Utilizing nomograms to predict prevalent vertebral fracture risk: An analysis of dysmobility syndrome in a community-dwelling population
Background: To determine a reliable method to predict prevalent vertebral fractures (VF) by assessing the association between dysmobility syndrome (DS) and VF in a community-dwelling population. Methods: This cross-sectional study enrolled 518 participants from fracture-prevention educational activi...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Biomedical Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2319417021001682 |
| _version_ | 1798004766312235008 |
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| author | Fang-Ping Chen Yu-Jr Lin An-Shine Chao Yu-Ching Lin Chen-Ming Sung Jung-Fu Chen Alice MK. Wong |
| author_facet | Fang-Ping Chen Yu-Jr Lin An-Shine Chao Yu-Ching Lin Chen-Ming Sung Jung-Fu Chen Alice MK. Wong |
| author_sort | Fang-Ping Chen |
| collection | DOAJ |
| description | Background: To determine a reliable method to predict prevalent vertebral fractures (VF) by assessing the association between dysmobility syndrome (DS) and VF in a community-dwelling population. Methods: This cross-sectional study enrolled 518 participants from fracture-prevention educational activities held in multiple communities in Taiwan. Assessments included questionnaires, fracture risk assessment tool (FRAX), bone mineral density (BMD) and body composition using dual-energy x-ray absorptiometry (DXA), lateral thoracolumbar spine x-rays (specifically T8-S1), grip strength (GS), walking speed, and fall history. Results: DS was noted in 257 participants (49.6%) and VF was identified in 196 participants (37.8%). A higher prevalence of VF was noted in those with DS. The prevalence of VF was significantly associated with age, gender, FRAX both with and without BMD, osteoporosis, low GS, and DS. In multivariate models accounting for age and sex, the c-index was greater in those with low GS plus osteoporosis as compared to DS alone. Low GS, osteoporosis, and pre-BMD FRAX all had similar c-indexes. Pre-BMD FRAX plus low GS and osteoporosis was superior in predicting VF compared to pre-BMD FRAX plus low GS or osteoporosis alone. Besides the inclusion of age and gender, the nomogram with pre-BMD FRAX major osteoporosis fracture probability (MOF) plus low GS had improved correlation between the estimated and actual VF probability than those with pre-BMD FRAX MOF plus osteoporosis. Conclusions: The constructed nomogram containing pre-BMD FRAX MOF plus low GS may be considered as a first-line prevalent VF screening method. Those with high-risk scores should subsequently undergo vertebral radiography and/or BMD. |
| first_indexed | 2024-04-11T12:28:37Z |
| format | Article |
| id | doaj.art-fd02d62b86144ab7b8de76f603192959 |
| institution | Directory Open Access Journal |
| issn | 2319-4170 |
| language | English |
| last_indexed | 2024-04-11T12:28:37Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Biomedical Journal |
| spelling | doaj.art-fd02d62b86144ab7b8de76f6031929592022-12-22T04:23:51ZengElsevierBiomedical Journal2319-41702022-12-01456931939Utilizing nomograms to predict prevalent vertebral fracture risk: An analysis of dysmobility syndrome in a community-dwelling populationFang-Ping Chen0Yu-Jr Lin1An-Shine Chao2Yu-Ching Lin3Chen-Ming Sung4Jung-Fu Chen5Alice MK. Wong6Keelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Corresponding author. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Keelung, 222 Mai-Chin Rd., Keelung 204, Taiwan.Research Service Center for Health Information, Chang Gung University, Taoyuan, TaiwanKeelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanKeelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Department of Radiology, Keelung Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanDepartment of Radiology, Keelung Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanKeelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Department of Endocrinology and Metabolism, Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, TaiwanDepartment of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, TaiwanBackground: To determine a reliable method to predict prevalent vertebral fractures (VF) by assessing the association between dysmobility syndrome (DS) and VF in a community-dwelling population. Methods: This cross-sectional study enrolled 518 participants from fracture-prevention educational activities held in multiple communities in Taiwan. Assessments included questionnaires, fracture risk assessment tool (FRAX), bone mineral density (BMD) and body composition using dual-energy x-ray absorptiometry (DXA), lateral thoracolumbar spine x-rays (specifically T8-S1), grip strength (GS), walking speed, and fall history. Results: DS was noted in 257 participants (49.6%) and VF was identified in 196 participants (37.8%). A higher prevalence of VF was noted in those with DS. The prevalence of VF was significantly associated with age, gender, FRAX both with and without BMD, osteoporosis, low GS, and DS. In multivariate models accounting for age and sex, the c-index was greater in those with low GS plus osteoporosis as compared to DS alone. Low GS, osteoporosis, and pre-BMD FRAX all had similar c-indexes. Pre-BMD FRAX plus low GS and osteoporosis was superior in predicting VF compared to pre-BMD FRAX plus low GS or osteoporosis alone. Besides the inclusion of age and gender, the nomogram with pre-BMD FRAX major osteoporosis fracture probability (MOF) plus low GS had improved correlation between the estimated and actual VF probability than those with pre-BMD FRAX MOF plus osteoporosis. Conclusions: The constructed nomogram containing pre-BMD FRAX MOF plus low GS may be considered as a first-line prevalent VF screening method. Those with high-risk scores should subsequently undergo vertebral radiography and/or BMD.http://www.sciencedirect.com/science/article/pii/S2319417021001682Vertebral fractureDysmobility syndromeFRAXBone mineral densityGrip strengthWalking speed |
| spellingShingle | Fang-Ping Chen Yu-Jr Lin An-Shine Chao Yu-Ching Lin Chen-Ming Sung Jung-Fu Chen Alice MK. Wong Utilizing nomograms to predict prevalent vertebral fracture risk: An analysis of dysmobility syndrome in a community-dwelling population Biomedical Journal Vertebral fracture Dysmobility syndrome FRAX Bone mineral density Grip strength Walking speed |
| title | Utilizing nomograms to predict prevalent vertebral fracture risk: An analysis of dysmobility syndrome in a community-dwelling population |
| title_full | Utilizing nomograms to predict prevalent vertebral fracture risk: An analysis of dysmobility syndrome in a community-dwelling population |
| title_fullStr | Utilizing nomograms to predict prevalent vertebral fracture risk: An analysis of dysmobility syndrome in a community-dwelling population |
| title_full_unstemmed | Utilizing nomograms to predict prevalent vertebral fracture risk: An analysis of dysmobility syndrome in a community-dwelling population |
| title_short | Utilizing nomograms to predict prevalent vertebral fracture risk: An analysis of dysmobility syndrome in a community-dwelling population |
| title_sort | utilizing nomograms to predict prevalent vertebral fracture risk an analysis of dysmobility syndrome in a community dwelling population |
| topic | Vertebral fracture Dysmobility syndrome FRAX Bone mineral density Grip strength Walking speed |
| url | http://www.sciencedirect.com/science/article/pii/S2319417021001682 |
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