Is Pathological Fracture Predictable in Patients with Postmenopausal Osteoporosis?

Öz

Osteoporosis (OP) is a metabolic bone disease characterized by a decrease in bone mass and an increase in bone fragility. The most important cause of morbidity and mortality of OP is osteoporotic fracture formation. Although there are many studies carried out to define fracture risk factors in postmenopausal osteoporosis (PMO), there is still controversy in these studies about which risk factor is actually effective in fracture formation. The aim of this study is to determine whether fracture risk can be predicted in patients with PMO. 124 patients diagnosed with PMO who admitted to the Physical Medicine and Rehabilitation outpatient department were included in the study. The presence of fractures and risk factors that may cause fractures in these patients were screened retrospectively. The patients were divided into two groups according to the presence of fractures, as patients with PMO with and without fractures and compared. While osteoporotic fractures were found in 50 of the patients with PMO (40,3%), no fractures were found in 74 patients (59,7%). As a result of the comparison between the two groups, a statistically significant relationship was found between advanced age and fracture formation. There was no significant relationship between body mass index (BMI), age at menopause, vitamin 25 (OH) D levels, bone mineral density (BMD) measurement T scores evaluated by dual-energy X-ray absorptiometry (DEXA) and fracture formation. Although the results suggest that it is difficult to accurately predict fracture formation, they suggest that studies that will screen a larger patient population with more data are needed.

Anahtar Kelimeler

• Postmenopausal osteoporosis
• Bone mineral density
• Pathological fracture

Postmenopozal Osteoporozlu Hastalarda Patolojik Kırık Oluşumu Öngörülebilir mi?

Öz

Osteoporoz (OP), kemik kütlesinde azalma ve kemik kırılganlığında artış ile karakterize metabolik bir kemik hastalığıdır. OP’nin en önemli morbidite ve mortalite nedeni osteoporotik kırık oluşumudur. Postmenopozal osteoporozda (PMO) kırık risk faktörlerini tanımlamak amacıyla yapılan birçok çalışma bulunmasına rağmen, bu çalışmalarda kırık oluşumunda gerçekte hangi risk faktörünün ne kadar etkili olduğu konusundaki bilgiler halen çelişkilidir. Bu çalışmada amaç, PMO’lu hastalarda kırık riskinin öngörülüp öngörülemeyeceğini belirlemektir. Fiziksel Tıp ve Rehabilitasyon Polikliniği’ne başvuran PMO tanılı 124 hasta çalışmaya dahil edildi. Bu hastaların kırık varlığı ve kırığa neden olabilecek risk faktörleri geriye yönelik olarak tarandı. Hastalar kırık varlığına göre, kırığı olan ve olmayan PMO’lu hastalar olarak iki gruba ayrılarak karşılaştırıldı. PMO’lu hastaların 50’sinde (%40,3) osteoporotik kırık saptanırken, 74 hastada (%59,7) kırık saptanmadı. İki grup arasında yapılan karşılaştırma sonucunda ileri yaş ile kırık oluşumu arasında istatistiksel olarak anlamlı ilişki saptandı. Vücut kitle indeksi (VKİ), menopoz yaşı, 25(OH) D vitamini düzeyleri, dual-enerji X-ışını absorbsiyometri (DEXA) ile değerlendirilen kemik mineral yoğunluğu (KMY) ölçümü T skorları ile kırık oluşumu arasında anlamlı ilişki saptanmadı. Sonuçlar kırık oluşumunun tam olarak öngörülmesinin zor olduğunu düşündürmekle birlikte, daha fazla sayıda veri ile yapılacak daha geniş hasta popülasyonunun tarandığı çalışmalara ihtiyaç olduğunu düşündürmektedir.

Anahtar Kelimeler

• Postmenopozal osteoporoz
• Kemik mineral yoğunluğu
• Patolojik kırık

Kaynakça

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