‐score of 0). These results suggest that, based on an individual's current age and BMD T‐score, it is possible to estimate the optimal time to repeat BMD testing for the individual. The prognostic model and approach presented in this study may help improve the individualization and management of osteoporosis.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Article
    DOI: 10.1359/jbmr.090514
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2009
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  • 12
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    Association between fat‐mass‐and‐obesity‐associated ( FTO ) gene and hip fracture susceptibility
    Wiley ; 2014
    In:  Clinical Endocrinology Vol. 81, No. 2 ( 2014-08), p. 210-217
    Details
    In: Clinical Endocrinology, Wiley, Vol. 81, No. 2 ( 2014-08), p. 210-217
    Abstract: Common variants in the fat‐mass‐and‐obesity‐associated ( FTO ) gene are related to body mass index ( BMI ), which is a predictor of hip fracture risk. This study sought to examine the association between variants in the FTO gene and hip fracture risk. Design and participants This is a prospective study including 934 postmenopausal women aged 60 years and above living in Dubbo, Australia (Dubbo Osteoporosis Epidemiology Study), followed up between 1989 and 2007. Measurements Six single nucleotide polymorphisms ( SNP s) (rs1421085, rs1558902, rs1121980, rs17817449, rs9939609 and rs9930506) of the FTO gene were genotyped using Taqman assay. Bone mineral density at the lumbar spine and femoral neck was measured by DXA ( GE ‐Lunar) at baseline. Incidence of hip fractures during the follow‐up was ascertained by reviewing X‐ray reports. We used Cox's models to estimate the association between the genetic variants and hip fracture risk. We also utilized Bayes factor to evaluate the association. Results One hundred and two women (11%) had sustained a hip fracture. The incidence of hip fracture was greater in women homozygous for the minor allele of all SNP s. Women homozygous for the minor allele ( AA ) of rs1121980 had significantly higher risk of hip fracture (hazard ratio, 2·06; 95% CI 1·17–3·62) than women homozygous for the major allele ( TT ). The observed data favoured the hypothesis of FTO gene and fracture association over the hypothesis of nonassociation by a factor of nine. Conclusion Common variations in the FTO gene are associated with hip fracture risk in women and that FTO gene may help improve the predictive value of hip fracture risk.
    Type of Medium: Online Resource
    ISSN: 0300-0664 , 1365-2265
    URL: Issue
    URL: Article
    DOI: 10.1111/cen.2014.81.issue-2
    DOI: 10.1111/cen.12335
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2004597-9
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  • 13
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    Asymptomatic Vertebral Deformity as a Major Risk Factor for Subsequent Fractures and Mortality: A Long‐Term Prospective Study
    Wiley ; 2005
    In:  Journal of Bone and Mineral Research Vol. 20, No. 8 ( 2005-08), p. 1349-1355
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 20, No. 8 ( 2005-08), p. 1349-1355
    Abstract: In elderly men and women, asymptomatic vertebral deformity was found to be associated with subsequent risk of symptomatic fractures, particularly vertebral fracture, and increased risk of mortality after a fracture. Introduction: Vertebral deformity is associated with an increased risk of fracture and mortality. However, it is unclear whether the three events of vertebral deformity, fracture, and mortality are linked with each other and what role BMD plays in these linkages. Materials and Methods: Vertebral deformity was determined from quantitative analysis of thoracolumbar spine X‐rays in 300 randomly individuals (114 men and 186 women) ⩾60 years of age (as of mid‐1989), who were randomly selected from the prospective Dubbo Osteoporosis Epidemiology Study. Incidence of atraumatic fractures and subsequent mortality were ascertained from 1989 to 2003. Cox's proportional hazards model was used to determine the association between asymptomatic vertebral deformities, osteoporotic fractures, and risk of mortality. Results: The prevalence of asymptomatic vertebral deformity was 31% in men and 17% in women. During the follow‐up period, subjects with vertebral deformity had a significantly higher risk of any fracture than those without vertebral deformity (44% versus 29%; hazards ratio [HR], 2.2; 95% CI, 1.4‐3.7), particularly symptomatic vertebral fracture (relative risk [RR] , 7.4; 95% CI, 3.2‐17.0). Mortality rate was highest after a symptomatic fracture among those with vertebral deformity (HR, 9.0; 95% CI, 3.1‐26.0). These associations were independent of age, sex, and BMD. Conclusion: Vertebral deformity was a strong predictor of subsequent risk of fractures, particularly symptomatic vertebral fracture, and may modify fracture‐associated mortality in both elderly men and women.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Article
    DOI: 10.1359/JBMR.050317
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2005
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  • 14
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    Residual Lifetime Risk of Fractures in Women and Men
    Wiley ; 2007
    In:  Journal of Bone and Mineral Research Vol. 22, No. 6 ( 2007-06), p. 781-788
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 22, No. 6 ( 2007-06), p. 781-788
