Sagittal alignment cut-off values for predicting future fall-related fractures in community-dwelling osteoporotic women.

PURPOSE: Determining the optimal cut-off value of sagittal alignment for detecting osteoporotic patients at high risk for fall-related fractures is essential for understanding fracture risk and informing clinicians and physical therapists. We determined the optimal cut-off value of sagittal alignment for detecting osteoporotic patients at high risk for fall-related fractures in this study. METHODS: In the retrospective cohort study, we enrolled a total of 255 women aged ≥ 65 years who visited an outpatient osteoporosis clinic. We measured participants' bone mineral density and sagittal alignment, including sagittal vertical axis (SVA), pelvic tilt, thoracic kyphosis, pelvic incidence, lumbar lordosis, global tilt, and gap score at the initial visit. The cut-off value for sagittal alignment that was significantly associated with fall-related fractures was calculated after using multivariate Cox proportional hazards regression analysis. RESULTS: Ultimately, 192 patients were included in the analysis. After a mean follow-up of 3.0 years, 12.0% (n = 23) had fractures due to falls. Multivariate Cox regression analysis confirmed that SVA (hazard ratio [HR] = 1.022, 95% confidence interval [CI] = 1.005-1.039) was the only independent predictor of fall-related fracture occurrence. The predictive ability of SVA for the occurrence of fall-related fractures was moderate (area under the curve [AUC] = 0.728, 95% CI = 0.623-0.834), with a cut-off value of 100 mm for SVA. SVA classified by cut-off value was also associated with an increased risk of developing fall-related fractures (HR = 17.002, 95% CI = 4.102-70.475). CONCLUSION: We found that assessing the cut-off value of sagittal alignment would be useful information in understanding fracture risk in postmenopausal older women.

A Comparison between Postmenopausal Osteoporotic Women and Normal Women of Their Nutrient Intakes and the Evaluation of Diet Quality / 대한지역사회영양학회지

The purpose of this study was to compare the nutrient intake and diet quality of postmenopausal osteoporotic women to those of control subjects, and to investigate the relationship among diet quality and bone mineral density in postmenopausal women. In this study, we classified the subjects into the postmenopausal osteoporotic women (n = 38) and control (n = 43) according to their lumbar spine bone mineral density and age. Dietary intakes, anthropometric measurements and dietary quality indices were measured and evaluated. The average age of osteoporotic and control group were 60.4 yrs and 58.3 yrs, respectively and there was no significant difference. Body weight, body mass index of osteoporotic group were significantly lower than those of control group. The average energy intake of osteoporotic and control group were 1243.3 kcal and 1475.8 kcal, respectively and there was a significant difference. The osteoporotic group consumed significantly lower quantities of protein, plant protein, vitamin A, vitamin B1, vitamin B2, folate, vitamin C, calcium, animal calcium, plant calcium, iron and zinc compared to the control group. The osteoporotic group consumed significantly lower of food, vegetables, mushrooms, fruits intakes compared to the control group. In the diet quality, protein, vitamin A, vitamin B1, vitamin B2, folate, vitamin C, calcium, iron, Zinc nutrient adequacy ratio (NAR) of osteoporotic group were significantly lower than that of control group. Mean adequacy ratio (MAR) of osteoporotic and control group were 0.63 and 0.78, respectively and there was significant difference. To evaluate nutrient density, Index of nutritional quality (INQ) was calculated by dividing nutrient content per 1,000 kcal of diet with RDA per 1,000 kcal. The average dietary variety score (DVS) of osteoporotic and control group were 22.4 and 33.2, respectively and there was significant difference. DVSs of pulses (p < 0.01), seeds (p < 0.01) and vegetables (p < 0.05) in osteoporotic group were significantly lower than those of the control. In conclusion, postmenopausal osteoporotic women had lower protein, vitamin A, folate, vitamin C, calcium, iron zinc intake quality and vegetables, mushrooms, fruits DVSs than those of the control. Therefore, to promote skeletal health enough energy and food should be consumed, and the maintenance of vitamin and mineral balance by increasing of vitamin A, folate, vitamin C, calcium, iron of intakes are very important.