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Epidemiology and diagnosis of postmenopausal osteoporosis

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Atlas of Postmenopausal Osteoporosis

Abstract

Postmenopausal osteoporosis is a common, debilitating disease. The lifetime risk of any fracture occurring in women from the age of 50 years is more than 40% (Figure 2.1) [Kanis et al. 2000]. The lifetime risk of a hip fracture in women is greater than the combined lifetime risks of breast, endometrial, and ovarian cancers. Postmenopausal osteoporosis is also likely to become more common in the decades ahead as the life expectancy of the population increases. The personal and economic burden of postmenopausal osteoporosis results from osteoporotic fractures, which are a significant public health problem, resulting in substantial morbidity and mortality. In the US alone, it has been estimated that around 2 million osteoporotic fractures occur each year. In Europe, it is estimated that more than 30% of women aged 50 years or older have osteoporosis as defined by the World Health Organization (WHO) criteria, with lifetime fracture incidence rates in these women of 14%, 11%, and 13% for hip, vertebral, and distal forearm, respectively [Dennison & Cooper, 2000]. The number of osteoporotic fractures in Europe in 2000 was estimated at 3.79 million [Kanis & Johnell, 2005]. Osteoporosis can develop undetected until a fracture occurs. Any bone can be affected, but fractures of the hip and spine are of special concern; hip fractures because they nearly always result in hospitalization and major surgery, leading to impaired mobility that can be prolonged or permanent, and may even result in death, while vertebral fractures can lead to loss of height, severe back pain and deformity and are also associated with increased mortality.

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References

  • Center JR, Nguyen TV, Schneider D et al. Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 1999; 353:878–82.

    Article  PubMed  CAS  Google Scholar 

  • Compston J. Skeletal effects of drugs. In: Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. 7th edition, Edited by CJ Rosen. Durham NC: American Society for Bome Mineral and Research, 2008; 293–7.

    Chapter  Google Scholar 

  • Cooper C. The crippling consequences of fractures and their impact on quality of life. Am J Med 1997; 103:12S–17S.

    Article  PubMed  CAS  Google Scholar 

  • Cooper C, Atkinson EJ, Jacobsen SJ et al. Population-based study of survival after osteoporotic fractures. Am J Epidemiol 1993; 137:1000–5.

    Google Scholar 

  • Cooper C, Melton LJ 3rd. Epidemiology of osteoporosis. Trends Endocrinol Metab 1992; 3:224–9.

    Article  PubMed  CAS  Google Scholar 

  • Cui LH, Choi JS, Shin MH et al. Prevalence of osteoporosis and reference data for lumbar spine and hip bone mineral density in a Korean population J Bone Mineral Metab, 2008; 26:609–17.

    Article  Google Scholar 

  • Cummings SR, Melton LJ 3rd. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002; 359:1761–7.

    Article  PubMed  Google Scholar 

  • Cummings SR, Nevitt MC, Browner WS et al. Risk factors for hip fracture in white women. N Engl J Med 1995; 332:767–73.

    Article  PubMed  CAS  Google Scholar 

  • Dargent-Molina P, Douchin MN, Corer C et al. Use of clinical risk factors in elderly women with low bone mineral density to identify women at higher risk of hip fracture: the EPIDOS prospective study. Osteoporos Int 2002; 13:595–9.

    Article  Google Scholar 

  • De Laet CE, Pols HA. Fractures in the elderly: epidemiology and demography. Baillieres Best Pract Res Clin Endocrinol Metab 2000; 14:171–9.

    Article  PubMed  Google Scholar 

  • Dennison E, Cooper C. Epidemiology of osteoporotic fractures. Horm Res 2000; 54(Suppl 1):58–63.

    PubMed  CAS  Google Scholar 

  • Fujiwara S, Nakamura T, Orimo H et al. Development and application of a Japanese model of the WHO fracture risk assessment tool (FRAXTM). Osteoporos Int 2008; 19:429–35.

    Article  PubMed  CAS  Google Scholar 

  • Garton MJ, Robertson EM, Gilbert FJ et al. Can radiologists detect osteopenia on plain radiographs? Clin Radiol 1994; 49:118–22.

    Article  PubMed  CAS  Google Scholar 

  • Genant HK, Cann CE, Ettinger B et al. Qualitative computed tomography of vertebral spongiosa: A sensitive method for detecting early bone loss after oophorectomy. Ann Intern Med 1982; 97:699–705.

    Article  PubMed  CAS  Google Scholar 

  • Genant HK, Engelke K, Fuerst T et al. Noninvasive assessment of bone mineral and structure: state of the art. J Bone Miner Res 1996; 11:707–30.

    Article  PubMed  CAS  Google Scholar 

  • Genant HK, Jergas M. Assessment of prevalent and incident vertebral fractures in osteoporosis research. Osteoporos Int 2003; 14(Suppl 3):S43–S55.

    PubMed  Google Scholar 

  • Genant HK, Siris E, Crans GG et al. Reduction in vertebral fracture risk in teriparatide-treated postmenopausal women as assessed by spinal deformity index. Bone 2005; 37:170–4.

    Article  PubMed  CAS  Google Scholar 

  • Genant HK, Wu CY, van Kuijk C et al. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 1993; 8:1137–48.

    Article  PubMed  CAS  Google Scholar 

  • Glüer CC, Hans D. How to use ultrasound for risk assessment: a need for defining strategies. Osteoporos Int 1999; 9:193–5.

    Article  PubMed  Google Scholar 

  • Greenspan SL, Myers ER, Maitland LA et al. Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. JAMA 1994; 271:128–33.

