Prevalence Of Osteopenia Research Articles

P1229 Updated Epidemiology of Osteoporosis in the Inflammatory Bowel Disease Population and Associated Risk Factors: Insights from a Retrospective Cohort Analysis

Abstract Background Osteoporosis is a prominent extra-intestinal complication in patients with inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD). The prevalence of osteopenia and osteoporosis among patients with IBD varies widely, ranging from 22%-77% and 17%-41%, respectively, depending on population characteristics, geographic location, and study design [1]. Despite these variations, the burden of osteoporosis in IBD is unequivocal, impacting quality of life and increasing the risk of fractures. Methods We conducted a retrospective cohort study using the TriNetX database to assess the incidence of osteoporosis in patients with IBD between 2013 and 2023. Data were stratified by age, sex, and race. A comparative analysis of osteoporosis risk in IBD versus non-IBD populations was performed, along with an exploration of risk factors specific to UC and CD cohorts. Propensity score matching was employed to adjust for confounders, including age, sex, race, BMI, smoking, primary sclerosing cholangitis (PSC), steroid use, autoimmune diseases, IBD medications, and surgical history. Risk was quantified as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results A total of 120,396 patients with IBD (mean age 43.8 ± 19.4, female sex 53.073%, White race 79.01%) were analyzed. The five-year incidence of osteoporosis was significantly higher in the IBD cohort (aOR: 1.43, 95% CI: 1.38-1.48) compared to the non-IBD cohort. Among IBD subtypes, CD patients exhibited a higher risk (aOR: 1.53, 95% CI: 1.46-1.60) compared to UC patients (aOR: 1.38, 95% CI: 1.32-1.44) [Figure 1]. Osteoporosis incidence was notably higher in females (IBD: 9.78%, UC: 10.48%, CD: 9.38%) than in males (IBD: 3.55%, UC: 3.67%, CD: 3.87%) and increased significantly with age, reaching 21.67% in patients over 80 years old. Racial disparities were evident, with the highest incidence observed among White patients (7.35%). Significant risk factors for osteoporosis in IBD included long-term corticosteroid use (aOR: 2.29, 95% CI: 2.25-2.32), malnutrition (aOR: 1.56, 95% CI: 1.53-1.59), use of TNF-alpha inhibitors (aOR: 1.40, 95% CI: 1.36-1.43), PSC (aOR: 2.30, 95% CI: 2.08-2.54), intestinal surgery (aOR: 1.21, 95% CI: 1.18-1.23), hemoglobin levels of <10 g/dL (aOR: 1.20, 95% CI: 1.19-1.21), albumin levels of <2.5 g/dL (aOR: 1.07, 95% CI: 1.05-1.08), and mood disorders (aOR: 1.16, 95% CI: 1.15-1.17) [Figure 2]. Conclusion Osteoporosis is a significant concern for patients with IBD, with females, older adults, and CD patients being most at risk. Early and targeted interventions are crucial to reducing bone loss and improving long-term outcomes in this vulnerable population.

Relationship between multi-nutrient intake and bone loss and osteoporosis in U.S. adults: Findings from NHANES.

The relationship between dietary nutrient intake and bone mineral density (BMD) has not been clarified. In the U.S. population, we have demonstrated that dietary intake of multiple nutrients (potassium, magnesium, and sodium) is positively associated with BMD and negatively associated with the prevalence of osteopenia. This study examined whether there is an association between dietary potassium, magnesium, and sodium intake and BMD, osteopenia, and osteoporosis, using data from the National Health and Nutrition Examination Surveys from 2005 to 2010, 2013 to 2014, and 2017 to 2018. We assessed the association of dietary potassium, magnesium, and sodium intake with BMD in 10,355 National Health and Nutrition Examination Survey participants during 2005 to 2010, 2013 to 2014, and 2017 to 2018. BMD of the whole femur was estimated by dual-energy X-ray absorptiometry. We utilized multiple linear regression models to examine the associations of dietary potassium, magnesium, and sodium intake with femoral BMD, osteopenia, and osteoporosis, after adjusting for various confounders. Dietary potassium, magnesium, and sodium intake are positively correlated with femur BMD when corrected for the confounders of age, sex, race/ethnicity, smoking behavior, education level, body mass index, poverty income ratio, serum uric acid, serum cholesterol, potential renal acid load, dietary calcium intake, dietary protein intake, and dietary vitamin D intake. Dietary intake of potassium, magnesium, and sodium was adversely correlated with the development of osteopenia and osteoporosis. Our study showed that intake of dietary nutrients (potassium, magnesium, and sodium) was correlated positively to femur BMD and adversely to osteopenia and osteoporosis in the U.S. population. Further research is needed on the association of dietary elemental intake with BMD.

