Hassan Adla B, Almarabheh Amer, Almekhyal Abdulaziz, Karashi Ali Redha, Saleh Jamal, Shaikh Mansoor, Alawadhi Abdulhameed, Jahrami Haitham
Department of Internal Medicine, College of Medicine and Health Sciences, Arabian Gulf University, Manama 329, Bahrain.
King Abdullah Medical City, Manama 329, Bahrain.
Healthcare (Basel). 2024 Dec 12;12(24):2515. doi: 10.3390/healthcare12242515.
Osteoporosis-related fragility fractures are increasing worldwide. An assessment of the prevalence of fragility fractures in Bahrain is needed to determine proper action and preventive strategies. The main objective of this study was to conduct a retrospective cross-sectional study to investigate the prevalence of fragility fractures in adult Bahraini patients. Another objective was to explore the relationship of fragility fracture risk with BMD, age, sex, BMI, vitamin D status, and therapy.
To investigate the fragility fractures, we retrospectively reviewed the dual-energy X-ray absorptiometry (DEXA) data of patients who underwent scans for the diagnosis of osteoporosis between 2016 and 2018. The data were collected from four large centers in Bahrain. The patients' medical records were reviewed for the fragility fracture data, BMD, sex, age, BMI, vitamin D status, and therapy.
Among a total of 4572 patients who visited the radiology departments during the 3-year study period, only 412 patients with fragility fractures were considered for the current study. The mean age of the patients in this cohort was 63.9 ± 12.2 years. There were 393 females (95.6%). Among the 431 fragility fractures, there were 175 (40.6%) belonging to three common fracture sites: vertebral (86, 20.9%), femur (60, 14.6%), and distal radius (Colles) fractures (29, 7%). Other fragility fractures were hand (7%), radius and ulna (3.7%), humerus (6.5%), tibia and fibula (5.6%), foot/ankle (27.9%), ribs (3.0%), and pelvis (1.6%). Our results revealed a significant association between the fragility fractures and BMD (χ = 6.7, = 0.035). We reported a significant association of fragility fracture with sex ( = 0.006) and with denosumab therapy ( < 0.001).
This study reported a reduced BMD and an increased prevalence of fragility fractures among Bahraini subjects. The highest frequencies of fragility fractures among our cohort were foot/ankle, vertebral, and hip fractures, respectively. We showed a statistically significant association between fragility fractures and BMD. The current study indicated that not only patients with low BMD but also patients with fragility fractures were undertreated. Thus, the immediate initiation of treatment and the synthesis of local osteoporosis treatment guidelines are warranted.
骨质疏松相关的脆性骨折在全球范围内呈上升趋势。需要对巴林脆性骨折的患病率进行评估，以确定适当的行动和预防策略。本研究的主要目的是进行一项回顾性横断面研究，以调查成年巴林患者中脆性骨折的患病率。另一个目的是探讨脆性骨折风险与骨密度、年龄、性别、体重指数、维生素D状态及治疗之间的关系。
为调查脆性骨折情况，我们回顾性分析了2016年至2018年间接受骨质疏松诊断扫描患者的双能X线吸收测定（DEXA）数据。数据收集自巴林的四个大型中心。查阅患者病历以获取脆性骨折数据、骨密度、性别、年龄、体重指数、维生素D状态及治疗情况。
在为期3年的研究期间，共有4572名患者前往放射科就诊，本研究仅纳入了412例脆性骨折患者。该队列患者的平均年龄为63.9±12.2岁。其中女性393例（95.6%）。在431例脆性骨折中，有175例（40.6%）属于三个常见骨折部位：椎体（86例，20.9%）、股骨（60例，14.6%）和桡骨远端（科雷氏）骨折（29例，7%）。其他脆性骨折包括手部（7%）、桡骨和尺骨（3.7%）、肱骨（6.5%）、胫腓骨（5.6%）、足/踝部（27.9%）、肋骨（3.0%）和骨盆（1.6%）。我们的结果显示脆性骨折与骨密度之间存在显著关联（χ = 6.7，P = 0.035）。我们报告脆性骨折与性别（P = 0.006）及地诺单抗治疗（P < 0.001）之间存在显著关联。
本研究报告称巴林受试者骨密度降低且脆性骨折患病率增加。我们队列中脆性骨折发生率最高的分别是足/踝部、椎体和髋部骨折。我们显示脆性骨折与骨密度之间存在统计学显著关联。当前研究表明不仅骨密度低的患者，而且脆性骨折患者的治疗均不充分。因此，有必要立即开始治疗并制定当地的骨质疏松治疗指南。
