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Articles: Lisa M. Kern, Neil R. Powe, Michael A. Levine, Annette L. Fitzpatrick, Tamara B. Harris, John Robbins, and Linda P. Fried Association between Screening for Osteoporosis and the Incidence of Hip Fracture Ann Intern Med 2005; 142: 173-181 [Abstract] [Full text] [PDF]

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Screening risk of fracture in Osteoporosis

Francisco R. Lafita, Belinda Garcia MD   (8 February 2005)

Screening risk of fracture in Osteoporosis 8 February 2005
Francisco R. Lafita, MD, PhD, FACP Gabinet Mèdic, Belinda Garcia MD Send rapid response to journal: Re: Screening risk of fracture in Osteoporosis frlafita{at}ilarportal.org Francisco R. Lafita, et al.	Bone fractures (especially femoral neck fractures) are one of the main concerns in patients with osteoporosis. (1) Kern and colleagues (2) interesting study shows how screening for osteoporosis was associated with a lower incidence of hip fractures over 6 years as compared with patients on usual medical care. Screened population showed a rate of low bone mineral density (BMD) of 33% and in 25 participants (1.8%) BMD was 2 SDs below the age-matched controls. Thirty-three incident fractures (2.4%) occurred in the screened group vs. 69 (4.0%) of the unscreened population. However it should be interesting to further investigate if fractures found in the screened group correlated with BMD decreases and if urinary bone resorption markers (NTx, CTx…) were previously increased in patients who suffered fractures as compared with those who did not. Authors also stated that not significant differences in hip fractures were noted among those patients in the screened group with low BMD users of bone enhancing medications as compared to not users. Therefore, serial determinations of BMD (3) and resorption markers (4) and their relationship with the use of bone enhancing medications should be interesting to perform in both groups of patients, in order to try to clear up the mechanism of the association found between screening for osteoporosis and reduction of fractures. 1. Contribution of bone mineral density and bone turnover markers to the estimation of risk of osteoporotic fracture in postmenopausal women. Garnero P, Delmas PD. Musculoskelet Neuronal Interact. 2004 Mar;4(1):50- 63. 2. Association between screening for osteoporosis and the incidence of hip fracture. Kern LM, Powe NR, Levine MA, Fitzpatrick AL, Harris TB, Robbins J, Fried LP. Ann Intern Med. 2005 Feb 1;142(3):173-81. 3. How should a DEXA scan be used to evaluate bisphosphonate therapy for osteoporosis? Koval PG, Easterling L, Pettus D, Mackler L, Gottschall AB. J Fam Pract. 2005 Jan;54(1):65-71. 4. Recommendations for monitoring antiresorptive therapies in postmenopausal osteoporosis. Roux C, Garnero P, Thomas T, Sabatier JP, Orcel P, Audran M; pour le Comite Scientifique du GRIO. Joint Bone Spine. 2005 Jan;72(1):26-31. Conflict of Interest: None declared