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Discriminative Capacity of Calcaneal Quantitative Ultrasound and of Osteoporosis and Fracture Risk Factors in Postmenopausal Women with Osteoporotic Fractures

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Abstract

Bone fragility fractures constitute the principal complication of osteoporosis. The identification of individuals at high risk of sustaining osteoporotic fractures is important for implementing preventive measures. The purpose of this study is to analyze the discriminative capacity of a series of osteoporosis and fracture risk factors, and of calcaneal quantitative ultrasound (QUS), in a population of postmenopausal women with a history of osteoporotic fracture. A cross-sectional analysis was made of a cohort of 5195 women aged 65 or older (mean±SD: 72.3±5.4 years) seen in 58 primary care centers in Spain. A total of 1042 women (20.1%) presented with a history of osteoporotic fracture. Most fractures (93%) were non-vertebral. Age-adjusted odds ratios corresponding to each decrease in one standard deviation of the different QUS parameters ranged from 1.47 to 1.55 (P < 0.001) for fractures. The age-adjusted multivariate analysis yielded the following risk factors independently associated with a history of osteoporotic fracture: number of fertile years, a family history of fracture, falls in the previous year, a history of chronic obstructive airway disease, the use of antiarrhythmic drugs, and a low value for any of the QUS parameters. The area under the receiver operating characteristic curve of the best model was 0.656. In summary, a series of easily assessable osteoporotic fracture risk factors has been identified. QUS was shown to discriminate between women with and without a history of fracture, and constitutes a useful tool for assessing fracture risk. Various of the vertebral and hip fracture risk factors frequently cited in North American and British populations showed no discriminative capacity in our series—thus suggesting that such factors may not be fully applicable to our population and/or to the predominant type of fractures included in the present study.

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Acknowledgements

This study was supported by an unrestricted grant from the Department of Medical Research, Lilly S.A. Madrid (Spain).

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Authors and Affiliations

  1. Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain

    J. L. Hernández & J. González-Macías

  2. Departamento de Investigación Médica., Lilly S.A. Avda. de la Industria, 30, 28108-Alcobendas, Madrid, Spain

    F. Marin & E. Arriaza

  3. Institut Municipal d’Investigació Mèdica, C/Dr. Aiguadar 80, Barcelona, Spain

    A. Díez-Pérez & J. Vila

  4. Centro de Salud Ciudad Jardin, C/ Sancho de Miranda s/n, Málaga, Spain

    S. Giménez

  5. Centro de Salud Fuente Palmera, Avda de las Palmeras 4, Fuente Palmera, Córdoba, Spain

    B. Galán

  6. Centro de Salud La Florida, C/ Fernando Madroñal 9, Alicante, Spain

    M. S. Arenas

  7. Centro de Salud Paulino Prieto, C/ Martinez Marina 10, Oviedo, Spain

    F. Suárez

  8. ABS Florida Sur, C/ Musas s/n Hospitalet de Llobregat, Barcelona, Spain

    L. Gayola

  9. Centro de Salud Delicias Sur, C/ Manuel Dronda 1, Zaragoza, Spain

    G. Guillén

  10. Centro de Salud Txantrea, C/M Auxiliadora s/n, Pamplona, Spain

    T. Sagredo

  11. Centro de Salud Algemesi-Alfafar, Parque Salvador Castell 6, Algemesi, Valencia, Spain

    R. Belenguer

  12. Centro de Salud El Abajón, C/ Principado de Asturias 30, Los Rozas, Madrid, Spain

    A. Moron

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  1. J. L. Hernández
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The ECOSAP study investigators

Corresponding author

Correspondence to F. Marin.

ECOSAP (Ecografia Ósea en Atención Primaria) Study Group:

ECOSAP (Ecografia Ósea en Atención Primaria) Study Group:

