Emel LÜLECİ, Mikail ÖZDEMİR, Seda KOZAN, Alp Eren ÇELENLİOĞLU, Pınar KURU, Hülya PEYNİRCİ CERŞİT, Ahmet CUMHUR, Şefikcan BİRİCİK, Aylin GÖKŞEN, Gülseren AKYÜZ

Fracture History in Osteoporosis: Risk Factors and its Effect on Quality of Life

Background: Fractures are one of the main outcomes in osteoporosis and have an important effect on the general health status. Aims: The purpose of this study was to determine the effect of major fracture history on quality of life. We also investigated the important risk factors and their effect on bone mineral density and fracture history. Study Design: Cross-sectional study. Methods: We recruited 105 patients who were admitted to an osteoporosis outpatient clinic. Medical history, family history, calcium intake, physical activity level and biochemical tests were evaluated. Lumbar spine and femur neck bone mineral density were measured. The Qualeffo- 41 questionnaire was also used for evaluating quality of life. Results: The average age of the 105 patients included in the study was 56.04±13.73 and 89% of them were post-menopausal women. The average body mass index was 26.84±5.99, which means that the women were overweight. Also, 48.5% of the patients were diagnosed with osteoporosis and 51.5% of them were diagnosed as low bone density. A total of 34 patients had a fracture history with minor trauma and some of the patients had more than one fracture (12 ankle and foot, 10 forearm, 9 vertebral, 4 hand, 3 hip, 2 rib, 1 tibial). When the patients with and without fracture history were compared, the mean Qualeffo-41 score in patients with fracture was 43.85±2.57 and in the non-fracture group was 36.27±2.01. Conclusion: Forearm, ankle and foot fractures can be commonly seen in osteoporosis patients with fracture history. We suggest that it is important to recognise osteoporosis prior to first fracture and disease-specific quality of life assessment should be done.

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1. What is Osteoporosis? [Internet] [cited 2013 July 13]. Available from: http://www.osteofound.org/what-is-osteoporosis.
2. Skugor M. Osteoporosis. [Internet] [cited 2013 August 27]. Avaiable from: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/osteoporosis-disease/#top.
3. Becker DJ, Kilgore ML, Morrisey MA. The societal burden of osteoporosis. Curr Rheumatol Rep 2010;12:186-91. [CrossRef]
4. Keskin D, Borman P, Eser F, Bodur H, Köse K. Evaluation of physical activity, bone mineral density and quality of life of elderly. Turk J Geriatr 2008;11:113-8.
5. World Health Organization, WHOQOL Measuring Quality of Life, 1997, Geneva. [Internet] [cited: 2013 July 13]. Available from: http:// www.who.int/mental_health/media/68.pdf.
6. Sezer N, Tomruk-Sutbeyaz S, Kibar S, Köseoğlu F, Aras M. Determinants of quality of life in postmenopausal osteoporosis. J PMR Sci 2009;12:19-25.
7. Akyüz G, Ofluoğlu D. Pain and quality of life in osteoporosis. In: Gökçe Kutsal Y. Osteoporoz. Modern Tıp Seminerleri: 19. Ankara: Güneş Kitabevi; 2001:204-11.
8. Dilek B, Baydar M, Sahin E, Uz B. The presence of osteoporosis and subclinical vertebralfracture in patients over 45 years of age with a fracture of the distal and of the radius. Turk J Phys Med Rehab 2012;58:220-4. [CrossRef]
9. Lips Æ P, van Schoor MN. Quality of life in patients with osteoporosis. Osteoporos Int 2005;16:447-55. [CrossRef]
10. Kocyigit H, Gulseren S, Erol A, Hizli N, Memis A. The reliability and validity of Turkish version of quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Clin Rheumatol 2003;22:18-23. [CrossRef]
11. Lunt M, Masaryk P, Scheidt-Nave C, Nijs J, Poor G, Pols H, et al. The effects of lifestyle, dietary dairy intake and diabetes on bone density and vertebral deformity prevalence: The EVOS study. Osteoporos Int 2001;12:688-98. [CrossRef]
12. von Muhlen D, Safii S, Jassal SK, Svartberg J, Barrett-Connor E.Associations between the metabolic syndrome and bone health in older men and women: The Rancho Bernardo Study. Osteoporos Int 2007:18:1337-44. [CrossRef]
13. Sahin Z, Kumbasar F, Yigit S, Yaman V, Turhan B, Kartal I. The effect of dressing style on vitamin D level in winter. Turkish Journal of Osteoporosis 2011;17:6-9.
14. Vitamin D and calcium: A systematic review of health outcomes, evidence report/technology assessment, Number 183, Agency for Healthcare Research and Quality (AHRQ) Publication No. 09-E015 Tufts Evidence-based Practice Center: August 2009.
15. Cranney A, Horsley T, O’Donnell S, Weiler H, Puil L, Ooi D, et al. Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep) 2007;1-235.
16. Adachi JD, Loannidis G, Berger C, Joseph L, Papaioannou A, Pickard L, et al. Canadian Multicentre Osteoporosis Study (CaMos) Research Group. The influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across Canada. Osteoporos Int 2001;12:903-8. [CrossRef]
17. Peker O, El O, Gulbahar S, Akalın E, Oncel S, Gökçe-Kutsal Y. The effects of life style and exercise habits on bone mineral density in postmenopausal period of women. Ege Fiz Tıp Reh Der 2001;7:105-12.
18. Adachi JD, Ioannidis G, Olszynski WP, Brown JP, Hanley DA, Sebaldt RJ. The impact of incident vertebral and non-vertebral fractures on health related quality of life in postmenopausal women. BMC Musculoskelet Disord 2002;3:11. [CrossRef]
19. Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C, et al. Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 2000;15:1384-92. [CrossRef]
20. Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE et al. calcium plus vitamin d supplementation and the risk of fractures. N Engl J Med 2006;354:669-83. [CrossRef]
21. Cerrahoglu L, Duruoz MT, Tıkız C, Ölçenler S, Tulukoğlu N, Süsin A. The correlation between dietary calcium ıntake and bone mineral density in postmenopausal women. Turkish Journal of Osteoporosis 2002;8:173-7
.22. Langsetmo L, Berger C, Kreiger N, Kovacs CS, Hanley DA, Jamal SA, et al. Calcium and vitamin D intake and mortality: Results from the canadian multicentre osteoporosis study (camos). J Clin Endocrinol Metab 2013;98:3010-8. [CrossRef]
23. Prevention and management of osteoporosis: Report of a WHO scientific group. (WHO technical report series; 921) World Health Organization Geneva: 2003.
24. Chen Z, Pettinger MB, Ritenbaugh C, LaCroix AZ, Robbins J, Caan BJ, et al. Habitual tea consumption and risk of osteoporosis: A prospective study in the women’s health ınitiative observational cohort. Am J Epidemiol 2003;158:772-81. [CrossRef]
25. Watts NB, Bilezikian JP, Camacho PM, Greenspan SL, Haris ST, Hodgson SF, et al. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practise for the diagnosis and treatment of postmenopausal osteoporosis. Endocr Pract 2010;16(Suppl 3):S1-37. [CrossRef]
26. National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Washington, DC: National Osteoporosis Foundation; 2010.
27. Mauck KF, Clarke BL. Diagnosis, screening, prevention, and treatment of osteoporosis. Mayo Clin Proc 2006;81:662-72. [CrossRef]