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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
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.
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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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