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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/11963

Title: Contributors to Secondary Osteoporosis and Metabolic Bone Diseases in Patients Presenting with a Clinical Fracture
Authors: Bours, Sandrine P. G.
van Geel, Tineke A. C. M.
GEUSENS, Piet
Janssen, Marcel J. W.
Janzing, Heinrich M. J.
Hoffland, Ge A.
Willems, Paul C.
van den Bergh, Joop P. W.
Issue Date: 2011
Publisher: ENDOCRINE SOC
Citation: JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 96 (5). p. 1360-1367
Abstract: Background: Previously undetected contributors to secondary osteoporosis and metabolic bone diseases (SECOB) are frequently found in patients with osteoporosis, but the prevalence in patients at the time they present with a clinical fracture is unknown. Methods: All consecutive patients with a recent clinical vertebral or nonvertebral fracture, who were able and willing to be investigated (n = 626: 482 women, 144 men, age range 50-97 yr) had bone mineral density and laboratory investigations (serum calcium, inorganic phosphate, 25-hydroxyvitamin D, creatinine, intact PTH, TSH, free T-4, serum and urine protein electrophoresis, and in men also serum testosterone). Results: Known SECOB contributors were present in 23.0% of patients and newly diagnosed SECOB contributors in 26.5%: monoclonal proteinemia (14 of 626), renal insufficiency grade III or greater (54 of 626), primary (17 of 626) and secondary (64 of 626) hyperparathyroidism, hyperthyroidism (39 of 626), and hypogonadism in men (12 of 144). Newly diagnosed SECOBs, serum 25-hydroxyvitamin D less than 50 nmol/liter (in 63.9%), and dietary calcium intake less than 1200 mg/d (in 90.6%) were found at any age, in both sexes, after any fracture (except SECOB in men with finger and toe fractures) and at any level of bone mineral density. Conclusion: At presentation with a fracture, 26.5% of patients have previously unknown contributors to SECOB, which are treatable or need follow-up, and more than 90% of patients have an inadequate vitamin D status and/or calcium intake. Systematic screening of patients with a recent fracture identifies those in whom potentially reversible contributors to SECOB and calcium and vitamin D deficiency are present. (J Clin Endocrinol Metab 96: 1360-1367, 2011)
Notes: [Bours, Sandrine P. G.] Maastricht Univ, Med Ctr, Dept Internal Med, Subdiv Endocrinol, NL-6202 AZ Maastricht, Netherlands. [Willems, Paul C.] Maastricht Univ, Med Ctr, Dept Orthoped Surg, NL-6202 AZ Maastricht, Netherlands. [Bours, Sandrine P. G.; van den Bergh, Joop P. W.] VieCuri Med Ctr Noord Limburg, Dept Internal Med, NL-5912 BL Venlo, Netherlands. [Janssen, Marcel J. W.] VieCuri Med Ctr Noord Limburg, Lab Clin Chem & Haematol, NL-5912 BL Venlo, Netherlands. [Janzing, Heinrich M. J.] VieCuri Med Ctr Noord Limburg, Dept Surg, NL-5912 BL Venlo, Netherlands. [Hoffland, Ge A.] VieCuri Med Ctr Noord Limburg, Dept Radiol, NL-5912 BL Venlo, Netherlands. [van Geel, Tineke A. C. M.] Maastricht Univ, Dept Gen Practice, CAPHRI Sch Publ Hlth & Primary Care, NL-6200 MD Maastricht, Netherlands. [Geusens, Piet P. M. M.] Maastricht Univ, Dept Internal Med, CAPHRI Sch Publ Hlth & Primary Care, Subdiv Rheumatol, NL-6200 MD Maastricht, Netherlands. [Geusens, Piet P. M. M.] Univ Hasselt, Biomed Res Ctr, B-3590 Diepenbeek, Belgium. [van den Bergh, Joop P. W.] Maastricht Univ, Med Ctr, Dept Internal Med, Sch Nutr Toxicol & Metab, NL-6200 MD Maastricht, Netherlands. s.bours@mumc.nl
URI: http://hdl.handle.net/1942/11963
DOI: 10.1210/jc.2010-2135
ISI #: 000290210600038
ISSN: 0021-972X
Category: A1
Type: Journal Contribution
Validation: ecoom, 2012
Appears in Collections: Research publications

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