Osteoporosis and osteopenia in young adults with spinal cord injury: The necessity of an early bone mineral density checkup

Objective: To identify the prevalence and risk factors for low bone density (LBD) in young adults with spinal cord injury (SCI). Design: Retrospective cross-sectional study. Setting: National Rehabilitation Center in Seoul, Korea. Participants: SCI patients aged 20–49 years hospitalized from January 2010 to October 2021. Interventions: Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry of the lumbar spine, femoral neck, and total hip. Outcome Measures: Areal BMD, Z-score and T-score of each region and prevalence of LBD. Results: Osteopenia and osteoporosis were diagnosed in 451 (58.2%) and 156 (20.1%) of 775 patients, respectively. Among 181 patients within 3 months of onset, 105 (58%) and 20 (11%) were diagnosed with osteopenia and osteoporosis, respectively. Additionally, the percentage of LBD increased significantly as the time from injury increased. On multivariate analysis, the risk factors for LBD in patients with early SCI within 12 months of onset were female sex (odds ratio [OR] = 2.49; 95% confidence interval [CI], 1.34-4.46; p = 0.002), body mass index (OR = 0.86; 95% CI, 0.81-0.92; p < 0.001), and age (OR = 1.04; 95% CI, 1.01-1.07; p = 0.005). Alcohol or smoking history, etiology, neurological level, or completeness of injury, and the Korean version of the spinal cord independence measure-III score were not significantly correlated with LBD. Conclusions: The prevalence of osteopenia and osteoporosis is high in young adults with SCI. In addition, the diagnosis rate is high in the test performed at the initial stages after injury. Therefore, early bone health monitoring should be performed in young adults with SCI.

A Study on the Prevalence of Osteoporosis in People with Different Altitudes in Sichuan, China.

Osteoporosis is a major health concern among the elderly, underscoring the importance of investigating its prevalence across different geographical regions. There is a current research gap regarding the incidence of osteoporosis and its variation by altitude within Sichuan, China. This study aimed to assess the prevalence of osteoporosis among populations residing at different altitudes in western Sichuan Province. This study utilized data from a population-based cohort in Sichuan, China. Representative locations were selected, and cluster random sampling was employed to conduct cohort studies across multiple sites in southwestern China. T Baseline data were collected from populations in Mianzhu, Kangting, and Sertar between July 2020 and August 2021. To assess differences in osteoporosis incidence among populations at different altitudes and with varying characteristics, we applied Chi-square and rank-sum tests. The study involved 4074 participants, including 1404 males (34.46%) and 791 individuals diagnosed with osteoporosis (19.42%). The prevalence of osteopenia in mid-altitude and high-altitude regions was 20.05% and 16.28%, respectively, while the prevalence of osteoporosis was significantly different, at 25.85% in mid-altitude areas compared to 13.00% in high-altitude areas (P < 0.001). Further analysis identified statistically significant differences in the prevalence of osteopenia and osteoporosis among females (P<0.001), middle-aged (P=0.015) and elderly populations (P=0.038), as well as among individuals who were underweight (P=0.011), normal weight (P<0.001), overweight (P<0.001), and obese (P=0.038). As altitude increased, the prevalence of osteoporosis decreased in all groups except the elderly, while the prevalence of osteopenia decreased among women and across various BMI categories, but increased among middle-aged and elderly individuals. Additionally, in high-altitude regions, Kangting recorded an 18.10% prevalence of osteopenia and a 14.26% prevalence of osteoporosis, compared to Sertar, which exhibited a 6.54% prevalence of osteopenia and a 6.23% prevalence of osteoporosis, indicating significant differences (P<0.001). This study demonstrates that higher altitudes are associated with a decreased prevalence of osteopenia and osteoporosis, particularly among females and middle-aged individuals. These results emphasize the importance of developing region-specific osteoporosis prevention strategies.

