Volume 6 · Number 1 · March 2014
- Journal of Osteoporosis and Mineral Metabolism. Five years on. New challenges [4-4]
- Treatment adherence: a difficult, but not impossible, challenge [5-7]
- Osteoporotic women with fractures show greater therapeutic compliance than those without fractures [8-13]
- Risk of fracture in the FRODOS cohort. Comparative study of the application of the Spanish, French, British and Swedish FRAX® models [14-19]
- Normal values of the aminoterminal propeptide of type I collagen (PINP) and the isomer beta I collagen carboxyterminal telopeptide (β-CTX) in serum of healthy premenopausal women of the Community of Madrid [20-22]
- Migratory arthralgia and sclerosing bone lesions. Differential diagnosis [23-26]
The Journal of Osteoporosis and Mineral Metabolism (Revista de Osteoporosis y Metabolismo Mineral) was first published in March 2009. It has now, therefore, completed its first five years. Born out of the need of the Spanish Society for Bone and Mineral Metabolism Research (Sociedad Española de Investigación Ósea y Metabolismo Mineral (SEIOMM) ) to have its own official organ to disseminate its scientific activities, taking over this role from the Revista Española de Enfermedades Metabólicas Óseas (REEMO) given the insoluble difficulties which the management committee of SEIOMM then found in reaching an agreement with the editors of REEMO, both from an economic point of view and, more importantly, regarding the management of the Journal.read more
The main aim of the treatment of a patient with osteoporosis is to avoid the appearance of osteoporotic fractures and, in the case in which it has already occurred, to avoid a new one. To achieve this is it important that in each specific case the risk of fracture is evaluated at the time and, as a function of its degree, low, medium or high, set out the preventative and therapeutic strategies necessary to reduce the risk of fracture in this specific person 1,2,3. One of the great challenges that still arises in daily clinical practice is to improve the adherence of patients to the various recommendations and treatments counselled by the health professionals.read more
Background: Fractures are a clinical complication of osteoporosis. Sufficient therapeutic compliance is necessary to reduce the risk of fracture. The literature suggests that a significant percentage of patients with osteoporosis soon abandon treatment, both drugs and calcium and vitamin D supplements.
Objectives: To study the degree of compliance with osteoporosis therapy in a population of women affected by the disease, with and without fragility fractures.
Patients and method: 413 women with a diagnosis of osteoporosis already established were included in the study consecutively, as they attended a health centre, without any selection or recruitment campaign.
Results: 38.6% of the women had suffered at least one fragility fracture, the most frequent being non-vertebral fractures as a whole, followed by vertebral fractures. Fractured patients had an average age 5 years older than those without fractures. The overall proportion of patients who were taking regular treatment was 66.1%, with the proportion of compliant patients being higher in those who had a fragility fracture, at 75.9% for those taking drugs in general and 84.1% for those taking calcium and vitamin D supplements, as against 59.7% and 68.4% respectively for those without fracture (p<0.001).
Conclusions: Those women affected by fragility fractures were older and had a greater adherence to treatment, both for drugs in general and for calcium and vitamin D supplements, than patients with osteoporosis without fractures. Non-vertebral fractures were those most commonly observed fractures.
Risk of fracture in the FRODOS cohort. Comparative study of the application of the Spanish, French, British and Swedish FRAX® models
Background and objectives: Studies on the validation of FRAX® in Spain show an underestimation of the risk of principal osteoporotic fractures (POFs) and more accurate predictions for femoral fractures (FF). It has been suggested that this algorithm may be improved with more specific data on the epidemiology of these fractures in Spain. The objectives of this work were to describe the baseline risk of fractures according to the Spanish FRAX® model in the participants of the FRODOS cohort, and to compare these data with the application of other European models of FRAX® in the same cohort.
Methods: Observational study in a population cohort of 2,968 postmenopausal women (59-70 years of age). The online desktop version of FRAX® was used for multiple data entries to calculate the risk of POFs and FFs at 10 years using the Spanish, French, British and Swedish models in the same cohort.
Results: The lowest risk corresponded to the Spanish model: FF: 1.22% (36 expected fractures) and POF: 5.28% (n=197), while the highest risk was for the Swedish model: FF: 3.15% and POF 13.51% (n=401). The models for France and the United Kingdom had intermediate values.
Conclusion: In a Spanish cohort of 2,968 postmenopausal women the percentage risk of expected fractures at 10 years increased following a south-north latitude gradient when different European FRAX® models were applied. The results for the incidence of fractures on the FRODOS cohort predicted for the coming years will confirm, or not, the usefulness of this analysis.
Normal values of the aminoterminal propeptide of type I collagen (PINP) and the isomer beta I collagen carboxyterminal telopeptide (β-CTX) in serum of healthy premenopausal women of the Community of Madrid
Introduction: In the laboratory it is sometimes difficult to find the normality intervals of the population itself, there being a tendency to give the normality value specified by the manufacturer of the reagent. The aim of this work was to calculate the normality values for aminoterminal propeptide of type I collagen (PINP) and for the beta isomer of carboxy-terminal telopeptide of type I collagen (β-CTX) in the blood of a group of premenopausal women from the autonomous Community of Madrid.
Materials and methods: The study was carried out in 50 healthy premenopausal women between 27 and 40 years of age (mean ± standard deviation of 34±3 years, working in a hospital and a pharmaceutical laboratory in Madrid.
Blood levels of PINP and β-CTX were determined using the technique of electrochemiluminescence (Elecsys, Roche).
Results: Normal values of 36.2±12.9 ng/ml (range 10.4 to 62) for PINP and 0.306±0.121 ng/ml (range of 0.064 to 0.548) for β-CTX were obtained.
Conclusions: Although the population sample used was small and localised, we consider that these values may be used as the normality interval for Spanish women.
Osteopokilosis is a rare benign bone dysplasia that may result in musculoskeletal pain, although it is usually asymptomatic. It is frequently suspected and diagnosed by the incidental finding of characteristic bone lesions on plain radiographs requested for another reason. Identifying these lesions and ruling out other possible causes is crucial to carry out a correct differential diagnosis and to avoid unnecessary invasive studies. We describe a case of a patient 32 years old who was referred to our rheumatology department because of joint pain.read more