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|Title: ||Secondary osteoporosis in patients with a recent clinical fracture.|
|Authors: ||Dumitrescu, B|
von Helden, S
van der Linden, S
|Issue Date: ||2006|
|Publisher: ||AMER SOC BONE & MINERAL RES|
|Citation: ||JOURNAL OF BONE AND MINERAL RESEARCH, 21. p. S404-S405|
|Abstract: ||Osteoporosis is a multifactorial metabolic bone disease that results in fragility fractures
with significant morbidity, mortality, health and social costs.
We investigated the fracture, fall risk profile and causes of secondary osteoporosis in
patients with a recent clinical fracture.
All women and men, older than 50 years who presented to the hospital with a fracture were
offered fracture and fall risk evaluation according to the Dutch guidelines, including bone
densitometry by dual X-ray absorptiometry (DXA). Patients with aT-score <-2.5 in the hip
and/or spine were further investigated for secondary osteoporosis. This included a set of
laboratory tests performed in all (ESR, hemoglobin, leucocytes, creatinine, calcium in
serum and 24-hours urine, alkaline phosphatase, phosphate, 25(OH) vitamin D, TSH) and
other tests when appropriate. In addition. morphometry of the vertebrae was performed
using DXA (anterior, mid or posterior height loss of>20%).
We evaluated 72 consecutive and consenting patients with aT-score <-2.5, 57 women
(79%) and 15 men (21%) mean age of69 years. 37 (51%) had secondary osteoporosis or
other associated diseases. Thirty patients (42%) had undiagnosed vitamin D deficiency
(0":50 nmol/I), 21 (29%) had endocrine diseases (10 known thyroid pathologies, 5
undiagnosed hyperparathyroidism(PTH>5,5 pmol/l), 2 men with unknown hypogonadism
(testosterone <9.4nmol/I), 8 (11%) had renal insufficiency (creatinine clearance <40ml/
min», 4 (6%) had inflammatory rheumatic diseases and 3 (4%) had alcohol abuse.
Thirty (42%) patients reported a history of non-vertebral fracture and one a history of a
clinical vertebral fracture. On morphometry 40(56%) patients had a prevalent vertebral
fracture. There were 35 patients with clinical fracture risks (49%), but 52 (72%) when
morphometry was included, 61 had fall risks (85%) and 60% had both fracture and fall
Secondary osteoporosis is frequent in patients entering the hospital with a recent clinical
fracture and aT-score <-2.5. More than half had previously undiagnosed vertebral
fractures. Several causes were undiagnosed and correctable and/or preventable such as vitamin D deficiency and endocrine diseases. These results suggest that patients with a
recent clinical fracture and osteoporosis deserve targeted evaluation, including the
detection of undiagnosed vertebral fractures.|
|Notes: ||Clin hosp, Bucharest, Romania. Univ Hasselt Belgium, Acad Hosp, Maastricht, Netherlands.|
|ISI #: ||000240866303240|
|Type: ||Journal Contribution|
|Appears in Collections: ||Research publications|
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