6536 National Trends in Prevalence of Prediabetes and Diabetes Among Women With Low Bone Mineral Density: 2009-2018

Abstract Disclosure: A. Atri: None. C. Anastasopoulou: None. Introduction: In recent years, bone fragility has emerged as a complication of prediabetes (preDM) and diabetes mellitus (DM), resulting in reduced bone mass and increased fracture risk, and is an important, though under-studied risk factor for osteoporosis. However, the converse relationship, trends in prevalence of preDM and DM in women with low bone mineral density (BMD) in the United States, are not well established. Methods: We used data from the National Health and Nutrition Examination Survey (NHANES) for the years 2009-10, 2013–14 and 2017–18 to include U.S. women aged ≥ 50 years with T-score ≤ -1. Osteoporosis assessment in NHANES was not completed in 2011–12 and 2015–16, and therefore not included in the analysis. Osteopenia and osteoporosis were defined by a femoral neck BMD ≤1 to 2.5, and ≤2.5 standard deviations (SDs) below the BMD of a young female adult mean (T-score). Femur neck BMD was measured by dual energy x-ray absorptiometry (DEXA). PreDM and DM were defined using HbA1c values of 5.7 - 6.4% and ≥ 6.5% respectively. Participants with missing HbA1c and BMD data were excluded. Descriptive statistics were used for comparing means and medians. The Cochran-Armitage test was utilized for trend analysis. Results: In this nationally representative sample of US women with low BMD, the median (IQR) T-score at femoral neck worsened from -1.74 (-1.4 to -2.17) in 2009-10 to -1.87 (-1.43 to -2.32) in 2017-18 (trend p = 0.001). Similarly, the prevalence of osteoporosis increased from 13.7% to 16.9% (trend p = 0.001). Overall, in this cohort, the national prevalence of both preDM and DM decreased from 40% to 32.9% and 9.6% to 9%, respectively (trend p = 0.001). Along with a reduction in the overall prevalence of osteopenia (86.3% to 83.1%, p=0.001), the prevalence of both preDM and DM decreased from 39.2% to 32.6% and 10% to 9% (p = 0.001). In those with osteoporosis, the prevalence of preDM decreased from 45.2% to 34.4% (p trend=0.001), however, the prevalence of DM increased from 7.5% to 8.7% (p trend =0.001). Overall rates of uncontrolled DM (HbA1c &amp;gt; 7%) in women with osteoporosis showed significant improvement (5.8% to 3.5%, p = 0.001). Discussion Despite worsening trend in femoral neck BMD among US women age ≥ 50 years from 2009-10 to 2017-18, the overall prevalence of preDM and DM improved by 7.1% and 0.6% respectively. However, this favorable trend was not observed among women with osteoporosis, where the overall prevalence of DM increased by 1.2%, though the rate of uncontrolled DM significantly decreased by 2.3%. Targeted interventions to improve blood glucose control among women with low BMD, especially those with osteoporosis are warranted, to improve bone health, as well as reduce fall and fracture risk. Presentation: 6/2/2024

Management of bone health in idiopathic inflammatory myopathies: A two-center audit in the United Kingdom and Hong Kong.

Patients with inflammatory idiopathic myopathies (IIM) face elevated risks of osteoporosis and fragility fracture. To evaluate current practice relating to bone health in adult patients with IIM in the United Kingdom and Hong Kong (HK). Patients were identified from IIM patient lists. Demographics, osteoporosis risk factors, DXA scans, and bone protection treatment were recorded. Adherence to regional standards was evaluated for each center. Following this, in the United Kingdom, up-to-date DXA scans were performed. Of 136 patients identified, 51 met selection criteria (UK, n = 20, HK, n = 31). Mean age in the United Kingdom was 59 (IQR 54-66); in Hong Kong, 65 (IQR 52.5-70). Most were female (UK 70%; HK 77%), current or previous steroid treatment was common (UK 90%; HK 100%) and some had experienced fragility fracture (UK 15%; HK 9%). The mean daily dose of prednisolone that patients were prescribed during the study was 12.5 mg (UK) and 14.3 mg (HK). Some patients had had a DXA scan (UK 50%; HK 35%) though several were outdated. Among those with BMD measured (UK, n = 20; HK, n = 11), osteopenia prevalence was 35% (UK) and 36% (HK) while osteoporosis was 5% (UK) and 36% (HK). Notably, 25% (UK) and 64% (HK) exceeded treatment thresholds. Treatments included anti-osteoporotic agents (UK 55%; HK 15%), Vitamin D/calcium supplements (UK 95%; HK 52%), or no treatment (UK 5%, HK 15%). Poor compliance with guidelines exists in both centers, particularly around investigation and monitoring of bone health for IIM patients. Integrated care models and increased resource allocation to bone health are imperative to improve management of this aspect of IIM.

#1904 Prevalence of osteoporosis in dialysis dependent CKD patients: a cross sectional study from India

