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Genetic factors and osteoporotic fractures in elderly people: prospective 25 year follow up of a nationwide cohort of elderly Finnish twins.

ABSTRACT: OBJECTIVE:To determine whether genetic factors partly explain variation in risk of osteoporotic fracture, the true end point of the osteoporosis problem. DESIGN:Prospective 25 year follow up of a nationwide cohort of elderly Finnish twins. SETTING:The Finnish twin cohort and the national hospital discharge register, covering the entire 5 million population of Finland. SUBJECTS:All same sex twin pairs born before 1946. The cohort contained 2308 monozygotic and 5241 dizygotic twin pairs (15 098 people) at the beginning of follow up. Main: outcome measure The number and concordance of osteoporotic fractures in the twin pairs, 1972-96. RESULTS:786 cohort members sustained an osteoporotic fracture. In women, the pairwise concordance rate for fracture (that is, the relative number of twin pairs in whom the fracture affected both twins in a pair) was 9.5% (95% confidence interval 5.3% to 15.5%) in monozygotic pairs and 7.9% (5.2% to 11.4%) in dizygotic pairs. In men, the figures were 9.9% (4.4% to 18.5%) and 2.3% (0.6% to 5.7%). CONCLUSIONS:Susceptibility to osteoporotic fractures in elderly Finns is not strongly influenced by genetic factors, especially in elderly women. The traditional strategy for prevention of osteoporotic fractures-that is, increasing peak bone mass and preventing age related bone loss-should be changed to include new elements such as prevention of falls and protection of the critical anatomical sites of the body when a fall occurs.

SUBMITTER: Kannus P

PROVIDER: S-EPMC28279 | biostudies-literature | 1999 Nov

REPOSITORIES: biostudies-literature

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Genetic factors and osteoporotic fractures in elderly people: prospective 25 year follow up of a nationwide cohort of elderly Finnish twins.

Kannus P P Palvanen M M Kaprio J J Parkkari J J Koskenvuo M M

BMJ (Clinical research ed.) 19991101 7221

<h4>Objective</h4>To determine whether genetic factors partly explain variation in risk of osteoporotic fracture, the true end point of the osteoporosis problem.<h4>Design</h4>Prospective 25 year follow up of a nationwide cohort of elderly Finnish twins.<h4>Setting</h4>The Finnish twin cohort and the national hospital discharge register, covering the entire 5 million population of Finland.<h4>Subjects</h4>All same sex twin pairs born before 1946. The cohort contained 2308 monozygotic and 5241 di ...[more]

PMID: 10567136

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Project description:BackgroundTo date, few reports have evaluated the long-term outcome of percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs) and the factors influencing the long-term outcome of this procedure are uncertain.MethodsA total of 91 patients underwent PKP for thoracolumbar OVCFs from June 2012 to December 2012. Pain Visual Analogue Scores (VAS) and Oswestry Disability Index (ODI) were recorded preoperatively and after 10-year follow-up. Factors that may affect surgical outcome, such as gender, age, height, weight, hypertension, diabetes, cause of injury, fracture segment, length of hospitalization, history of previous spinal surgery, preoperative bone mineral density (BMD), preoperative VAS and ODI scores, length of surgery, bone cement dosage, postoperative standardized anti-osteoporosis treatment, and other new vertebral fractures, were analyzed by multiple linear regression with VAS and ODI scores at the last follow-up. The correlation factors affecting the efficacy were analyzed.ResultsThe preoperative and final follow-up pain VAS was 7.9 ± 1.1 and 2.2 ± 1.1. ODI scores were 30.4 ± 4.2 and 10.7 ± 2.6. The difference was statistically significant (P < 0.05). Most of the patients were females aged 65-75 years who suffered low-energy injuries, with most of the fracture segments in the thoracolumbar region (T11-L2). At the final follow-up visit, 12 cases (13.19%) developed other new vertebral fractures, and 33 cases (36.26%) continued to adhere to anti-osteoporosis treatment after discharge. Multiple linear regression analysis showed that there was a statistical difference between gender and VAS score at the last follow-up (P < 0.05), and between age, cause of injury and postoperative standardized anti-osteoporosis treatment and ODI at the last follow-up (P < 0.05). There were no statistically significant differences between the other factors and the final follow-up VAS and ODI scores (P > 0.05).ConclusionThe long-term outcome after PKP is satisfactory. Age, gender, cause of injury, and standardized postoperative anti-osteoporosis treatment may be factors affecting the long-term outcome.

Dataset Information

Genetic factors and osteoporotic fractures in elderly people: prospective 25 year follow up of a nationwide cohort of elderly Finnish twins.

Publications

Genetic factors and osteoporotic fractures in elderly people: prospective 25 year follow up of a nationwide cohort of elderly Finnish twins.

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