J. Brunet, J. Comerma (ABS Sant Llatzer, Terrassa); C. Rubio, S. Cañadas, M. Berenguer (ABS Florida Nord, Hospitalet); J.M. Pérez (ABS Florida Sur, Hospitalet); E. Galindo, R.M. Alcolea, T. Rama (ABS Llefiá Badalona); J.J. Montero (ABS Ronda Prim, Mataró); E. Marco, S. Saura (ABS Sarriá de Ter, Girona); C. Carbonell, A. Cama, C. Olmos (ABS Via Roma, Barcelona); R. Villafáfila, C, Bentue (ABS Viladecans II, Barcelona); G. Amorós, E. Barraquer (CAP Horta Lisboa, Barcelona); M.B. Brun, L. Pons (CAP Montcada i Reixac, Barcelona); M. Abizanda, A. Cervera (CAP Gran Via, Barcelona); J. Gálvez, E. Mira (C.S. Los Ángeles, Alicante); V. Borreguero, M.A. Cabrera (C.S. El Pla Hospital, Alicante); A. Cebreiro, M. Puchades, J. Cantero (C.S. Algemesi-Alfafar, Valencia); R. González, M.L. Altarriba, A. García (C.S. Salvador Pau, Valencia); M.A. Fortea, M.A. López (C.S. Campanar, Valencia); A. Gimeno, Z. Pla (C.S. La Alcudia, Valencia); C. Alfonso, B. García (C.S. San Andrés, Murcia); J.E. Carrasco, J. Aliaga (C.S. Abarán, Murcia); J.A. Godinez, A. Durán (C.S. Antequera, Málaga); S. Áivarez (C.S. Las Albarizas, Marbella); F. Ruiz (C.S. Las Lagunas, Mijas Costa); R. Moya, M.A. Martin, M.M. Pérez, R. Vera (C.S. Cerro del Águila, Sevilla); T. Guerrero, H. Sánchez (C.S. Fuensanta, Sevilla); J. Calvo, J.A. Alameda, T. Toscano (CS El Molino de la Vega, Huelva); D. Martín (C.S. Torredelcampo, Jaén); J.A. Castro, J. Ortiz (C.S. Cartuja-Almanjayar, Granada); J.J. Rascón, P. Arqueros (C.S. Ciudad Jardín, Almería); E. Santos, M. Turégano (C.S. Zona Centro, Cáceres); M. Espigares, J. Pozuelos (C.S. La Paz, Badajoz); G. Rodríguez, J.M. Comas (C.S. Puebla de Montalbán, Toledo); E. Magaña, J. Pérez (C.S. Estación “Paseo del Muelle”, Talavera de la Reina); F. Chavida, C. Cancelo (C.S. Brihuega, Guadalajara); F. Lorta (C.S. La Roda, Albacete); D. Zapatero, M. Sanz, A.C. Áivarez, D. Ramírez (C.S. Avda. de Daroca, Madrid); R. Julián, M.V. Castell (C.S. Peñagrande, Madrid); J.C. Muñoz, S. Tojeiro (C.S. San Fernando, Madrid); M.L. Pascual, I. Nieto (C.S. Paseo de la Chopera, Madrid); J.A. Granados, F. Gómez, S. Sánchez (C.S. Guayaba, Madrid); O. Ortega de Santos, I. Jimeno (C.S. Isla de Oza, Madrid); C. Cámara, R. Tarano; T. Cascales (C.S. Coronel de Palma, Madrid); C. Onrrubia, R. Martín (C.S. José Aguado, León); M. Borge, C. Gago (C.S. Arturo Eyres Sur, Valladolid); E. Blanco, I. Flores (C.S. Béjar, Salamanca); J.L. Aguayo, P. Benavides (C.S. Pumarín, Oviedo); R. Villanueva, J.C. de la Fuente (C.S. García Alonso “Bombero Etxaniz,” Bilbao); E. Sampedro, V. Rubio (C.S. Hermanos Iturrino, Irún); M.C. Napal, J.A. Tabar (C.S. Barañain, Navarra); M.D. Martínez, A. Brugos (C.S. Rochapea, Pamplona); F.E. Teruel (C.S. Txantrea, Pamplona); M. Flores, M. Tejedor, E. Royo (C.S. Espartero, Logroño); L.V. Hernández, (C.S. La Almunia, Zaragoza); R. Córdoba, G. Guillén, E. de la Figuera (C.S. Delicias Sur, Zaragoza); and M. Nieva, A. Pérez, (Dpto. Investigación Médica, Lilly S. A., Madrid).

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Hernández, J., Marin, F., González-Macías, J. et al. Discriminative Capacity of Calcaneal Quantitative Ultrasound and of Osteoporosis and Fracture Risk Factors in Postmenopausal Women with Osteoporotic Fractures. Calcif Tissue Int 74, 357–365 (2004). https://doi.org/10.1007/s00223-003-0158-6

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