Abstract Background and Aims Chronic kidney disease (CKD) is associated with the development of mineral bone disorder (MBD), osteoporosis, and fragility fractures. However, the data on prevalence of Osteopenia and osteoporosis in Chronic kidney disease in India is scarce This multicentric, cross sectional study was done to assess the prevalence of osteoporosis in dialysis dependent chronic kidney disease patients. Method This study was conducted in CKD patients on maintenance hemodialysis. Osteoporosis and osteopenia were confirmed on the basis of T-scores using portable- Heel Ultrasound Bone Densitometer. Results A total of 1033 Dialysis patients were screened during August 2022 to December 2022. More than half (56%) of the patients were male. The prevalence of osteoporosis and osteopenia was observed to be 17% and 66%, respectively. Mean T- Score observed in overall population was -1.71 + .0.85, while it was -1.66 + 0.86 and -1.77 + 0.83 in males and females respectively. The maximum T- score observed in males was 2.0 and in females it was 4.0. In females, the minimum T-score was -4.3 while in males it was -2.51. Overall, 16.5% of males and 18% of females were osteoporotic. Among geriatric males (&amp;gt;60 years), average T-score was -1.55 + 0.42 while in geriatric female it was 1.78 + 0.80 Conclusion This data of Osteopenia and osteoporosis should be alarming as osteopenia itself is considered a very serious risk factor for the development of osteoporosis. Early intervention for diagnosis and timely initiation of treatment of osteoporosis is recommended for the CKD population to prevent complications like fractures and falls.

Prevalence of osteopenia and osteoporosis in middle-aged and older Korean men with testosterone deficiency syndrome: a cross-sectional study

Testosterone plays an important role in regulating fertility, muscle mass and bone density. Low bone mineral density has been reported in men with testosterone deficiency syndrome (TDS); however, there is limited research available on the prevalence of TDS. In this study, we aimed to determine the prevalence of osteoporosis and osteopenia in middle-aged and older men (n = 4707, age: 40–79 years) with TDS. Their total serum testosterone levels were measured, and TDS was defined as a testosterone level of ≤3.5 ng/mL. To assess bone mineral density, we used dual-energy X-ray absorptiometry to measure the density at the lumbar spine (L1–L4) and femoral neck (T-score: osteopenia ≤−1.0; osteoporosis ≤−2.5). We performed logistic regression analysis to calculate adjusted odds ratios (AORs) after adjusting for age, body mass index, physical activity and VO2peak (Volume oxygen peak). The results showed a significant difference in physical activity between men with TDS and those without TDS (NTDS) in both middle-aged and older age groups (p &lt; 0.05). Among middle-aged men, the AOR for osteopenia in the lumbar spine was 1.2-fold higher (Confience interval, CI (Confidence interval), 1.017–2.698), and in the femoral neck, it was 1.3-fold higher (CI, 1.012–3.013) for individuals with TDS compared to those without TDS. In older men, the AOR for osteopenia in the femoral neck increased by 1.4-fold (CI, 1.029–2.530). In conclusion, our findings suggest that middle-aged men with TDS have a higher likelihood of experiencing osteopenia in both the lumbar spine and femoral neck, while older men are more likely to have osteopenia, specifically in the femoral neck, but not osteoporosis.

Bone Metabolism in Men who Live with HIV Aged 50 years and Over: Impact of Infection Duration.

Early diagnosis and effective antiretroviral therapy (ART) lead to similar life expectancy in people living with HIV (PLWH) compared to the general population. This population faces problems such as decreased bone mineral density (BMD) and increased fracture risk. The aim of this study was to determine the prevalence of osteoporosis in men aged 50 years and over who were PLWH and to determine risk factors and changes in bone metabolism with bone turnover markers. 79 male PLWH aged 50 years and over were followed up in our outpatient clinic between May 2021 and October 2021. The patients' demographic, clinical, laboratory, and DEXA data were analyzed. Serum levels of bone turnover markers were measured. The prevalence of osteopenia, osteoporosis, and normal BMD was found to be 55.7%, 13.9%, and 30.4%, respectively. A correlation was found between low BMD and low body mass index, elapsed time since diagnosis of HIV infection, high rate of use of ART, and long usage time of tenofovir disoproxil fumarate + protease inhibitor. A one-year increase in HIV infection duration was associated with an increased risk of low BMD by 1.246. Compared to studies conducted on the general population, the prevalence of osteoporosis in male PLWH aged 50 years and older was two times higher. The limited effect of the duration of ART use on low BMD may be due to the patients' histories of replacement therapy. Therefore, to eliminate the negative effects of ART on BMD, it may be beneficial to start replacement therapy when necessary.

Osteopenia of Prematurity and its Maternal and Nutrition-Related Factors Among Preterm Infants Admitted to the NICU Department of Afzalipour Medical Center

