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The role of carboxy-terminal cross-linking telopeptide of type I collagen, dual x-ray absorptiometry bone strain and Romberg test in a new osteoporotic fracture risk evaluation: A proposal from an observational study.
PLoS One. 2018; 13(1):e0190477.Plos

Abstract

The consolidated way of diagnosing and treating osteoporosis in order to prevent fragility fractures has recently been questioned by some papers, which complained of overdiagnosis and consequent overtreatment of this pathology with underestimating other causes of the fragility fractures, like falls. A new clinical approach is proposed for identifying the subgroup of patients prone to fragility fractures. This retrospective observational study was conducted from January to June 2015 at the Nuclear Medicine-Bone Metabolic Unit of the of the Fondazione IRCCS Ca' Granda, Milan, Italy. An Italian population of 125 consecutive postmenopausal women was investigated for bone quantity and bone quality. Patients with neurological diseases regarding balance and vestibular dysfunction, sarcopenia, past or current history of diseases and use of drugs known to affect bone metabolism were excluded. Dual X-ray absorptiometry was used to assess bone quantity (bone mineral density) and bone quality (trabecular bone score and bone strain). Biochemical markers of bone turnover (type I collagen carboxy-terminal telopeptide, alkaline phosphatase, vitamin D) have been measured. Morphometric fractures have been searched by spine radiography. Balance was evaluated by the Romberg test. The data were evaluated with the neural network analysis using the Auto Contractive Map algorithm. The resulting semantic map shows the Minimal Spanning Tree and the Maximally Regular Graph of the interrelations between bone status parameters, balance conditions and fractures of the studied population. A low fracture risk seems to be related to a low carboxy-terminal cross-linking telopeptide of type I collagen level, whereas a positive Romberg test, together with compromised bone trabecular microarchitecture DXA parameters, appears to be strictly connected with fragility fractures. A simple assessment of the risk of fragility fracture is proposed in order to identify those frail patients at risk for osteoporotic fractures, who may have the best benefit from a pharmacological and physiotherapeutic approach.

Authors+Show Affiliations

Nuclear Medicine Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.Gastroenterology and Digestive Endoscopy Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.Villa Santa Maria Institute, Tavernerio (CO), Italy.TECHNOLOGIC S.r.l. Hologic Italia, Turin, Italy.Postgraduation School in Radiodiagnostics, University of Milan, Milan, Italy.Physical Medicine and Rehabilitation Physician, A.S.P. I.M.M e S. e P.A.T, Milan, Italy.Endocrinology and Metabolic Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Clinical Chemistry and Microbiology Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Radiodiagnostics Unit, IRCCS Policlinico San Donato, Milan, Italy.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29304151

Citation

Ulivieri, Fabio M., et al. "The Role of Carboxy-terminal Cross-linking Telopeptide of Type I Collagen, Dual X-ray Absorptiometry Bone Strain and Romberg Test in a New Osteoporotic Fracture Risk Evaluation: a Proposal From an Observational Study." PloS One, vol. 13, no. 1, 2018, pp. e0190477.
Ulivieri FM, Piodi LP, Grossi E, et al. The role of carboxy-terminal cross-linking telopeptide of type I collagen, dual x-ray absorptiometry bone strain and Romberg test in a new osteoporotic fracture risk evaluation: A proposal from an observational study. PLoS ONE. 2018;13(1):e0190477.
Ulivieri, F. M., Piodi, L. P., Grossi, E., Rinaudo, L., Messina, C., Tassi, A. P., Filopanti, M., Tirelli, A., & Sardanelli, F. (2018). The role of carboxy-terminal cross-linking telopeptide of type I collagen, dual x-ray absorptiometry bone strain and Romberg test in a new osteoporotic fracture risk evaluation: A proposal from an observational study. PloS One, 13(1), e0190477. https://doi.org/10.1371/journal.pone.0190477
Ulivieri FM, et al. The Role of Carboxy-terminal Cross-linking Telopeptide of Type I Collagen, Dual X-ray Absorptiometry Bone Strain and Romberg Test in a New Osteoporotic Fracture Risk Evaluation: a Proposal From an Observational Study. PLoS ONE. 2018;13(1):e0190477. PubMed PMID: 29304151.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of carboxy-terminal cross-linking telopeptide of type I collagen, dual x-ray absorptiometry bone strain and Romberg test in a new osteoporotic fracture risk evaluation: A proposal from an observational study. AU - Ulivieri,Fabio M, AU - Piodi,Luca P, AU - Grossi,Enzo, AU - Rinaudo,Luca, AU - Messina,Carmelo, AU - Tassi,Anna P, AU - Filopanti,Marcello, AU - Tirelli,Anna, AU - Sardanelli,Francesco, Y1 - 2018/01/05/ PY - 2016/10/12/received PY - 2017/12/17/accepted PY - 2018/1/6/entrez PY - 2018/1/6/pubmed PY - 2018/2/22/medline SP - e0190477 EP - e0190477 JF - PloS one JO - PLoS ONE VL - 13 IS - 1 N2 - The consolidated way of diagnosing and treating osteoporosis in order to prevent fragility fractures has recently been questioned by some papers, which complained of overdiagnosis and consequent overtreatment of this pathology with underestimating other causes of the fragility fractures, like falls. A new clinical approach is proposed for identifying the subgroup of patients prone to fragility fractures. This retrospective observational study was conducted from January to June 2015 at the Nuclear Medicine-Bone Metabolic Unit of the of the Fondazione IRCCS Ca' Granda, Milan, Italy. An Italian population of 125 consecutive postmenopausal women was investigated for bone quantity and bone quality. Patients with neurological diseases regarding balance and vestibular dysfunction, sarcopenia, past or current history of diseases and use of drugs known to affect bone metabolism were excluded. Dual X-ray absorptiometry was used to assess bone quantity (bone mineral density) and bone quality (trabecular bone score and bone strain). Biochemical markers of bone turnover (type I collagen carboxy-terminal telopeptide, alkaline phosphatase, vitamin D) have been measured. Morphometric fractures have been searched by spine radiography. Balance was evaluated by the Romberg test. The data were evaluated with the neural network analysis using the Auto Contractive Map algorithm. The resulting semantic map shows the Minimal Spanning Tree and the Maximally Regular Graph of the interrelations between bone status parameters, balance conditions and fractures of the studied population. A low fracture risk seems to be related to a low carboxy-terminal cross-linking telopeptide of type I collagen level, whereas a positive Romberg test, together with compromised bone trabecular microarchitecture DXA parameters, appears to be strictly connected with fragility fractures. A simple assessment of the risk of fragility fracture is proposed in order to identify those frail patients at risk for osteoporotic fractures, who may have the best benefit from a pharmacological and physiotherapeutic approach. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/29304151/The_role_of_carboxy_terminal_cross_linking_telopeptide_of_type_I_collagen_dual_x_ray_absorptiometry_bone_strain_and_Romberg_test_in_a_new_osteoporotic_fracture_risk_evaluation:_A_proposal_from_an_observational_study_ L2 - http://dx.plos.org/10.1371/journal.pone.0190477 DB - PRIME DP - Unbound Medicine ER -