Impact of Risedronate on Bone Mineral Density and Quality of Life in Postmenopausal Women with Osteoporosis: The Results of 1-Year Follow up

Our objective was to assess the impact of treatment with risedronate on the bone mineral density and quality of life in the women who had postmenopausal osteoporosis (PMO). Sixty-five patients with PMO were included in the study. Forty-five of them were selected randomly, and constituted the study group while the remaining 20 served as control. Forty-five patients comprising the study group were treated with 5 mg risedronate and 1000 mg calcium for 1 year while 20 control patients were treated only with 1000 mg calcium. The quality of life of the patients was evaluated with Notthingham Health Profile (NHP) scale both at the beginning and at the end of the study. Bone mineral densities were measured in the vertebral and femoral regions using DEXA at the beginning, and at 6th and 12th months of the treatment. The results of patients and controls were not different significantly after 6 months follow up (p>0.05). At the end of 1 year follow up, the bone mineral density of the treatment group increased significantly while it decreased significantly in the controls (p<0.05). Quality of life increased significantly in the treatment group (p0.05). The parameters related to the limitation of physical activity did not change significantly in the treatment group (p>0.05). In conclusion, by increasing the bone mineral density, risedronate increases the quality of bone, decreases the risk of fracture and pain, and positively effects the quality of life

Association of Obesity with Forearm Fractures, Bone Mineral Density and Fracture Risk (FRAX®) During Postmenopausal Period

Objective: The aim of this study was to investigate the association among obesity with bone mineral density (BMD) and subsequent fracture risk among postmenopausal women with a previous forearm fracture. Materials and Methods: The study enrolled obese (n=40) and normal-weight (n=40) postmenopausal women who had a previous forearm fracture. BMD measurements were obtained using a GE-LUNAR DPX dual energy X-ray absorptiometry scan for all subjects. FRAX® fracture risk scores were calculated taking into account former fractures and current risk factors of the subjects. Both groups were compared with respect to their BMD values, T scores, FRAX® risk scores and frequency of previous fractures. Results: No difference was observed between groups with regard to mean age, mean age of menopause onset and mean serum calcium, phosphorus and alkaline phosphatase levels (p>0.05 for all). Statistically, obese patients showed highly significantly greater mean BMD values at lumbar spine (L1-L4) and femoral neck in comparison to subjects with normal body weight (p=0.000 for all). Obese patients had a lower 10-year probability of a major osteoporotic fracture on average as determined by FRAX® fracture risk score compared to that in normal-weight subjects (p<0.05). Also, obese group had a lower 10-year probability of a hip fracture versus normal-weight subjects (p<0.01). Both groups were found to have a similar frequency of previous fractures. Conclusion: Although obese patients in this study had greater BMD values and lower FRAX® risk scores, the probability of subsequent fractures predicted for the obese group was not lower when compared to that predicted for normal-weight group. It should be kept in mind that obesity may not necessarily be protective against fractures and treatment algorithms based solely on BMD might be inadequate to predict future fracture risk

Effect of Patient Follow-Up System on the Treatment Compliance of Osteoporotic Patients and on Quality of Life

Objective: Osteoporosis is a chronic disease that can take a long time to treat and is an important public health issue since it increases the risk of fractures and it has negative effects on quality of life with its social, psychological, economic and physical dimensions. It was aimed to evaluate the effect of patient follow-up program on drug compliance and quality of life. Materials and Methods: This study included 233 patients diagnosed with osteoporosis and the study was continued with 200 patients (173 females with postmenopausal osteoporosis, 27 males with senile osteoporosis). Patients were divided into 3 groups as daily, weekly and monthly follow-up groups. Patients were called by telephone with the help of patient follow-up program. Monthly Medication Possession Ratio (MPR) was calculated. Qualeffo-41 quality of life data were assessed at baseline, at the 3rd and 6th months. Results: From the baseline within 6 months, MPR levels were significantly increased in all groups (p<0.05). Monthly follow-up group was found the most compatible group compared to others. Significant changes in quality of life were observed (p<0.05). Conclusions: Dose intervals, especially long dose interval regimens and patient drug reminder programs are highly effective on compliance and quality of life would be better as the compliance increases. It should be bear in mind that if treatment incompliance occurs it may lead to medical harms and economical losses. (Turkish Journal of Osteoporosis 2014;20: 46-50

Investigating Correlation between Type I collagen N-Telopeptides X, Morphologic Parameters of Vertebra and DEXA values of the Patients with Postmenopausal Osteoporosis

Osteoporosis is the most often seen skeletal disease that is an important public health problem. Type I collagen N-Telopeptides (NTx) is described as the specific marker of bone resorption. Its urinary level increases during the menopausal period. In our study, 50 female patients were included. Their mean age was 64.7±2.7 years and ranges between 45-69. Their mean menopause duration was 15.4±3.1 years. The control group was established with 30 female patients. Their mean age and ranges were 63.9±2.1years and 44-68 respectively. Their mean menopause duration was 14.1±2.5 years. The difference level of urinary NTx was found to be significant between patients and control group. Significant differences were found between the vertebra morphologic parameters of the patients and control group. In addition, correlation was determined between level of urinary NTx and lomber DEXA (T) values. In conclusion, significant correlations were found to exist between the level of urinary NTx, vertebra morphologic parameters and DEXA values

Investigating correlation between type I collagen N-telopeptides X, morphologic parameters of vertebra and DEXA values of the patients with postmenopausal osteoporosis

