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. 2020 Jul;19(2):72-79.
doi: 10.5114/pm.2020.97844. Epub 2020 Jul 13.

High rates of undiagnosed and untreated osteoporosis in postmenopausal women receiving medical services in the area of Upper Silesia

Marcin Hachuła  1 , Barbara Pietrzyk  2 , Wojciech Gruszka  2 , Ida Cedrych  3 , Jerzy Chudek  2   3
Affiliations

High rates of undiagnosed and untreated osteoporosis in postmenopausal women receiving medical services in the area of Upper Silesia

Marcin Hachuła et al. Prz Menopauzalny. 2020 Jul.

Abstract

Introduction: High social cost and high risk of disability make postmenopausal osteoporosis one of major public health problem in the 21st century. The aim of this study was to assess frequency of undiagnosed and untreated osteoporosis in postmenopausal women in the Upper Silesia Region of Poland. Additionally, we compare estimation of the 10-year probability of major osteoporotic fractures (MOF) and hip fractures (HF) based on fracture risk assessment tool (FRAX) with and without bone mineral density (BMD).

Material and methods: The survey included 450 postmenopausal women (age 65 ±11 years). A detailed questionnaire included demographic and anthropometric data, comorbidity, history of previous low-energy fractures, family medical history, and treatment for osteoporosis. The FRAX calculator was used to estimate the risk of MOF and HF.

Results: Osteoporosis was previously diagnosed in 23.7% women. Of those 70.2% were receiving vitamin D, 27% calcium preparations, 33% bisphosphonates, and 22% were untreated. Only 42.2% women with previous fractures had been diagnosed with osteoporosis and 42.8% received any treatment. 12.5% women with FRAX-BMD ≥ 10% had no risk factors of osteoporosis and < 10% risk of MOF and HF in FRAX without BMD.

Conclusions: Osteoporosis often remains undiagnosed and untreated in postmenopausal women. There is a great need to popularize FRAX without BMD calculator among physicians, especially GPs, as the risk calculation justify the implementation of antiosteoporotic therapy. Women with burden of risk factors of fractures and borderline FRAX without BMD values, should be referred to a densitometry examination, as having greater risk of fracture than shown by FRAX without BMD.

Keywords: FRAX calculator; osteoporosis; postmenopausal women; undiagnosed osteoporosis; untreated osteoporosis.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Fig. 1
Fig. 1
Undiagnosed osteoporosis in postmenopausal women (n = 103)
Fig. 2
Fig. 2
Optimal and suboptimal treatment for osteoporosis among patients with the disease (n = 111)
Fig. 3
Fig. 3
The comparison of FRAX-BMD and FRAX-BMI (Bland-Altman method)
See this image and copyright information in PMC

References

    1. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis Prevention, Diagnosis, and Therapy. JAMA 2001; 285: 785-795.
    1. Kanis JA, Cooper C, Rizzoli R, Reginster JY; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2019; 30: 3-44. - PMC - PubMed
    1. Janiszewska M, Kulik T, Dziedzic M, et al. Osteoporoza jako problem społeczny–patogeneza, objawy i czynniki ryzyka osteoporozy pomenopauzalnej. Probl Hig Epidemiol 2015; 96: 106-114.
    1. Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002; 359: 1761-1767. - PubMed
    1. Abrahamsen B, van Staa T, Ariely R, et al. Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 2009; 20: 1633-1650. - PubMed