Факторы риска переломов у пациентов с цереброваскулярными заболеваниями

Abstract

Aim. To study the link between various risk factors and an occurrence of osteoporotic fractures (OPF) in women who have had a first ischemic stroke (IS). Materials and methods. The study included 170 women 45 to 80 years of age who have had the first IS and received neurorehabilitation treatment for post-stroke speech disorders in the Center for Speech Pathology and Neurorehabilitation in Moscow in 2011–2013. For all women, the ten-year absolute risk of major OPF and hip fractures (HF) was retrospectively analyzed using the FRAX algorithm, excluding the data on bone mineral density. The risk of OPF was assessed according to the treatment intervention threshold proposed by the Russian Osteoporosis Association in 2012. In January 2021, a telephone survey was conducted to register the fractures that occurred over the past period of time. The SPSS Version 20 was used for statistical analysis of the results. Results. During the study period, fractures with a minimal level of trauma occurred in 34 (20%) women (fractures of fingers, toes, and skull bones were excluded). The absolute risk of OPF and HF in women with a low-traumatic fracture was higher than in patients without it (p<0.001), but did not reach the treatment intervention threshold proposed by the Russian Osteoporosis Association in 2012. Correlation analysis demonstrated the association between the occurrence of low-traumatic fractures in patients who had the first non-cardioembolic IS and the following parameters: age (rd=0.277; p<0.001), weight (rd=-0.368; p<0.001), body mass index (rd=-0.378; p<0.001), total cholesterol concentration (rd=0.189; p=0.014), type 2 diabetes mellitus (f=0.225; p=0.003), HF in parents (f=0.375; p<0.001). Conclusion. The results of this study demonstrate the presence of an association between the occurrence of low-traumatic fractures in patients with prior non-cardioembolic IS and traditional risk factors included in the FRAX algorithm, as well as with type 2 diabetes mellitus.