Low-trauma fractures without osteoporosis
Document type :
Compte-rendu et recension critique d'ouvrage
PMID :
Title :
Low-trauma fractures without osteoporosis
Author(s) :
Lespessailles, Eric [Auteur correspondant]
Imagerie Multimodale Multiéchelle et Modélisation du Tissu Osseux et articulaire [I3MTO]
Cortet, B. [Auteur]
Service de rhumatologie[Lille]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab (ex-pmoi)]
Legrand, E. [Auteur]
Guggenbuhl, P. [Auteur]
Foie, métabolismes et cancer
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Roux, Clément [Auteur]
Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité [CRESS (U1153 / UMR_A_1125 / UMR_S_1153)]
Imagerie Multimodale Multiéchelle et Modélisation du Tissu Osseux et articulaire [I3MTO]
Cortet, B. [Auteur]
Service de rhumatologie[Lille]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab (ex-pmoi)]
Legrand, E. [Auteur]
Guggenbuhl, P. [Auteur]
Foie, métabolismes et cancer
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Roux, Clément [Auteur]
Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité [CRESS (U1153 / UMR_A_1125 / UMR_S_1153)]
Journal title :
Osteoporosis International
Pages :
1771--1778
Publisher :
Springer Verlag
Publication date :
2017
ISSN :
0937-941X
English keyword(s) :
bmd
diagnosis of osteoporosis
low-trauma fracture
normal bmd
treatment of osteoporosis
diagnosis of osteoporosis
low-trauma fracture
normal bmd
treatment of osteoporosis
HAL domain(s) :
Sciences du Vivant [q-bio]/Cancer
Sciences du Vivant [q-bio]/Alimentation et Nutrition
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Endocrinologie et métabolisme
Sciences du Vivant [q-bio]/Alimentation et Nutrition
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Endocrinologie et métabolisme
English abstract : [en]
In clinical practice, areal bone mineral density (aBMD) is usually measured using dual-energy X-ray absorptiometry (DXA) to assess bone status in patients with or without osteoporotic fracture. As BMD has a Gaussian ...
Show more >In clinical practice, areal bone mineral density (aBMD) is usually measured using dual-energy X-ray absorptiometry (DXA) to assess bone status in patients with or without osteoporotic fracture. As BMD has a Gaussian distribution, it is difficult to define a cutoff for osteoporosis diagnosis. Based on epidemiological considerations, WHO defined a DXA-based osteoporosis diagnosis with a T-score <-2.5. However, the majority of individuals who have low-trauma fractures do not have osteoporosis with DXA (i.e., T-score <-2.5), and some of them have no decreased BMD at all. Some medical conditions (spondyloarthropathies, chronic kidney disease and mineral bone disorder, diabetes, obesity) or drugs (glucocorticoids, aromatase inhibitors) are more prone to cause fractures with subnormal BMD. In the situation of fragility fractures with subnormal or normal BMD, clinicians face a difficulty as almost all the pharmacologic treatments have proved their efficacy in patients with low BMD. However, some data are available in post hoc analyses in patients with T score >-2. Overall, in patients with a previous fragility fracture (especially vertebra or hip), treatments appear to be effective. Thus, the authors recommend treating some patients with a major fragility fracture even if areal BMD T score is above -2.5.Show less >
Show more >In clinical practice, areal bone mineral density (aBMD) is usually measured using dual-energy X-ray absorptiometry (DXA) to assess bone status in patients with or without osteoporotic fracture. As BMD has a Gaussian distribution, it is difficult to define a cutoff for osteoporosis diagnosis. Based on epidemiological considerations, WHO defined a DXA-based osteoporosis diagnosis with a T-score <-2.5. However, the majority of individuals who have low-trauma fractures do not have osteoporosis with DXA (i.e., T-score <-2.5), and some of them have no decreased BMD at all. Some medical conditions (spondyloarthropathies, chronic kidney disease and mineral bone disorder, diabetes, obesity) or drugs (glucocorticoids, aromatase inhibitors) are more prone to cause fractures with subnormal BMD. In the situation of fragility fractures with subnormal or normal BMD, clinicians face a difficulty as almost all the pharmacologic treatments have proved their efficacy in patients with low BMD. However, some data are available in post hoc analyses in patients with T score >-2. Overall, in patients with a previous fragility fracture (especially vertebra or hip), treatments appear to be effective. Thus, the authors recommend treating some patients with a major fragility fracture even if areal BMD T score is above -2.5.Show less >
Language :
Anglais
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