    Abstract: In a sample of 1358 women and 858 men, ≥60 yr of age who have been followed‐up for up to 15 yr, it was estimated that the mortality‐adjusted residual lifetime risk of fracture was 44% for women and 25% for men. Among those with BMD T‐scores ≤ −2.5, the risks increased to 65% in women and 42% in men. Introduction: Risk assessment of osteoporotic fracture is shifting from relative risk to an absolute risk approach. Whereas BMD is a primary predictor of fracture risk, there has been no estimate of mortality‐adjusted lifetime risk of fracture by BMD level. The aim of the study was to estimate the residual lifetime risk of fracture (RLRF) in elderly men and women. Materials and Methods: Data from 1358 women and 858 men ≥60 yr of age as of 1989 of white background from the Dubbo Osteoporosis Epidemiology Study were analyzed. The participants have been followed for up to 15 yr. During the follow‐up period, incidence of low‐trauma, nonpathological fractures, confirmed by X‐ray and personal interview, were recorded. Incidence of mortality was also recorded. BMD at the femoral neck was measured by DXA (GE‐LUNAR) at baseline. Residual lifetime risk of fracture from the age of 60 was estimated by the survival analysis taking into account the competing risk of death. Results: After adjusting for competing risk of death, the RLRF for women and men from age 60 was 44% (95% CI, 40–48) and 25% (95% CI, 19–31), respectively. For individuals with osteoporosis (BMD T‐scores ≤ −2.5), the mortality‐adjusted lifetime risk of any fracture was 65% (95% CI, 58–73) for women and 42% (95% CI, 24–71) for men. For the entire cohort, the lifetime risk of hip fracture was 8.5% (95% CI, 6–11%) for women and 4% (95% CI, 1.3–5.4%) for men; risk of symptomatic vertebral fracture was 18% (95% CI, 15–21%) for women and 11% (95% CI, 7–14%) for men. Conclusions: These estimates provide a means to communicate the absolute risk of fracture to an individual patient and can help promote the identification and targeting of high‐risk individuals for intervention.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Article
    DOI: 10.1359/jbmr.070315
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2007
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  • 15
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    Progressively increasing fracture risk with advancing age after initial incident fragility fracture: The Tromsø Study
    Wiley ; 2013
    In:  Journal of Bone and Mineral Research Vol. 28, No. 10 ( 2013-10), p. 2214-2221
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 28, No. 10 ( 2013-10), p. 2214-2221
    Abstract: The risk of subsequent fracture is increased after initial fractures; however, proper understanding of its magnitude is lacking. This population‐based study examines the subsequent fracture risk in women and men by age and type of initial incident fracture. All incident nonvertebral fractures between 1994 and 2009 were registered in 27,158 participants in the Tromsø Study, Norway. The analysis included 3108 subjects with an initial incident fracture after the age of 49 years. Subsequent fracture ( n  = 664) risk was expressed as rate ratios (RR) and absolute proportions irrespective of death. The rates of both initial and subsequent fractures increased with age, the latter with the steepest curve. Compared with initial incident fracture rate of 30.8 per 1000 in women and 12.9 per 1000 in men, the overall age‐adjusted RR of subsequent fracture was 1.3 (95% CI, 1.2–1.5) in women, and 2.0 (95% CI, 1.6–2.4) in men. Although the RRs decreased with age, the absolute proportions of those with initial fracture who suffered a subsequent fracture increased with age; from 9% to 30% in women and from 10% to 26% in men, between the age groups 50–59 to 80+ years. The type of subsequent fracture varied by age from mostly minor fractures in the youngest to hip or other major fractures in the oldest age groups, irrespective of type and severity of initial fracture. In women and men, 45% and 38% of the subsequent hip or other major fractures, respectively, were preceded by initial minor fractures. The risk of subsequent fracture is high in all age groups. At older age, severe subsequent fracture types follow both clinically severe and minor initial incident fractures. Any fragility fracture in the elderly reflects the need for specific osteoporosis management to reduce further fracture risk. © 2013 American Society for Bone and Mineral Research.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v28.10
    DOI: 10.1002/jbmr.1952
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2013
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  • 16
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    Prevalence of and risk factors for sarcopenia in community‐dwelling people: The Vietnam Osteoporosis Study
    Wiley ; 2023
    In:  Journal of Cachexia, Sarcopenia and Muscle
    Details
    In: Journal of Cachexia, Sarcopenia and Muscle, Wiley
    Abstract: Sarcopenia is a geriatric disease characterized by the progressive and generalized loss of skeletal lean mass and strength with age. The prevalence of sarcopenia in the Vietnamese population is unknown. This study sought to estimate the prevalence of and risk factors for sarcopenia among community‐dwelling individuals in Vietnam. Methods This cross‐sectional study is part of the ongoing Vietnam Osteoporosis Study project. The study involved 1308 women and 591 men aged 50 years and older as at 2015 (study entry). Whole‐body dual‐energy X‐ray absorptiometry was used to measure the appendicular skeletal lean mass. Anthropometric and clinical data were collected using a structured questionnaire. Sarcopenia was defined according to the criteria proposed by the Asian Working Group for Sarcopenia in 2019. Logistic regression analysis was used to determine the association between potential risk factors and sarcopenia. Results The prevalence of sarcopenia in women and men was 14% ( n  = 183) and 16% ( n  = 83), respectively. Age (odds ratio [OR] per 10 years = 1.37; 95% confidence interval [CI] 1.26–1.48) and being underweight (OR = 1.61; 95% CI 1.00–2.58) were independently associated with increased risk of sarcopenia. The combination of low physical activity, being underweight and advancing age accounted for ~27% of sarcopenic patients. However, most of the attributable fraction was due to ageing. Conclusions Sarcopenia is common in community‐dwelling Vietnamese adults, particularly those with advancing age, who are underweight and with low physical activity.