Background: Osteopenia is a relatively common disorder in premature infants. If this disease is not diagnosed and treated promptly, it will lead to impaired growth in infancy. The present study was performed to assess the relationship between osteopenia and neonatal/maternal factors among premature neonates hospitalized in the neonatal intensive care unit (NICU) of Afzalipour Medical Center. Methods: The present cross-sectional study was performed on 100 premature infants who were admitted to the NICU of Afzalipour Medical Center in Kerman in 2017 and 2018. Alkaline phosphatase was measured in one-month-old infants as a screening criterion for osteopenia and its relation with factors such as birth weight, weight gain, duration of hospitalization, duration of intravenous feeding, type of nutrition, volume of formula, and food supplement consumption was investigated. Results: Of the total 100 preterm babies, based on the criterion utilized for diagnosis of osteopenia (alkaline phosphatase above 900 units/L), 41 infants had osteopenia of prematurity (41% prevalence). Infants who used breastmilk alone mostly had osteopenia of prematurity. The prevalence of osteopenia was higher among girls compared with boys. The mean length of hospitalization was longer and the total parenteral nutrition venous feeding was longer among neonates with osteopenia compared with other neonates. The mean serum vitamin D levels were significantly lower in mothers of premature neonates with osteopenia compared with others. Conclusion: Infants who were fed exclusively with breast milk were more vulnerable to osteopenia, and supplements should be considered in these infants.

Characteristics of bone metabolism disorders in military personnel in the Arctic regions: prospective study

OBJECTIVE. To study characteristics of bone metabolism disorders in military personnel in the Arctic regions.&#x0D; MATERIALS AND METHODS. The survey was conducted and medical documentation of 189 male soldiers aged 23–42 (average age - 29,6±5,6) was studied. Depending on the duty station all the surveyed were divided into two groups: I – 107 soldiers, performing military service in the Arctic regions with at least 2 years of experience, II – 82 soldiers from the Western Military Region. Complaints, anamnesis data, objective status (including anthropometry) and medical documentation were assessed and studied in the surveyed military personnel. For estimating bone-mineral density, the method of calcaneus ultrasonography, using «GE Healthcare Achilles» densitometer was applied. The content of total calcium, inorganic phosphorus as well as the concentration of bone resorption markers – СТХ and NTX in the blood serum were used as analyzed laboratory rate of bone metabolism.&#x0D; RESULTS. The study showed that almost half of the military personnel in the Arctic regions (48,6%) had the rate of bone-mineral density below the average value for healthy men of the same age group. It was noted that prevalence of osteopenia in the Arctic is significantly higher compared to military personnel from temperate regions. When studying bone resorption markers, it was noted that the group of Arctic military personnel experienced statistically significant increase in NTX, characterizing the rate of degradation in the newly formed bone as well as the tendency towards increase in CTX, reflecting the rate of degradation relative to the old bone.&#x0D; DISCUSSION. The main link in the pathogenesis of low bone-mineral density in military personnel in the unfavorable Arctic environment is D3 vitamin metabolism disorder by lowering its formation in the skin and also it limited intake with food. High prevalence of disorder in bone-mineral density among Arctic military personnel might indicate the need for a more rigorous selection process in the Arctic regions with a mandatory in-depth survey of the bone metabolism system (determination of total calcium content, inorganic phosphorus, D3 vitamin) as well as performing according to osteodensitometry. It is advisable to conduct an annual survey of the Arctic military personnel at the duty station, involving a visiting military-medical commission with a therapist or rheumatologist as its member.

PREVALENCE OF OSTEOPOROSIS IN HIV-INFECTED PATIENTS INITIATING ANTI-RETROVIRAL DRUGS LIVING IN JOHANNESBURG

Low-energy fractures complications are a major public health issue that make osteoporosis even worse. In sub-Saharan Africa, the prevalence of osteoporosis varies from 18.2% to 65.8%. There was no change in bone mineral density between HIV-infected and non-HIV-infected women in Sub-Saharan Africa, where HIV is widespread. Other investigations that demonstrated that HIV-infected people had poor BMD both before and after starting anti-retroviral treatment did not consistently show a low BMD finding. Inflammation-mediated bone remodelling has been associated with low BMD in HIV-infected patients. Antiretroviral Therapy has been demonstrated to exacerbate bone loss in addition to the pre-existing intrinsic risk of developing osteoporosis.Question: Is there loss of bone in HIV-infected patients before initiating ART?The patients who were HIV-positive and enrolled in the ADVANCE research were retrospectively reviewed on a desk. All of the 1053 individuals in the ADVANCE research had a DXA scan performed to evaluate BMD as part of the initial screening and recruitment approach. The ADVANCE research enrolled HIV-positive people and randomly assigned them to three ART arms.A total of 400 patients were reviewed. Of these 400 records reviewed, 62.3% were female. 80% of the participants were younger than 40 years old, and 3% were older than 50 years. 82% were virally suppressed with less than 50 viral copies. The prevalence of osteopenia was 25.5% and osteoporosis was 2.8%, observed in predominantly African female participants aged between 30 and 39 years.The findings of this study confirm that there is pre-existing bone loss among HIV-infected ART naïve individuals. Approximately 28.3% in our study had clinically confirmed evidence of bone loss and of these, 2.8% of the entire cohort had osteoporosis. Bone loss was most prevalent in black females who are virologically suppressed.

