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dc.contributor.authorBorgen, Tove Tveitanen_US
dc.contributor.authorBjørnerem, Åshilden_US
dc.contributor.authorSolberg, Lene Bergendalen_US
dc.contributor.authorAndreasen, Camillaen_US
dc.contributor.authorBrunborg, Cathrineen_US
dc.contributor.authorStenbro, May-Britten_US
dc.contributor.authorHübschle, Lars Michaelen_US
dc.contributor.authorFroholdt, Anneen_US
dc.contributor.authorFigved, Wenderen_US
dc.contributor.authorApalset, Ellen Margreteen_US
dc.contributor.authorGjertsen, Jan-Eriken_US
dc.contributor.authorBasso, Trudeen_US
dc.contributor.authorLund, Idaen_US
dc.contributor.authorHansen, Ann Kristinen_US
dc.contributor.authorStutzer, Jens-Meinharden_US
dc.contributor.authorOmsland, Tone Kristinen_US
dc.contributor.authorNordsletten, Larsen_US
dc.contributor.authorFrihagen, Frede Jonen_US
dc.contributor.authorEriksen, Erik Finken_US
dc.PublishedBorgen TT, Bjørnerem Å, Solberg LB, Andreasen C, Brunborg C, Stenbro M, Hübschle LM, Froholdt A, Figved W, Apalset EM, Gjertsen JE, Basso T, Lund I, Hansen AK, Stutzer J, Omsland TK, Nordsletten L, Frihagen FJ, Eriksen EF. Post-Fracture Risk Assessment: Target The Centrally Sited Fractures First! A Sub-Study of NoFRACT. Journal of Bone and Mineral Research. 2019;34(11):2036-2044eng
dc.description.abstractThe location of osteoporotic fragility fractures adds crucial information to post‐fracture risk estimation. Triaging patients according to fracture site for secondary fracture prevention can therefore be of interest to prioritize patients considering the high imminent fracture risk. The objectives of this cross‐sectional study were therefore to explore potential differences between central (vertebral, hip, proximal humerus, pelvis) and peripheral (forearm, ankle, other) fractures. This substudy of the Norwegian Capture the Fracture Initiative (NoFRACT) included 495 women and 119 men ≥50 years with fragility fractures. They had bone mineral density (BMD) of the femoral neck, total hip, and lumbar spine assessed using dual‐energy X‐ray absorptiometry (DXA), trabecular bone score (TBS) calculated, concomitantly vertebral fracture assessment (VFA) with semiquantitative grading of vertebral fractures (SQ1–SQ3), and a questionnaire concerning risk factors for fractures was answered. Patients with central fractures exhibited lower BMD of the femoral neck (765 versus 827 mg/cm2), total hip (800 versus 876 mg/cm2), and lumbar spine (1024 versus 1062 mg/cm2); lower mean TBS (1.24 versus 1.28); and a higher proportion of SQ1‐SQ3 fractures (52.0% versus 27.7%), SQ2–SQ3 fractures (36.8% versus 13.4%), and SQ3 fractures (21.5% versus 2.2%) than patients with peripheral fractures (all p  < 0.05). All analyses were adjusted for sex, age, and body mass index (BMI); and the analyses of TBS and SQ1–SQ3 fracture prevalence was additionally adjusted for BMD). In conclusion, patients with central fragility fractures revealed lower femoral neck BMD, lower TBS, and higher prevalence of vertebral fractures on VFA than the patients with peripheral fractures. This suggests that patients with central fragility fractures exhibit more severe deterioration of bone structure, translating into a higher risk of subsequent fragility fractures and therefore they should get the highest priority in secondary fracture prevention, although attention to peripheral fractures should still not be diminished.en_US
dc.rightsAttribution-NonCommercial-NoDerivs CC BY-NC-NDeng
dc.titlePost-Fracture Risk Assessment: Target The Centrally Sited Fractures First! A Sub-Study of NoFRACTen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright 2019 The Author(s)
dc.source.journalJournal of Bone and Mineral Research

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