The Differences Of Bone Mineral Density, Bone Turnover Markers And FRAX Calculation Between Severe Osteoporotic Elderly Female Patients With And Without Fractures

Objectives:Compare the differences of bone mineral density (aBMD, vBMD), bone turnover markers and FRAX calculation between the severe osteoporotic elder female patients with and without fractures.Methods:30elderly women with severe osteoporosis, who had fracture group and non-fracture group (each group including of15cases) were studied. Some important clinical information were collected, dual energy X-ray absorptiometry (DXA) was used to measure the area bone mineral density (aBMD) of the first to the fourth lumbar vertebra and left femur of each patients. Volume bone mineral density (vBMD) of the second to the fourth lumbar vertebra and left femur were measured by quantitative computed tomography. Serum osteocalcin (OC), bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase type5b (TRAP-5b) and urine collagen type I cross-linked C-telopeptide (U-CTX) were measured by ELISA. The10-year probability of a major osteoporotic fracture and a hip fracture was calculated by using the fracture risk assessment (FRAX) model. All the result differences were analyses between the two groups.Results:1. Body weight and body mass index in fracture group were significantly lower than in non-fracture group (P<0.05).2. There were no statistical differences between the two groups in lumbar vertebra aBMD and BMC measured by DXA. While, the BMC of left femur neck and aBMD of total hip in fracture group were significantly lower than in non-fracture group (P<0.05).3. The vBMD of the second to the fourth lumbar trabecular bone measured by QCT in fracture group was significantly lower than in non-fracture group (P<0.05), as well as the aBMD and BMC of the integral femur neck which also measured by QCT.4. The bone turnover index of the serum OC, BAP, TRAP-5b and urine CTX had no statistical differences between the two groups. But they are at high turnover levels.5. In the FRAX model, whether BMD values were included of, both the predict10-year probability of major osteoporotic fracture and hip fracture were much higher in fracture group than that in non-fracture group(P<0.01).There was no significantly difference between the two groups in the prediction of10-year probability of major osteoporotic fracture and hip fracture, when the history of prior fracture was denied. Conclusions:The patients with severe osteoporosis had a high level in bone turnover; compared with DXA, QCT was more sensitive to reflect the changes of bone mineral density; the fracture history played a very important role in FRAX model.