    Type of Medium: Online Resource
    ISSN: 2190-5991 , 2190-6009
    URL: Article
    DOI: 10.1002/jcsm.13383
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 17
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    Mechanography assessment of fall risk in older adults: the Vietnam Osteoporosis Study
    Wiley ; 2021
    In:  Journal of Cachexia, Sarcopenia and Muscle Vol. 12, No. 5 ( 2021-10), p. 1161-1167
    Details
    In: Journal of Cachexia, Sarcopenia and Muscle, Wiley, Vol. 12, No. 5 ( 2021-10), p. 1161-1167
    Abstract: Jumping mechanography is a technology for quantitatively assessing muscular function and balance in older adults. This study sought to define the association between jumping mechanography parameters and fall risk in Vietnamese individuals. Methods The study involved 375 women and 244 men aged 50 years and older, who were recruited from the general population in Ho Chi Minh City (Vietnam). The individuals had been followed for 2 years. At baseline, Esslinger Fitness index (EFI), jumping power, force, velocity of lower limbs, and the ability to maintain balance were measured by a Leonardo Mechanograph Ground Reaction Force system (Novotec Medical, Pforxheim, Germany). The incidence of falls during the follow‐up period was ascertained from self‐report. Logistic regression analysis was used to analyse the association between jumping mechanography parameters and fall risk. Results The average age of participants at baseline was 56.7 years (SD 5.85). During the 2 year follow‐up, 92 falls were reported, making the incidence of fall at ~15% [95% confidence interval (CI), 12.1 to 18.2]. The incidence of fall increased with advancing age, and women had a higher incidence than men (17.6% vs. 10.7%; P  = 0.024). In univariate analysis, maximal velocity [odds ratio (OR) 0.65; 95% CI, 0.52 to 0.82], maximal force (OR 0.83; 95% CI, 0.65 to 1.04), and maximal power (OR 0.68; 95% CI, 0.52 to 0.88) were each significantly associated with fall risk. EFI was not significantly associated with fall risk (OR 1.09; 95% CI, 0.86 to 1.39). However, in a multiple logistic regression model, greater maximum velocity was associated with lower odds of fall (OR 0.38; 95% CI, 0.16 to 0.92). Conclusions These data suggest that jumping mechanography is a useful tool for assessing fall risk in older adults of Vietnamese background.