Influencing factors of bone mass abnormalities among postmenopausal women in Tibet, China

BackgroundThis study aimed to provide a reference for the prevention and treatment of abnormal bone mass in postmenopausal women by analysing the current situation and influencing factors of bone mass abnormalities in Tibet.MethodsA total of 229 postmenopausal Tibetan women were randomly selected from six counties by a multistage cluster random sampling method. Multiple logistic regression was utilized to analyse the status and influencing factors of bone mass abnormalities in postmenopausal Tibetan women.ResultsAmong 229 postmenopausal Tibetan women, the prevalence of osteopenia and osteoporosis was 54.6% and 9.6%, respectively. Age {odds ratio (OR) = 0.022 [95% confidence interval (CI) = 0.003 ~ 0.163]}, BMI [OR = 441.902 (20.899,9343.717)], altitude [OR = 18.818 (1.391,254.585)], and creatinine (CREA) levels [OR = 0.895 (0.825 ~ 0.971)] were significantly associated with the risk of osteoporosis.ConclusionPostmenopausal Tibetan women had high rates of abnormal bone mass. Age, BMI, altitude and CREA levels were associated with osteoporosis. It is suggested that relevant departments should take targeted measures to promote health education on the prevention of osteoporosis in the general population and increase the screening of high-risk groups for osteoporosis to improve the bone health of postmenopausal Tibetan women.

Detection of low bone mineral density in self-referred and medically referred patients

IntroductionThe Mexican health-care system is a mixture of governmental and private institutions. The osteoporosis screening algorithm has a multiple case start-point, the most common being medical referral; however, self-screening is available where patients can arrange a bone densitometry themselves. ObjectiveThe aim of this study is to evaluate the impact of self-screening for osteoporosis and osteopenia among a Mexican population. Materials and methodsA retrospective observational study was performed as a secondary outcome from an institutional cohort of patients who attended an osteoporosis center. We divided the cohort into two groups: self-referred patients and medical-referred patients. ResultsThe overall prevalence of osteoporosis between the two groups was 1160 (self-referred n=44; 29.5% vs medical-referred n=227; 22.5%; p=.057) (OR (Odds Ratio); 95% CI (Confidence Interval): 1.44; .98–2.12) and the prevalence of osteopenia was (n=122; 81.9% vs n=811; 80.2%; p=.633) (OR (Odds Ratio); 95% CI (Confidence Interval): 1.11; .71–1.73). ConclusionThere was no statistical difference between the self-referred and the medically referred patients in the overall diagnosis of osteoporosis and/or osteopenia. Nevertheless, the incidence of osteoporosis and osteopenia as an outcome for the self-referred patients was not lower than that of those with a medical referral.

Factors Related to Reduced Bone Density in β-Thalassemia Major Patients: Mazandaran Thalassemia Registry

Introduction: OsteoPenia and osteoPorosis are known to be one of the main comPlications of β-thalassemia major (β-TM). The aim of this study was to determine the factors associated with decreased bone density of these Patients.&#x0D; Methods: Lumbar and femoral neck bone mineral density (BMD) in β-TM Patients characterized via Dual-energy X-ray absorPtiometry (DXA) to PinPoint the association of iron chelators, diabetes mellitus, serum ferritin above 3000 ng/mL, hemoglobin below 8 gr/dl, using hydroxyurea, liver siderosis and moderate to severe hePatic and cardiac siderosis with BMD. The information was collected from the thalassemia registry in 2019 and statistical analysis was Performed by STATA-13 software.&#x0D; Results: Out of 1959 ParticiPants with β-thalassemia major registered in the registry, 139 ones (7.09%) had bone mineral density (53 males and 86 females). The Prevalence of abnormal bone density in the lumbar and femoral neck was (52.48 to 47.66) 57.5 and (40.18 to 57.52) 48.85 Percent, resPectively. After adjusting for the effects of Possible interventions, the odds ratio of abnormal bone density in the Patients consuming hydroxyurea and deferasirox were 0.24 (0.03 to 1.73) and 0.25 (0.03 to 1.69), resPectively. The highest odds were 8.21 (0.18 to 360.22), and 6.72 (0.60 to 74.83) for moderate to severe cardiac and hePatic dePosition, resPectively.&#x0D; Conclusion: The Prevalence of osteoPenia and osteoPorosis is high among thalassemia major Patients. ConsumPtion of hydroxyurea and deferasirox is the most imPortant Protective factor and moderate to severe cardiac and hePatic siderosis are the most imPortant risk factors for abnormal bone density.

