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SUN-388 Role of QUS and Functional Tests in Evaluating Fracture Risk Based on Frax Tool
Background: Osteoporosis is common among elderly people, and identifying those at high risk for fracture is very important. Aim: To evaluate whether the use of quantitative calcaneal ultrasound (QUS), the Sitting–rising test (SRT) and handgrip test (HT) are additional tools for tracking fragility fr...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7208261/ http://dx.doi.org/10.1210/jendso/bvaa046.1493 |
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author | Gama, Eduardo Medeiros Ferreira de Pinho, Leandro Kasuki Jomori Madeira, Miguel Duarte, Carlos Pessoa, Girlene Canhete Moraes, Aline Barbosa Amaral, Maria Caroline Alves Coelho Neto, Francisco Paula Paranhos de Farias, Maria Lucia Fleiuss |
author_facet | Gama, Eduardo Medeiros Ferreira de Pinho, Leandro Kasuki Jomori Madeira, Miguel Duarte, Carlos Pessoa, Girlene Canhete Moraes, Aline Barbosa Amaral, Maria Caroline Alves Coelho Neto, Francisco Paula Paranhos de Farias, Maria Lucia Fleiuss |
author_sort | Gama, Eduardo Medeiros Ferreira |
collection | PubMed |
description | Background: Osteoporosis is common among elderly people, and identifying those at high risk for fracture is very important. Aim: To evaluate whether the use of quantitative calcaneal ultrasound (QUS), the Sitting–rising test (SRT) and handgrip test (HT) are additional tools for tracking fragility fracture risk when compared to FRAX and NOGG. Methods: During the national campaign against osteoporosis, held in 2018 in Rio de Janeiro, participants were randomly selected to perform QUS, SRT and HT, besides categorization of the risk of major and hip fractures by FRAX and NOGG. The following adequacy values were used: QUS T-score> -1.05 (adequate) or ≤ -1.05 (inadequate); Sitting – rising test (SRT) (composite score): age-reference values at quartiles 3 and 4 (adequate); quartiles 1 and 2 (inadequate); best result 3 attempts of the dominant arm handgrip test, according to age and gender: percentile ≥50 (adequate) and <50 (inadequate); FRAX tool: suggests high risk for major osteoporotic fractures if > 20% and for hip fractures when > 3%; NOGG (complement to FRAX): patient′s risk for major and for hip fractures considered as low (green zone), medium (yellow zone) or high (red zone). Qui square test was used for associations. Results: We included 162 individuals: 118 females, mean age 66.8 years and 44 males, mean age 71.8 years. High risk of hip fractures by FRAX was observed in 51% of those patients with a QUS T-score ≤-1.05 while it was observed in 28% of those with a QUS T-score> -1.05 (p=0.005). An inadequate QUS T-score was also associated with a higher risk of hip fracture by NOGG (p=0.007). An inadequate SRT and HT were not associated with a high fracture risk. Conclusions: As densitometry, a method established in clinical practice for the diagnosis of osteoporosis, has limitations in its use, other tools are necessary for tracking the risk of fragility fractures in these events. Quantitative calcaneal ultrasound was a good predictor of hip fracture risk, while SRT and HT were not capable of evaluate for fracture risk stratification in our study, reinforcing the need for QUS for screening in large populations. Having strength and functional ability did not eliminate the need for investigation. |
format | Online Article Text |
id | pubmed-7208261 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-72082612020-05-13 SUN-388 Role of QUS and Functional Tests in Evaluating Fracture Risk Based on Frax Tool Gama, Eduardo Medeiros Ferreira de Pinho, Leandro Kasuki Jomori Madeira, Miguel Duarte, Carlos Pessoa, Girlene Canhete Moraes, Aline Barbosa Amaral, Maria Caroline Alves Coelho Neto, Francisco Paula Paranhos de Farias, Maria Lucia Fleiuss J Endocr Soc Bone and Mineral Metabolism Background: Osteoporosis is common among elderly people, and identifying those at high risk for fracture is very important. Aim: To evaluate whether the use of quantitative calcaneal ultrasound (QUS), the Sitting–rising test (SRT) and handgrip test (HT) are additional tools for tracking fragility fracture risk when compared to FRAX and NOGG. Methods: During the national campaign against osteoporosis, held in 2018 in Rio de Janeiro, participants were randomly selected to perform QUS, SRT and HT, besides categorization of the risk of major and hip fractures by FRAX and NOGG. The following adequacy values were used: QUS T-score> -1.05 (adequate) or ≤ -1.05 (inadequate); Sitting – rising test (SRT) (composite score): age-reference values at quartiles 3 and 4 (adequate); quartiles 1 and 2 (inadequate); best result 3 attempts of the dominant arm handgrip test, according to age and gender: percentile ≥50 (adequate) and <50 (inadequate); FRAX tool: suggests high risk for major osteoporotic fractures if > 20% and for hip fractures when > 3%; NOGG (complement to FRAX): patient′s risk for major and for hip fractures considered as low (green zone), medium (yellow zone) or high (red zone). Qui square test was used for associations. Results: We included 162 individuals: 118 females, mean age 66.8 years and 44 males, mean age 71.8 years. High risk of hip fractures by FRAX was observed in 51% of those patients with a QUS T-score ≤-1.05 while it was observed in 28% of those with a QUS T-score> -1.05 (p=0.005). An inadequate QUS T-score was also associated with a higher risk of hip fracture by NOGG (p=0.007). An inadequate SRT and HT were not associated with a high fracture risk. Conclusions: As densitometry, a method established in clinical practice for the diagnosis of osteoporosis, has limitations in its use, other tools are necessary for tracking the risk of fragility fractures in these events. Quantitative calcaneal ultrasound was a good predictor of hip fracture risk, while SRT and HT were not capable of evaluate for fracture risk stratification in our study, reinforcing the need for QUS for screening in large populations. Having strength and functional ability did not eliminate the need for investigation. Oxford University Press 2020-05-08 /pmc/articles/PMC7208261/ http://dx.doi.org/10.1210/jendso/bvaa046.1493 Text en © Endocrine Society 2020. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Bone and Mineral Metabolism Gama, Eduardo Medeiros Ferreira de Pinho, Leandro Kasuki Jomori Madeira, Miguel Duarte, Carlos Pessoa, Girlene Canhete Moraes, Aline Barbosa Amaral, Maria Caroline Alves Coelho Neto, Francisco Paula Paranhos de Farias, Maria Lucia Fleiuss SUN-388 Role of QUS and Functional Tests in Evaluating Fracture Risk Based on Frax Tool |
title | SUN-388 Role of QUS and Functional Tests in Evaluating Fracture Risk Based on Frax Tool |
title_full | SUN-388 Role of QUS and Functional Tests in Evaluating Fracture Risk Based on Frax Tool |
title_fullStr | SUN-388 Role of QUS and Functional Tests in Evaluating Fracture Risk Based on Frax Tool |
title_full_unstemmed | SUN-388 Role of QUS and Functional Tests in Evaluating Fracture Risk Based on Frax Tool |
title_short | SUN-388 Role of QUS and Functional Tests in Evaluating Fracture Risk Based on Frax Tool |
title_sort | sun-388 role of qus and functional tests in evaluating fracture risk based on frax tool |
topic | Bone and Mineral Metabolism |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7208261/ http://dx.doi.org/10.1210/jendso/bvaa046.1493 |
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