Asking the right questions helps to diagnose osteoporosis
MedWire News: Questionnaires detailing a patient's personal and family medical history are a useful diagnostic tool for osteoporosis patients suffering metaphyseal fractures, say researchers.
"There are various risk factors, which are assumed to correlate with osteoporosis. These are anamnestic details of the patient's medical history," say Leila Kolios (Burn Care Centre, Ludwigshafen, Germany) and colleagues.
The researchers confirmed that a set of these risk factors correlates with pathologic bone mineral density (BMD) and could therefore prove a cost-effective tool for indentifying osteoporosis in fracture patients.
The study, published in BMC Musculoskeletal Disorders, involved 12 male and 66 female patients, with an overall mean age of 62.2 years, who had suffered a metaphyseal fracture of the distal radius, proximal humerus or proximal femur.
All filled out a questionnaire asking about a set of 22 risk factors previously linked to osteoporosis, with two of these applying only to the women. The questions included whether there was a patient or family history of osteoporotic fracture, early menopause, low body mass index (< 20 kg/m2), or alcohol abuse. Using dual-energy X-ray absoprtiometry (DXA), osteoporosis prevalence in the patient cohort was measured - overall, 76.9% of the patients had low BMD and 43.6% showed manifest osteoporosis.
The risk factor questionnaire correlated highly significantly with low BMD; the leading risk factors being a positive family history of osteoporosis, age greater than70 years, nicotine abuse, early menopause, reduction of body height by 4cm or more, and previous osteoporotic fracture.
Four of the risk factors in the questionnaire were not present in the cohort; therefore anorexia nervosa, BMI less than 20 kg/m2, hyperparathyroidism, and malabsorption syndrome were not investigated here.
All but 11 patients had blood and urine samples assessed for 11 bone-metabolism-specific laboratory values; seven of these values were significantly associated with BMD. Homocysteine, vitamin D, and desoxypyridinoline were the most commonly abnormal factors, followed by parathyroid hormone, procollagen Typ 1 N propeptide, creatinine, and vitamin B12.
"Astonishingly, the cost-effective and 'simple' medical questionnaire showed a high correlation with reduced BMD and therewith presents next to the laboratory values a powerful instrument for osteoporosis diagnostics," conclude the researchers.
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By Chloe McIvor