Risk of osteopaenia, osteoporosis and osteoporotic fractures in patients with chronic pancreatitis: A systematic review and meta-analysis

Chronic pancreatitis results in irreversible pancreatic dysfunction and malnutrition which, alongside excess alcohol intake, can increase the risk of low bone density. Osteoporosis increases the risk of fractures and chronic bone pain, reduces quality of life, and poses considerable costs to healthcare. Despite this, there remains a paucity of literature evaluating bone health in this patient population. This systematic review and meta-analysis evaluated the prevalences of osteopaenia, osteoporosis and fractures in patients with chronic pancreatitis. A comprehensive search of Medline, Embase, ClinicalTrials.gov, and CENTRAL databases was undertaken to identify eligible studies from January 2000 to May 2022. The prevalences of osteopenia, osteoporosis and fragility fractures were extracted from the included studies. Where available, a subgroup analysis was performed to compare the likelihood of developing osteoporosis in patients with chronic pancreatitis compared with control. Nineteen studies reporting on 2,027,764 participants (20,460 with chronic pancreatitis and 2,007,304 controls) were included. The pooled prevalence of osteoporosis was 19% (95% CI 13 to 26%; I2=94%). Patients with chronic pancreatitis were more likely to have osteoporosis when compared with those in the control group (OR 2.80, 95% CI 1.86 to 4.21; I2=21%). The prevalences of osteopaenia and fractures in patients with chronic pancreatitis were 37% (95% CI 31 to 44%; I2=81%) and 14% (95% CI 7 to 22%; I2=99%) respectively. The prevalences of osteopenia and osteoporosis are significant in patients with chronic pancreatitis and can increase the risk of developing fractures. Further population-based studies are required to evaluate the disease burden of osteoporotic fractures and associated morbidity and mortality in chronic pancreatitis.

O148 Risk of osteoporotic fractures in patients with chronic pancreatitis: a systematic review and meta-analysis

Abstract Introduction Chronic pancreatitis is a progressive fibroinflammatory disease and can lead to irreversible loss of pancreatic function and malnutrition. These, alongside excess alcohol intake, increase the risk of low bone density. Osteoporosis can be debilitating, reduces quality of life, increases fracture risk, and poses significant costs to healthcare. There remains, however, a paucity in current literature evaluating the prevalence of osteoporosis in this population. This meta-analysis evaluates the prevalence of osteoporosis and fractures in chronic pancreatitis. Methods A systematic search of Medline, Embase, CENTRAL, and ClinicalTrials.gov databases was undertaken to identify studies between January 2000 and May 2022. The primary outcome of osteoporosis prevalence and secondary outcomes of osteopenia prevalence and fragility fractures were extracted from the included studies. Where available, a subgroup analysis was performed to compare the likelihood of developing osteoporosis in chronic pancreatitis compared with control. Results Nineteen studies evaluating 2,027,767 participants were included in the analysis (20,463 and 2,007,304 were in the chronic pancreatitis and control groups respectively). The pooled prevalence of osteoporosis was 19% (95% CI 13-26%; I2=94%). Patients with chronic pancreatitis were more likely to have osteoporosis when compared with controls (OR 2.80, 95% CI 1.86-4.21). The prevalence of osteopenia and overall fractures were 37% (95% CI 31-44%; I2=81%) and 14% (95% CI 7-22%; I2= 99%) respectively. Conclusion The prevalence of osteoporosis and osteopenia are considerable in chronic pancreatitis and can also result in fractures. Further population-based studies are required to evaluate the disease burden of osteoporotic fractures and associated mortality in chronic pancreatitis.

Risk factors of osteoporosis and osteopenia in postmenopausal women based on the L2–L4 BMD T score of the lumbar spine: a study in Iran

Objective To determine the risk factors of osteoporosis and osteopenia of the spine in postmenopausal women. Method An analytical cross-sectional study was performed on postmenopausal women. The T-score of the lumbar spine (L2–L4) was measured by densitometry and compared between osteoporotic, osteopenia, and normal women. Results One thousand three hundred fify-nine postmenopausal women were evaluated. The prevalence of osteopenia and osteoporosis was 58.2% and 12.8% respectively. Age, BMI, parity, total breastfeeding years, dairy use, calcium-D supplements, and regular exercise were significantly different in women with osteoporosis, osteopenia, and normal women. Ethnicity, diabetes, and previous fracture history were only other among women with osteoporosis (not osteopenia) and normal women. For osteopenia of the spine, age [AOR 1.08 (1.05–1.11; p < .001)] was the risk factor, and BMI = >30 [AOR 0.36 (0.28–0.58; p < .001)] and BMI 25–<30 [AOR 0.55 (0.34–0.88; p = .012)] were protective factors. Hyperthyroidism (AOR 23.43, p = .010), Kurdish ethnicity (AOR 2.96, p = .009), not having regular exercise (AOR 2.22, p = .012), previous fracture history (AOR 2.15, p = .041)], and age (AOR 1.14, p < .001)], were risk factors for osteoporosis, while BMI ≥30 [AOR 0.09, p < .001], BMI 25–<30 [AOR 0.28, p = .001], and diabetes [AOR 0.41, p = .038] were protective factors for osteoporosis of the spine. Conclusion Hyperthyroidism, low BMI <25, parity ≥ 6, Kurdish ethnicity, not having regular exercise, history of previous fracture, and age, were risk factors for osteoporosis of the spine respectively, while low BMI and age were risk factors for osteopenia.

