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      Clinical Interventions in Aging (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on prevention and treatment of diseases in people over 65 years of age. Sign up for email alerts here.

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      Dorsal and ventral thoracic 12 vertebra body height is associated with incident lumbar vertebral fracture in postmenopausal osteoporotic women

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          Abstract

          Purpose

          We measured dorsal and ventral thoracic 12 vertebral (T12V) body heights as a way to predict lumbar vertebral fracture (LVF) in postmenopausal women. MRI of dorsal and ventral T12V body heights has not yet been used to investigate their association with LVF. We hypothesized that the dorsal and ventral T12V body height are important morphologic parameters in the prediction of LVF.

          Patients and methods

          In total, 80 osteoporotic patients with LVF (LVF group) and 80 osteoporotic patients without LVF (control group) were examined by MRI at the lumbothoracic level. Sagittal T2-weighted MRI images in the T12 level were obtained from all subjects. We analyzed both the dorsal and ventral T12V body height. The difference in dorsal and ventral body heights of the control and LVF patients was calculated at the T12V level.

          Results

          The average dorsal T12V body height was 21.25±1.64 mm in the control group and 20.11±1.49 mm in the LVF group. The average ventral T12V body heights were 19.51±1.54 mm and 17.62±1.95 mm, respectively. The LVF group had significantly lower dorsal and ventral T12V body heights (both P<0.001). ROC curve analysis showed the best cut-off value for dorsal T12V body height value of 20.74 mm, with 62.5% sensitivity and 60.0% specificity. The best cut-off point of ventral T12V body height was 18.76 mm, with 68.8% sensitivity and 67.5% specificity.

          Conclusion

          This study confirmed the association between dorsal and ventral T12V body height and occurrence of LVF in postmenopausal women with osteoporosis. Dorsal and ventral T12V body height were both significantly associated with LVF, with ventral T12V body height being a more sensitive measurement parameter. Thus, to predict risk of LVF in patients, the treating physician should carefully inspect the ventral T12V body height.

          Most cited references42

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          Osteoporosis: A Review of Treatment Options.

          Approximately 10 million men and women in the U.S. have osteoporosis,1 a metabolic bone disease characterized by low bone density and deterioration of bone architecture that increase the risk of fractures.2 Osteoporosis-related fractures can increase pain, disability, nursing home placement, total health care costs, and mortality.3 The diagnosis of osteoporosis is primarily determined by measuring bone mineral density (BMD) using noninvasive dual-energy x-ray absorptiometry. Osteoporosis medications include bisphosphonates, receptor activator of nuclear factor kappa-B ligand inhibitors, estrogen agonists/antagonists, parathyroid hormone analogues, and calcitonin.3-6 Emerging therapies utilizing novel mechanisms include a cathepsin K inhibitor and a monoclonal antibody against sclerostin.7,8 While professional organizations have compiled recommendations for the management of osteoporosis in various populations, a consensus has yet to develop as to which is the gold standard; therefore, economic evaluations have been increasingly important to help guide decision-makers. A review of cost-effectiveness literature on the efficacy of oral bisphosphonates has shown alendronate and risedronate to be most cost-effective in women with low BMD without previous fractures.9 Guidelines are inconsistent as to the place in therapy of denosumab (Prolia, Amgen). In economic analyses evaluating treatment of postmenopausal women, denosumab outperformed risedronate and ibandronate; its efficacy was comparable to generic alendronate, but it cost more.10 With regard to older men with osteoporosis, denosumab was also found to be cost-effective when compared with bisphosphonates and teriparatide (Forteo, Lilly).11.
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            Long-term risk of osteoporotic fracture in Malmö.

            The objectives of the present study were to estimate long-term risks of osteoporotic fractures. The incidence of hip, distal forearm, proximal humerus and vertebral fracture were obtained from patient records in Malmö, Sweden. Vertebral fractures were confined to those coming to clinical attention, either as an inpatient or an outpatient case. Patient records were examined to exclude individuals with prior fractures at the same site. Future mortality rates were computed for each year of age from Poisson models using the Swedish Patient Register and the Statistical Year Book. The incidence and lifetime risk of any fracture were determined from the proportion of individuals fracture-free from the age of 45 years. Lifetime risk of shoulder, forearm, hip and spine fracture were 13.3%, 21.5%, 23.3% and 15.4% respectively in women at the age of 45 years. Corresponding values for men at the age of 45 years were 4.4%, 5.2%, 11.2% and 8.6%. The risk of any of these fractures was 47.3% and 23.8% in women and men respectively. Remaining lifetime risk was stable with age for hip fracture, but decreased by 20-30% by the age of 70 years in the case of other fractures. Ten and 15 year risks for all types of fractures increased with age until the age of 80 years, when they approached lifetime risks because of the competing probabilities of fracture and death. We conclude that fractures of the hip and spine carry higher risks than fractures at other sites, and that lifetime risks of fracture of the hip in particular have been underestimated.
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              Postmenopausal Osteoporosis: A Clinical Review

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                Author and article information

                Journal
                Clin Interv Aging
                Clin Interv Aging
                Clinical Interventions in Aging
                Clinical Interventions in Aging
                Dove Medical Press
                1176-9092
                1178-1998
                2019
                15 February 2019
                : 14
                : 375-380
                Affiliations
                [1 ]Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
                [2 ]Department of Anesthesiology and Pain Medicine, National Police Hospital, Seoul, Korea
                [3 ]Department of Anesthesiology and Pain Medicine, Catholic Kwandong University, College of Medicine, International St. Mary’s Hospital, Incheon, Korea, uk201@ 123456hanmail.net
                Author notes
                Correspondence: Young Uk Kim, Department of Anesthesiology and Pain Medicine, Catholic Kwandong University, College of Medicine, International St. Mary’s Hospital, Simgokro 100 Gil 25, Seo-gu, Incheon, Korea, Tel +82 10 3243 6643, Fax +82 32 290 3568, Email uk201@ 123456hanmail.net
                Article
                cia-14-375
                10.2147/CIA.S199402
                6388793
                47419dc3-631a-4290-83c6-5fe803ad43ff
                © 2019 Bang et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Health & Social care
                lumbar vertebral fracture,osteoporosis,vertebral body,dorsal,ventral,height
                Health & Social care
                lumbar vertebral fracture, osteoporosis, vertebral body, dorsal, ventral, height

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