Osteoporotic vertebral fractures and subsequent fractures: risk factors from a retrospective observational study of patients with osteoporosis.

IF 3.9 3区生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Frontiers in Molecular Biosciences Pub Date : 2025-03-19 eCollection Date: 2025-01-01 DOI:10.3389/fmolb.2025.1558052

Mingxing Fan, Ran Lu, Jiayuan Wu, Jie Huang, Yanming Fang

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引用次数: 0

Abstract

Purpose: Osteoporosis is a progressive, systemic, skeletal disorder characterized by increased bone fragility and susceptibility to fracture. Prior fractures are a strong predictor of subsequent fractures, but it is essential to identify further clinical and demographic characteristics of patients with osteoporosis that are associated with subsequent fracture risk.

Methods: In this retrospective observational cohort study, male and female patients over the age of 55 years with osteoporosis who experienced vertebral fractures between 2019 and 2021 were included. All patients' basic clinical data, serum biochemical and bone turnover markers, bone mineral density, and other indicators were recorded uniformly. The incidence of subsequent fractures during the two-year follow-up period was analyzed. Independent risk factors for subsequent fractures were identified by binary logistic regression analysis.

Results: A total of 1,096 patients were included. Of these, 311 (28.4%) patients suffered a subsequent fracture during the two-year follow-up period. The incidences of subsequent fracture sites were 18.4% vertebral, 14.2% forearm/wrist/hand, and 9.9% hip/femur. Compared with the non-subsequent fracture group (non-SFG), binary logistic regression analysis showed that body mass index (BMI) (OR [95% CI] 0.825 [0.720-0.945]; P = 0.006), femoral neck bone mineral density (BMD) T-score (OR [95% CI] 0.067 [0.012-0.385]; P = 0.002), and C-terminal telopeptide of type 1 collagen (CTX) levels (OR [95% CI] 6.089 [1.735-21.375]; P = 0.005) were independent risk factors associated with subsequent fractures.

Conclusion: Patients with osteoporosis and previous vertebral fractures are at a higher risk of further fractures at a two-year follow-up period. BMI, femoral neck BMD T-score, and CTX levels were independent risk factors for refracture. Integrating BMI, femoral neck BMD, and CTX levels into an individualized care plan for patients with osteoporotic vertebral fractures may help prevent subsequent fractures in high-risk populations.

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骨质疏松性椎体骨折和随后的骨折：来自骨质疏松患者回顾性观察研究的危险因素。

目的：骨质疏松症是一种进行性的、全身性的骨骼疾病，其特征是骨骼脆性增加和骨折易感性增加。先前的骨折是后续骨折的一个强有力的预测因素，但有必要进一步确定与后续骨折风险相关的骨质疏松症患者的临床和人口统计学特征。方法：在这项回顾性观察队列研究中，纳入了2019年至2021年期间发生椎体骨折的55岁以上骨质疏松症患者。所有患者的基本临床资料、血清生化及骨转换指标、骨密度等指标均统一记录。在两年的随访期间，分析后续骨折的发生率。通过二元logistic回归分析确定后续骨折的独立危险因素。结果：共纳入1096例患者。其中，311例（28.4%）患者在两年随访期间发生骨折。随后骨折部位的发生率为椎体18.4%，前臂/手腕/手14.2%，髋关节/股骨9.9%。与非后续骨折组（non-SFG）比较，二元logistic回归分析显示，体重指数（BMI） (OR [95% CI] 0.825 [0.720-0.945]；P = 0.006)，股骨颈骨密度（BMD） t评分(OR [95% CI] 0.067 [0.012-0.385]；P = 0.002)， 1型胶原c端末端肽（CTX）水平(OR [95% CI] 6.089 [1.735-21.375]；P = 0.005)是与后续骨折相关的独立危险因素。结论：骨质疏松和既往椎体骨折的患者在两年的随访期间有更高的进一步骨折的风险。BMI、股骨颈BMD t评分和CTX水平是再骨折的独立危险因素。将BMI、股骨颈骨密度和CTX水平整合到骨质疏松性椎体骨折患者的个体化护理计划中，可能有助于预防高危人群的后续骨折。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Molecular Biosciences Biochemistry, Genetics and Molecular Biology-Biochemistry

CiteScore

7.20

自引率

4.00%

发文量

1361

审稿时长

14 weeks

期刊介绍： Much of contemporary investigation in the life sciences is devoted to the molecular-scale understanding of the relationships between genes and the environment — in particular, dynamic alterations in the levels, modifications, and interactions of cellular effectors, including proteins. Frontiers in Molecular Biosciences offers an international publication platform for basic as well as applied research; we encourage contributions spanning both established and emerging areas of biology. To this end, the journal draws from empirical disciplines such as structural biology, enzymology, biochemistry, and biophysics, capitalizing as well on the technological advancements that have enabled metabolomics and proteomics measurements in massively parallel throughput, and the development of robust and innovative computational biology strategies. We also recognize influences from medicine and technology, welcoming studies in molecular genetics, molecular diagnostics and therapeutics, and nanotechnology. Our ultimate objective is the comprehensive illustration of the molecular mechanisms regulating proteins, nucleic acids, carbohydrates, lipids, and small metabolites in organisms across all branches of life. In addition to interesting new findings, techniques, and applications, Frontiers in Molecular Biosciences will consider new testable hypotheses to inspire different perspectives and stimulate scientific dialogue. The integration of in silico, in vitro, and in vivo approaches will benefit endeavors across all domains of the life sciences.