Extremely high risk of further fractures in osteoporosis sufferers

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 (Image: Pixabay CC0)
(Image: Pixabay CC0)

Bone fractures due to osteoporosis are a major risk for the elderly. It is therefore all the more important to identify people at risk. An international team of authors with the participation of scientists from Med Uni Graz has analyzed how high the risk is of suffering a second bone fracture after the first: The risk is almost 90 percent higher.

Scientists from more than one hundred institutions collaborated on the meta-analysis, which has now been published in "Osteoporosis International". The first author is John Kanis from the University of Sheffield, and Barbara Obermayer-Pietsch from the Clinical Department of Endocrinology and Diabetology at Med Uni Graz was also a co-author. The scientists used primary data of patients from 64 databases practically worldwide.

"We examined data from 665,971 men and from 1,438,535 million women from 32 countries. The observation period was 19.5 million person-years," the scientists* wrote. The study was intended to provide information for the future use of the so-called Frax score. This is a tool for determining risk, especially for osteoporosis-related bone fractures. Information entered includes age, sex, any fractures in the parents’ generation, bone density, medications (e.g. cortisone), diet (e.g. also alcohol consumption), smoking, etc. The algorithm leads to a calculation of the risk of osteoporosis-related fractures. The algorithm leads to the calculation of a fracture risk for the next ten years.

In the current study, one of the most important parameters of Frax was to be better determined in terms of its value: fractures already suffered. The results indicate a very high significance of fractures that have already occurred. According to the authors, "A previous bone fracture carried a significantly increased risk of clinically prominent fractures (increased by a factor of 1.88) compared with no such event." The risk for any osteoporosis-related fracture was increased by a factor of 1.87, and for a significant osteoporotic fracture (hip/femoral neck, vertebra, forearm, note) by 83 percent. Hip fracture occurred more frequently by a factor of 1.82.

Many more women than men suffer from osteoporosis. In the study, this was irrelevant to the further risk of those affected. "There was no significant difference in this risk ratio between men and women," the scientific paper states. For these people at extremely high risk for further such problems, bone density apparently matters little. "Low bone density explained only a small proportion of further fractures overall (17 percent) and hip fractures (33 percent)." In any case, he said, the findings could be used to more accurately determine patients’ individual risk in the future. In Austria, around 14,000 people suffer femoral neck fractures every year.

Text reference: SALZBURGER NACHRICHTEN ONLINE from 17.08.2023

Barbara Obermayer-Pietsch Clinical Department of Endocrinology and Diabetology To the article in SALZBURGER NACHRICHTEN