    Article  PubMed  CAS  Google Scholar 

  • Jiang G, Ferrar L, Barrington N et al. Standardised quantitative morphometry: a modified approach for quantitative identification of prevalent vertebral deformities Osteoporosis Int 2007; 18: 1411–9.

    Article  CAS  Google Scholar 

  • Johnell O, Oden A, De Laet C et al. Biochemical indices of bone turnover and the assessment of fracture probability. Osteoporos Int 2002; 13:523–6.

    Article  PubMed  CAS  Google Scholar 

  • Kanis A, Johnell O, Oden A et al. FRAXTM and the assessment of fracture probability in men and women from the UK. Osteoporos Int 2008a; 19:385–397.

    Article  PubMed  CAS  Google Scholar 

  • Kanis J, Johnell O. Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 2005; 16:229–38.

    Article  PubMed  CAS  Google Scholar 

  • Kanis J, Johansson H, Johnell O et al. Alcohol intake as a risk factor for fracture. Osteoporos Int 2005a; 16:737–2.

    Article  PubMed  Google Scholar 

  • Kanis J, Johnell O, Oden A. Smoking and fracture risk: a metaanalysis. Osteoporos Int 2005b; 16:155–62.

    Article  PubMed  CAS  Google Scholar 

  • Kanis JA, Borgstrom F, De Laet C et al. Assessment of fracture risk. Osteoporos Int 2005c; 16:581–9.

    Article  PubMed  Google Scholar 

  • Kanis JA, Johnell O, Oden A et al. Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int 2001; 12:989–95.

    Article  PubMed  CAS  Google Scholar 

  • Kanis JA, Johnell O, Oden A et al. Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 2000; 11:669–74.

    Article  PubMed  CAS  Google Scholar 

  • Klotzbuecher CM, Ross PD, Landsman PB et al. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 2000; 15:721–39.

    Article  PubMed  CAS  Google Scholar 

  • Lau EM. Epidemiology of osteoporosis. Best Pract Res Clin Rheumatol 2001; 15:335–44.

    Article  PubMed  CAS  Google Scholar 

  • Lindsay R, Silverman SL, Cooper C et al. Risk of new vertebral fracture in the year following a fracture. JAMA 2001; 285:320–3.

    Article  PubMed  CAS  Google Scholar 

  • Marottoli RA, Berkman LF, Cooney LM Jr. Decline in physical function following hip fracture. J Am Geriatr Soc 1992; 40:861–6.

    PubMed  CAS  Google Scholar 

  • Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 1996; 312:1254–9.

    Article  PubMed  CAS  Google Scholar 

  • Melton LJ 3rd. How many women have osteoporosis now? J Bone Miner Res 1995; 10:175–7.

    Article  PubMed  Google Scholar 

  • National Osteoporosis Foundation. 1996 and 2015 Osteoporosis Prevalence Figures: State-by-State Report. Washington, DC: National Osteoporosis Foundation; 1997.

    Google Scholar 

  • National Osteoporosis Society. Position Statement on the Reporting of Dual Energy X-ray Absorptiometry (DXA) Bone Mineral Density Scans. London: National Osteoporosis Society; 2002a.

    Google Scholar 

  • National Osteoporosis Society. Primary Care Strategy for Osteoporosis and Falls. London: National Osteoporosis Society; 2002.

    Google Scholar 

  • Nevitt MC, Cummings SR. Type of fall and risk of hip and wrist fractures: the Study of Osteoporotic Fractures. J Am Geriatr Soc 1993; 41:1226–34.

    PubMed  CAS  Google Scholar 

  • O’Neill TW, Felsenberg D, Varlow J et al. The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 1996; 11:1010–8.

    Article  CAS  Google Scholar 

  • Papaioannou A, Watts NB, Kendler DL et al. Diagnosis and management of vertebral fractures in elderly adults. Am J Med 2002; 113:220–8.

    Article  PubMed  Google Scholar 

  • Ray NF, Chan JK, Thamer M et al. Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res 1997; 12:24–35.

    Article  PubMed  CAS  Google Scholar 

  • Ross PD. Clinical consequences of vertebral fractures. Am J Med 1997; 103(Suppl 2A):30S–42S.

    Article  PubMed  CAS  Google Scholar 

  • Schlaich C, Minnie HW, Bruckner T et al. Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 1998; 8:261–7.

    Article  PubMed  CAS  Google Scholar 

  • Siris ES, Miller PD, Barrett-Connor E et al. Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 2001; 286:2815–22.

    Article  PubMed  CAS  Google Scholar 

  • Torgerson DJ, Campbell MK, Thomas RE et al. Prediction of perimenopausal fractures by bone mineral density and other risks factors. J Bone Miner Res 1996; 11:293–7.

    Article  PubMed  CAS  Google Scholar 

  • Wainwright SA, Marshall LM, Ensrud KE et al. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab 2005; 90:2787–93.

    Article  PubMed  CAS  Google Scholar 

  • Wei TS, Hu CH, Wang SH et al. Fall characteristics, functional mobility and bone mineral density as risk factors of hip fracture in the community-dwelling ambulatory elderly. Osteoporos Int 2001; 12:1050–5.

    Article  PubMed  CAS  Google Scholar 

  • World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Tech Report Series 1994; 843:1–129.

    Google Scholar 

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Compston, J., Genant, H. (2010). Epidemiology and diagnosis of postmenopausal osteoporosis. In: Rizzoli, R. (eds) Atlas of Postmenopausal Osteoporosis. Springer Healthcare, Tarporley. https://doi.org/10.1007/978-1-907673-28-3_2

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  • DOI: https://doi.org/10.1007/978-1-907673-28-3_2

  • Publisher Name: Springer Healthcare, Tarporley

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