engleski

OSTEOPOROTIC FRACTURES: ASSOCIATION OF BMI AND DENSITOMETRY T-SCORES IN POSTMENOPAUSAL WOMEN

Background: Osteoporosis represents second most important public health problem after cardiovascular diseases. Frequency of osteoporotic fractures (OPF) increases during the life time as most hazardous complication of osteoporosis. Vertebral fractures are often neglected, where 1/3 of fractures are asymptomatic and not diagnosed in the most of the cases, but OPF in the spinal area increases risk of the next osteoporotic fractures for five times during one year period. Due to pain and static disbalance in the spine after OPF, body weight is unevenly distributed on hips and pelvis which represents additional risk of OPF in the area of axial skeleton and in the hip area. Fractures in the distal radius area and other locations can be diagnostic lead for timely discovery of osteoporosis and possible OPF. Objectives: The aim of this study is to investigate correlation between bone mineral density and osteoporotic fractures in postmenopausal women with osteoporosis. Methods: In group of 205 examenees dual X-ray absorptiometry (DXA) at lumbar spine and femoral neck, biochemism and standard radiograms of thoracic and lumbar spine were performed. Osteoporosis was diagnosed in 166 patients 69.0 yr. SD &plusmn ; 9.55, among which 44 had OPF or 26.5 % .On thoracic and lumbal spine were 15.2% of OPF, only on lumbal spine were 9 % OPF, on distal radius 5 % and 6.7% fractures on other locations. No OPF occured in femoral neck area. Fractured vertebral bodies eather on thoracic or lumbar spine were measured on radiograms from moderate (&#8804; 40%) to severe ( &#8805; 40% of hight). Spine T-score was -3.24 SD &plusmn ; 1.1, hip T-score was -2.24 SD&plusmn ; 1.21, and BMD spine was 0.689 &plusmn ; 0.098 and BMD of hip was 0.697 &plusmn ; 0.094. In second examined group there were 162 patients yr. 66, 7 SD &plusmn ; 11, 4 who had typical fractures caused by minimal trauma like in patinents with osteoporosis and OPF. In this group DXA and additional radiologic tests were not performed and osteoporosis was not diagnosed. Results: Analysis of data for BMD and T-score of lumbar spine show statistical significant correlation ( p < 0.005) with incidence of OPF of thoracic and lumbar spine but not for femoral neck. On standard x-ray of thoracic and lumbar spine more than one fractured vertebral bodies from gr.I to gr. III in patients with T-score > -3.2 were shown in >15%. Therefore, we provide standard x-ray ot thoracic spine followed by densitometry as a standard proceedure and algorhitm in diagnosis and completing real picture and frequency of osteoporosis and OPF

osteoporotic fractures; dual X-ray absorptiometry; osteoporosis; statistical correlation; standard x-ray

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