Osteoporoz en sık görülen iskelet sistemi hastalığı olup, önemli bir halk sağlığı problemidir. Tip l kollajen telopeptidler (NTx) kemiğin osteoklastlarca gerçekleştirilen yıkımının spesifik göstergesi olarak tanımlanmış ve NTx'in idrar düzeyinin menopoz döneminde arttığı gösterilmiştir. Çalışmamıza 50 kadın alındı. Çalışmada olguların yaş ortalaması 64.7±2.7 yıl, yaş aralığı ise 45-69 olarak saptandı. Olguların menopoz ortalama süresi 15.4 ± 3.1 yıl olarak saptandı. 30 kadın olgu da kontrol grubu olarak alındı. Kontrol grubunda yaş ortalaması 63.9 ± 2.1 yıl, yaş aralığı ise 44- 68 olarak saptandı. Kontrol grubunda menopoz ortalama süresi 14.1 ±2.5 yıl olduğu bulundu. Olgu ve kontrol grupları arasında NTx düzeyleri arasındaki farkın anlamlı olduğu saptandı (p<0.001). Olgu ve kontrol grubunun vertebra morfolojik parametreleri arasında anlamlı farklar olduğu saptandı. Olgu grubunda L1 ve L2 DEXA (T) değeri ile NTx idrar düzeyi arasında korelasyonların varlığı görüldü. Sonuç olarak NTx idrar düzeyi ile vertebra morfolojik parametreleri ve DEXA değerleri arasında anlamlı korelasyonların olduğu düşünülmektedir.Osteoporosis is the most often seen skeletal disease that is an important public health problem. Type I collagen N-Telopeptides (NTx) is described as the specific marker of bone r&eacute;sorption. Its urinary level increases during the menopausal period. In our study, 50 female patients were included. Their mean age was 64.7+2.7 years and ranges between 45-69. Their mean menopause duration was 15.4&plusmn;3.1 years. The control group was established with 30 female patients. Their mean age and ranges were 63.9&plusmn;2.1 years and 4468 respectively. Their mean menopause duration was 14.1+2.5 years. The difference level of urinary NTx was found to be significant between patients and control group. Significant differences were found between the vertebra morphologic parameters of the patients and control group. In addition, correlation was determined between level of urinary NTx and lomber DEXA (T) values. In conclusion, significant correlations were found to exist between the level of urinary NTx, vertebra morphologic parameters and DEXA values

Investigation of the Association Between Bone Mineral Density and Predisposing Factors in Osteoporotic Postmenopausal Women in a Sample of Patients From Gaziantep and Trabzon

Our objective was to investigate the association between the bone mineral density and risk factors predisposing to osteoporosis as well as impact of regional factors on bone mineral density by comparing the data obtained from patients who lived in Gaziantep (a province in the south east of this country) and Trabzon (a province in the north east of this country). Included in the study were 318 patients, of whom 162 were from Gaziantep and 156 from Trabzon. Bone mineral density of the patients was measured with DEXA, and those who had a t score below (-2.0) SD on bone mineral density measurement in the back and hip regions were included in the study. An osteoporosis follow up questionnaire that was modified from MEDOS study questionnaire was filled. The patients who lived in Gaziantep were fatter than those who lived in Trabzon (p0.05). The bone mineral density (L2-4 femur (total) and Wards triangle) of the patients who lived in Trabzon was significantly lower than in Gaziantep (p<0.001). There was no statitical difference between the two groups regarding hair color, coffee and dressing habits, daily milk consumption, history of maternal milk ingestion, and alcohol and cigarette abuse (p>0.05). White skin color and high tea consumption were more common in the second group (p<0.001). Some parameters like dark or wheat skin and black eye color, birth and abortion rate, and sun bathing habis were more common in the first group (p<0.001). In conclusion, fist and cost effective option to estimate whether the patient carries a high risk is to evaluate the place where the patient lives as well the habits and traditions. The proceeding bone mineral density measurement will help to diagnose the disease. We believe that this approach will help not only for early diagnosis of osteoporosis but also useful economically

High-Dose Steroid-Induced Protrusio Acetabuli: A Case Report

The aim of presenting this case was to demonstrate that using high doses of corticosteroids which are not directly involved in etiological factors can cause secondary protrusio acetabuli. Protrusio acetabuli is identified with an acetabular line projecting ilioischial line for 3 mm in males and 6 mm in females on antero-posterior radiographs of the pelvis. This is the first case seen in the literature, despite various studies conducted about the etiology, no common factor was found. In 1939, Gilmour classified them as following; the group, in which any underlying pathology can not be shown as primary, and the group that progress protrusio as a result of any underlying pathology as secondary. The patient was a 73 year-old woman with pain, loss of ROM in right hip and difficulty in walking for 2 years. Four years ago with a diagnosis of eosinophilic pneumonia she received prednisolone (1 mg/kg/day). She was constantly using salmeterol+fluticasone (500/50 mcg)) twice daily. Bone mineral density and other laboratory findings were normal. The cause of the patient's right hip pain was associated to the acetabular protrusion which progressed rapidly within two years due to use of steroid and osteoarthritis progressing secondarily to acetabular protrusion. To the best of our knowledge this case is seen in the literature for the first time. It should not be disregarded that such patients may show clinical progression in a short time. Therefore, drug history of the patients with hip pain should be evaluated in detail and treatments should be determined accordingly