Predicting Non-traumatic Incident Fractures on Rheumatic Disease Patients on Long-term Glucocorticoids
Background: To identify contributors to non-traumatic incident fractures on rheumatic disease patients who are on long term glucocorticoids (LTGC) Methods: Two hundred and twenty patients on LTGC (110 with vertebral fracture and 110 without vertebral fracture) who participated in a cross-sectional s...
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| Format: | Article |
| Language: | English |
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World Scientific Publishing
2024-01-01
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| Series: | Journal of Clinical Rheumatology and Immunology |
| Online Access: | https://www.worldscientific.com/doi/10.1142/S2661341724740377 |
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| author | Sze-Lok Lau Ho So James Francis Griffith Vivian Wing Yin Hung Violet Ka Lai Lee Kitty Yan Kwok Shirley King Yee Ying Jack Jock Wai Lee Crystal Ying Chan Ling Qin Lai-Shan Tam |
| author_facet | Sze-Lok Lau Ho So James Francis Griffith Vivian Wing Yin Hung Violet Ka Lai Lee Kitty Yan Kwok Shirley King Yee Ying Jack Jock Wai Lee Crystal Ying Chan Ling Qin Lai-Shan Tam |
| author_sort | Sze-Lok Lau |
| collection | DOAJ |
| description | Background: To identify contributors to non-traumatic incident fractures on rheumatic disease patients who are on long term glucocorticoids (LTGC) Methods: Two hundred and twenty patients on LTGC (110 with vertebral fracture and 110 without vertebral fracture) who participated in a cross-sectional study in 2014-2015 were invited to have repeated assessments on 1) aBMD using dual-energy X-ray absorptiometry (DXA), 2) volumetric BMD (vBMD), microstructure and bone strength assessment of the wrist and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT) and 3) spine radiographs in the 5th year. Clinical covariates were recorded on questionnaires, and Fracture Risk Assessment Tool (FRAX) score was calculated accordingly. Non-traumatic incident fracture over the 5-year were documented. Receiver operating characteristic curve (ROC) analysis was performed to compare the strength of fracture prediction tools. Results: Out of the 140 patients who completed the 5th year assessments, 47 (33.6%) developed incident fractures. History of previous fracture, aBMD at hip and lumbar spine, T-score, trabecular vBMD, trabecular bone volume fraction and estimated bone strength at the tibia at baseline remained significantly different after adjusting for age between the group with and without incident fractures. The area under curve (AUC) of a prediction model comprised of age, history of previous fracture and average trabecular vBMD at tibia was comparable with that of the FRAX score (0.710 vs 0.679-0.702), and slightly outperformed than the AUC of DXA aBMD at hip and lumbar spine (0.628-0.668) under ROC analysis. Conclusion: Age, history of previous fracture and average trabecular vBMD at tibia could be the main contributors in building a prediction model for non-traumatic incident fracture in rheumatic disease patients on LTGC. |
| format | Article |
| id | doaj-art-5430e0849dba4167819e66e7a89738d2 |
| institution | Kabale University |
| issn | 2661-3417 2661-3425 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | World Scientific Publishing |
| record_format | Article |
| series | Journal of Clinical Rheumatology and Immunology |
| spelling | doaj-art-5430e0849dba4167819e66e7a89738d22024-11-12T08:27:23ZengWorld Scientific PublishingJournal of Clinical Rheumatology and Immunology2661-34172661-34252024-01-0124supp01505110.1142/S2661341724740377Predicting Non-traumatic Incident Fractures on Rheumatic Disease Patients on Long-term GlucocorticoidsSze-Lok Lau0Ho So1James Francis Griffith2Vivian Wing Yin Hung3Violet Ka Lai Lee4Kitty Yan Kwok5Shirley King Yee Ying6Jack Jock Wai Lee7Crystal Ying Chan8Ling Qin9Lai-Shan Tam10Department of Medicine n Therapeutics, The Chinese University of Hong Kong, Hong Kong SARDepartment of Medicine n Therapeutics, The Chinese University of Hong Kong, Hong Kong SARDepartment of Imaging & Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SARBone Quality and Health Centre of the Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SARDepartment of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong SARDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong SARDepartment of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong SARThe Jockey Club School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong SARThe Jockey Club School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong SARBone Quality and Health Centre of the Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SARDepartment of Medicine n Therapeutics, The Chinese University of Hong Kong, Hong Kong SARBackground: To identify contributors to non-traumatic incident fractures on rheumatic disease patients who are on long term glucocorticoids (LTGC) Methods: Two hundred and twenty patients on LTGC (110 with vertebral fracture and 110 without vertebral fracture) who participated in a cross-sectional study in 2014-2015 were invited to have repeated assessments on 1) aBMD using dual-energy X-ray absorptiometry (DXA), 2) volumetric BMD (vBMD), microstructure and bone strength assessment of the wrist and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT) and 3) spine radiographs in the 5th year. Clinical covariates were recorded on questionnaires, and Fracture Risk Assessment Tool (FRAX) score was calculated accordingly. Non-traumatic incident fracture over the 5-year were documented. Receiver operating characteristic curve (ROC) analysis was performed to compare the strength of fracture prediction tools. Results: Out of the 140 patients who completed the 5th year assessments, 47 (33.6%) developed incident fractures. History of previous fracture, aBMD at hip and lumbar spine, T-score, trabecular vBMD, trabecular bone volume fraction and estimated bone strength at the tibia at baseline remained significantly different after adjusting for age between the group with and without incident fractures. The area under curve (AUC) of a prediction model comprised of age, history of previous fracture and average trabecular vBMD at tibia was comparable with that of the FRAX score (0.710 vs 0.679-0.702), and slightly outperformed than the AUC of DXA aBMD at hip and lumbar spine (0.628-0.668) under ROC analysis. Conclusion: Age, history of previous fracture and average trabecular vBMD at tibia could be the main contributors in building a prediction model for non-traumatic incident fracture in rheumatic disease patients on LTGC.https://www.worldscientific.com/doi/10.1142/S2661341724740377 |
| spellingShingle | Sze-Lok Lau Ho So James Francis Griffith Vivian Wing Yin Hung Violet Ka Lai Lee Kitty Yan Kwok Shirley King Yee Ying Jack Jock Wai Lee Crystal Ying Chan Ling Qin Lai-Shan Tam Predicting Non-traumatic Incident Fractures on Rheumatic Disease Patients on Long-term Glucocorticoids Journal of Clinical Rheumatology and Immunology |
| title | Predicting Non-traumatic Incident Fractures on Rheumatic Disease Patients on Long-term Glucocorticoids |
| title_full | Predicting Non-traumatic Incident Fractures on Rheumatic Disease Patients on Long-term Glucocorticoids |
| title_fullStr | Predicting Non-traumatic Incident Fractures on Rheumatic Disease Patients on Long-term Glucocorticoids |
| title_full_unstemmed | Predicting Non-traumatic Incident Fractures on Rheumatic Disease Patients on Long-term Glucocorticoids |
| title_short | Predicting Non-traumatic Incident Fractures on Rheumatic Disease Patients on Long-term Glucocorticoids |
| title_sort | predicting non traumatic incident fractures on rheumatic disease patients on long term glucocorticoids |
| url | https://www.worldscientific.com/doi/10.1142/S2661341724740377 |
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