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The importance of morphometric radiographic vertebral assessment for the detection of patients who need pharmacological treatment of osteoporosis among postmenopausal diabetic Korean women

Authors
Choi, YJ; Yang, SO; Shin, CS; Chung, YS
Citation
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 23(8):2099-2105, 2012
Journal Title
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
ISSN
0937-941X1433-2965
Abstract
Many diabetic patients with vertebral fractures remain undiagnosed and untreated. We found that more than two-thirds of osteoporotic diabetic women could not be identified for pharmacological treatment according to the NOF guidelines if without radiographic vertebral assessment. This study shows the importance of radiographic vertebral assessment for identifying patients who need treatment for osteoporosis in diabetic women.



INTRODUCTION: Diagnosis of vertebral fracture (VF) is important for identifying patients who need pharmacologic therapy for osteoporosis. However, many patients with vertebral fractures remain undiagnosed and untreated. This study evaluated the number of patients with VFs who would be unrecognized as candidates for osteoporosis treatments according to the National Osteoporosis Foundation (NOF) Clinician’s Guidelines to the Treatment of Osteoporosis, among postmenopausal diabetic Korean women without spinal imaging.



METHODS: A total of 873 postmenopausal diabetic women were enrolled. Lateral plain radiographs of the thoracolumbar spine and total hip BMD were obtained. The Fracture Risk Assessment Tool (FRAX®) probability was computed using the algorithm available online at http://www.shef.ac.uk/FRAX (South Korea version). The subjects with and without VFs were classified into candidates for osteoporosis treatment [Tx+by NOF] and not candidates for osteoporosis treatment [Tx−by NOF] according to the NOF pharmacologic treatment guidelines, regardless of the presence of VFs.



RESULTS: Forty-six percent of postmenopausal diabetic womenhad morphometric VFs. Among the subjects with morphometric VFs, only 2% of the patients had previously diagnosed VFs by medical doctors. In addition, 73.6% of the patients with VFs were not included in the [Tx+by NOF] group, given the assumption of no radiographic diagnosis of VFs.



CONCLUSIONS: With regard to increased risk of VFs in postmenopausal Korean women with type 2 diabetes mellitus, radiographic vertebral assessment would be useful for the clinical identification of osteoporosis and fractures.
MeSH terms
Absorptiometry, PhotonAgedAlgorithmsBone DensityCross-Sectional StudiesDiabetes Mellitus, Type 2/complicationsFemaleHip/*radiographyHumansLumbar Vertebrae/*radiographyMiddle AgedOsteoporosis, Postmenopausal/complications/diagnosis/*radiographyOsteoporotic Fractures/complications/diagnosis/*radiographyPractice Guidelines as TopicRepublic of KoreaRisk Assessment/methodsRisk FactorsSpinal Fractures/complications/diagnosis/*radiography
DOI
10.1007/s00198-011-1803-y
PMID
21975560
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Endocrinology & Metabolism
AJOU Authors
최, 용준정, 윤석
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