    Type of Medium: Online Resource
    ISSN: 2190-5991 , 2190-6009
    URL: Issue
    URL: Article
    DOI: 10.1002/jcsm.v12.5
    DOI: 10.1002/jcsm.12751
    Language: English
    Publisher: Wiley
    Publication Date: 2021
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  • 18
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    Prediction of Bone Mineral Density and Fragility Fracture by Genetic Profiling
    Wiley ; 2017
    In:  Journal of Bone and Mineral Research Vol. 32, No. 2 ( 2017-02), p. 285-293
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 32, No. 2 ( 2017-02), p. 285-293
    Abstract: Although the susceptibility to fracture is partly determined by genetic factors, the contribution of newly discovered genetic variants to fracture prediction is still unclear. This study sought to define the predictive value of a genetic profiling for fracture prediction. Sixty‐two bone mineral density (BMD)‐associated single‐nucleotide polymorphisms (SNPs) were genotyped in 557 men and 902 women who had participated in the Dubbo Osteoporosis Epidemiology Study. The incidence of fragility fracture was ascertained from X‐ray reports between 1990 and 2015. Femoral neck BMD was measured by dual‐energy X‐ray absorptiometry. A weighted polygenic risk score (genetic risk score [GRS]) was created as a function of the number of risk alleles and their BMD‐associated regression coefficients for each SNP. The association between GRS and fracture risk was assessed by the Cox proportional hazards model. Individuals with greater GRS had lower femoral neck BMD ( p 〈 0.01), but the variation in GRS accounted for less than 2% of total variance in BMD. Each unit increase in GRS was associated with a hazard ratio of 1.20 (95% CI, 1.04 to 1.38) for fracture, and this association was independent of age, prior fracture, fall, and in a subset of 33 SNPs, independent of femoral neck BMD. The significant association between GRS and fracture was observed for the vertebral and wrist fractures, but not for hip fracture. The area under the receiver‐operating characteristic (ROC) curve (AUC) for the model with GRS and clinical risk factors was 0.71 (95% CI, 0.68 to 0.74). With GRS, the correct reclassification of fracture versus nonfracture ranged from 12% for hip fracture to 23% for wrist fracture. A genetic profiling of BMD‐ associated genetic variants could improve the accuracy of fracture prediction over and above that of clinical risk factors alone, and help stratify individuals by fracture status. © 2016 American Society for Bone and Mineral Research.
    Type of Medium: Online Resource
    ISSN: 0884-0431 , 1523-4681
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v32.2
    DOI: 10.1002/jbmr.2998
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2017
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  • 19
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    Association of Muscle Weakness With Post-Fracture Mortality in Older Men and Women: A 25-Year Prospective Study : QUADRICEPS WEAKNESS AND POST-FRACTURE MORTALITY
    Wiley ; 2017
    In:  Journal of Bone and Mineral Research Vol. 32, No. 4 ( 2017-04), p. 698-707
    Details
    In: Journal of Bone and Mineral Research, Wiley, Vol. 32, No. 4 ( 2017-04), p. 698-707
    Type of Medium: Online Resource
    ISSN: 0884-0431
    URL: Issue
    URL: Article
    DOI: 10.1002/jbmr.v32.4
    DOI: 10.1002/jbmr.3037
    RVK:
    XA 52230
    Language: English
    Publisher: Wiley
    Publication Date: 2017
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  • 20
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    Emerging inflammatory bowel disease demographics, phenotype, and treatment in South Asia, South‐East Asia, and Middle East: Preliminary findings from the Inflammatory Bowel Disease‐Emerging Nations' Consortium
    Wiley ; 2022
    In:  Journal of Gastroenterology and Hepatology Vol. 37, No. 6 ( 2022-06), p. 1004-1015
    Details
    In: Journal of Gastroenterology and Hepatology, Wiley, Vol. 37, No. 6 ( 2022-06), p. 1004-1015
    Abstract: Inflammatory bowel disease (IBD) is emerging in the newly industrialized countries of South Asia, South‐East Asia, and the Middle East, yet epidemiological data are scarce. Methods We performed a cross‐sectional study of IBD demographics, disease phenotype, and treatment across 38 centers in 15 countries of South Asia, South‐East Asia, and Middle East. Intergroup comparisons included gross national income (GNI) per capita. Results Among 10 400 patients, ulcerative colitis (UC) was twice as common as Crohn's disease (CD), with a male predominance (UC 6678, CD 3495, IBD unclassified 227, and 58% male). Peak age of onset was in the third decade, with a low proportion of elderly‐onset IBD (5% age  〉  60). Familial IBD was rare (5%). The extent of UC was predominantly distal (proctitis/left sided 67%), with most being treated with mesalamine (94%), steroids (54%), or immunomodulators (31%). Ileocolic CD (43%) was the commonest, with low rates of perianal disease (8%) and only 6% smokers. Diagnostic delay for CD was common (median 12 months; interquartile range 5–30). Treatment of CD included mesalamine, steroids, and immunomodulators (61%, 51%, and 56%, respectively), but a fifth received empirical antitubercular therapy. Treatment with biologics was uncommon (4% UC and 13% CD), which increased in countries with higher GNI per capita. Surgery rates were 0.1 (UC) and 2 (CD) per 100 patients per year. Conclusions The IBD‐ENC cohort provides insight into IBD in South‐East Asia and the Middle East, but is not yet population based. UC is twice as common as CD, familial disease is uncommon, and rates of surgery are low. Biologic use correlates with per capita GNI.
    Type of Medium: Online Resource
    ISSN: 0815-9319 , 1440-1746
    URL: Issue
    URL: Article
    DOI: 10.1111/jgh.v37.6
    DOI: 10.1111/jgh.15801
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2006782-3
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