Bone mineral density status in patients with recent-onset rheumatoid arthritis.

Osteoporosis is a sizable comorbidity complication in Rheumatoid Arthritis (RA) sufferers. In the current study, the prevalence of osteopenia and osteoporosis in active RA sufferers and the association of disease-related factors of osteoporosis and reduced bone mineral density (BMD) have been examined. In this cross-sectional study, 300 new-onset symptoms (less than one year) RA patients without a history of glucocorticoids or DMARDs were selected. Biochemical blood measurements and BMD status were performed with dual-energy X-ray absorptiometry. According to the T-scores of the patients, they were divided into three groups: osteoporosis<-2.5, -2.5 < osteopenia <-1, and - 1 < normal. Also, the MDHAQ questionnaire, DAS-28, and FRAX criteria were calculated for all patients. Multivariate logistic regression was used to determine the associated factors of osteoporosis and osteopenia. The Prevalence of osteoporosis and osteopenia was 27% (95%CI:22-32) and 45% (95%CI:39-51), respectively. The multivariate regression analysis showed that age could play a role as an associated factor for spine/hip Osteoporosis and Osteopenia. The female gender is also a predictor of Spine osteopenia Patients with Total hip Osteoporosis were more likely to have higher DAS-28 (OR 1.86, CI 1.16-3.14) and positive CRP (OR 11.42, CI 2.65-63.26). recent-onset RA patients are at risk for osteoporosis and its complications, regardless of using glucocorticoids or DMARDs. Demographic factors (e.g. age and female gender), patients' MDHAQ scores, and disease-related factors(e.g., DAS-28, positive CRP were associated with reduced BMD levels. Therefore, it is recommended that clinicians investigate early BMD measurements to have a reasonable judgment for further interventions. The online version contains supplementary material available at 10.1007/s40200-023-01200-w.

Impact of osteosarcopenia on disability and mortality among Japanese older adults.

In clinical settings, muscle mass and bone mineral density assessments are usually performed using dual-energy X-ray absorptiometry (DXA), the clinicalstandard technique. However, DXA is often unavailable in community settings. This study aimed to determine whether osteoporosis, osteopenia (OP) and sarcopenia (SP) identified by simplified instruments are associated with the future incidence of disability and mortality and evaluate the validity of these instruments as community screening tools. We also examined osteosarcopenia (OS), defined as the coexistence of OP and SP, as a new indicator of geriatric syndromes to determine whether it has an additive effect on adverse outcome incidence compared with OP and SP alone. In total, 8995 older adults participated in the study (women: 51.7%, average age: 73.5±5.4years). Data were extracted from the Japanese national cohort study, National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. We determined OP based on T-scores generated based on the speed of sound, which is the time taken for ultrasound waves to go through a determined distance in the calcaneus bone. Skeletal muscle mass was evaluated using a bioimpedance analysis device. Handgrip strength and walking speed were measured as physical performance indicators. Incidences of disability and mortality were prospectively determined for 5years. The prevalence of OP, SP and OS was 45.5%, 3.9% and 7.4%, respectively. The incidence of disability in the nonOP/nonSP, OP, SP and OS groups was 6.5%, 14.9%, 20.5% and 33.5%, respectively. The incidence of mortality in the nonOP/nonSP, OP, SP and OS groups was 4.0%, 4.9%, 10.3% and 10.2%, respectively. Participants with OP (hazard ratio [HR]: 1.45, 95% confidence interval [CI]: 1.25-1.68), SP (HR: 1.38, 95% CI: 1.08-1.76) and OS (HR: 1.73, 95% CI: 1.43-2.09) had a higher risk of disability than nonOP/nonSP participants. Participants with OP (HR: 1.31, 95% CI: 1.04-1.64) and OS (HR: 1.45, 95% CI: 1.05-2.00) had a higher risk of mortality than nonOP/nonSP participants. SP was not significantly related to mortality (HR: 1.14, 95% CI: 0.90-1.45). There was no statistical interaction between OP and SP in incident disability and mortality. Among older adults, OS identified by bioimpedance and quantitative ultrasound assessments was associated with an increased risk of disability and mortality. Further research is needed to implement these findings in community health activities, such as setting precise cut-off values and constructing accurate disability and mortality prediction models.