- Clinical Study
- Low Predictive Value of FRAX Adjusted by Trabecular Bone Score for Osteoporotic Fractures in Korean Women: A Community-Based Cohort Study
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Hana Kim, Jung Hee Kim, Min Joo Kim, A Ram Hong, HyungJin Choi, EuJeong Ku, Ji Hyun Lee, Chan Soo Shin, Nam H. Cho
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Endocrinol Metab. 2020;35(2):359-366. Published online June 24, 2020
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DOI: https://doi.org/10.3803/EnM.2020.35.2.359
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Abstract
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- Background
The value of the Fracture Risk Assessment Tool (FRAX) and the trabecular bone score (TBS) for assessing osteoporotic fracture risk has not been fully elucidated in Koreans. We conducted this study to clarify the predictive value of FRAX adjusted by TBS for osteoporotic fractures in Korean women.
Methods After screening 7,192 eligible subjects from the Ansung cohort, 1,165 women aged 45 to 76 years with available bone mineral density (BMD) and TBS data were enrolled in this study. We assessed their clinical risk factors for osteoporotic fractures and evaluated the predictive value of FRAX with or without BMD and TBS.
Results During the mean follow-up period of 7.5 years, 99 (8.5%) women suffered major osteoporotic fractures (MOFs) and 28 (2.4%) experienced hip fractures. FRAX without BMD, BMD-adjusted FRAX, and TBS-adjusted FRAX were significantly associated with the risk of MOFs (hazard ratio [HR] per percent increase, 1.08; 95% confidence interval [CI], 1.03 to 1.14; HR, 1.09; 95% CI, 1.03 to 1.15; and HR, 1.07; 95% CI, 1.02 to 1.13, respectively). However, BMD-adjusted FRAX and TBS-adjusted FRAX did not predict MOFs better than FRAX without BMD based on the Harrell’s C statistic. FRAX probabilities showed limited value for predicting hip fractures. The cut-off values of FRAX without BMD, FRAX with BMD, and FRAX with BMD adjusted by TBS for predicting MOFs were 7.2%, 5.0%, and 6.7%, respectively.
Conclusion FRAX with BMD and TBS adjustment did not show better predictive value for osteoporotic fractures in this study than FRAX without adjustment. Moreover, the cut-off values of FRAX probabilities for treatment might be lower in Korean women than in other countries.
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Citations
Citations to this article as recorded by
- Update on the utility of trabecular bone score (TBS) in clinical practice for the management of osteoporosis: a systematic review by the Egyptian Academy of Bone and Muscle Health
Yasser El Miedany, Walaa Elwakil, Mohammed Hassan Abu-Zaid, Safaa Mahran Egyptian Rheumatology and Rehabilitation.2024;[Epub] CrossRef - Enhancing Osteoporosis Management: A Thorough Examination of Surgical Techniques and Their Effects on Patient Outcomes
Mihnea Popa, Adrian Cursaru, Bogdan Cretu, Sergiu Iordache, Georgian L Iacobescu, Razvan Spiridonica, Bogdan Serban, Catalin Cirstoiu Cureus.2024;[Epub] CrossRef - Imaging bone turnover assessment through volumetric density-adjusted standardized uptake value using quantitative bone SPECT/CT in osteoporosis
Dong Yun Lee, Jungsu S. Oh, Ji Wan Kim, Seung Hun Lee, Beom-Jun Kim, Jung-Min Koh, Jae Seung Kim, Jin-Sook Ryu EJNMMI Research.2024;[Epub] CrossRef - Comparison of predictive value of FRAX, trabecular bone score, and bone mineral density for vertebral fractures in systemic sclerosis: A cross-sectional study
Kyung-Ann Lee, Hyun-Joo Kim, Hyun-Sook Kim Medicine.2023; 102(2): e32580. CrossRef - Screening for the primary prevention of fragility fractures among adults aged 40 years and older in primary care: systematic reviews of the effects and acceptability of screening and treatment, and the accuracy of risk prediction tools
Michelle Gates, Jennifer Pillay, Megan Nuspl, Aireen Wingert, Ben Vandermeer, Lisa Hartling Systematic Reviews.2023;[Epub] CrossRef - Chronic airway disease as a major risk factor for fractures in osteopenic women: Nationwide cohort study
Sung Hye Kong, Ae Jeong Jo, Chan Mi Park, Kyun Ik Park, Ji Eun Yun, Jung Hee Kim Frontiers in Endocrinology.2023;[Epub] CrossRef - Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Disease
Enisa Shevroja, Jean-Yves Reginster, Olivier Lamy, Nasser Al-Daghri, Manju Chandran, Anne-Laurence Demoux-Baiada, Lynn Kohlmeier, Marie-Paule Lecart, Daniel Messina, Bruno Muzzi Camargos, Juraj Payer, Sansin Tuzun, Nicola Veronese, Cyrus Cooper, Eugene V. Osteoporosis International.2023; 34(9): 1501. CrossRef - Comparison of HU histogram analysis and BMD for proximal femoral fragility fracture assessment: a retrospective single-center case–control study
Sun-Young Park, Hong Il Ha, Injae Lee, Hyun Kyung Lim European Radiology.2022; 32(3): 1448. CrossRef - Association of Trabecular Bone Score-Adjusted Fracture Risk Assessment Tool with Coronary Artery Calcification in Women
Tzyy-Ling Chuang, Yuh-Feng Wang, Malcolm Koo, Mei-Hua Chuang Diagnostics.2022; 12(1): 178. CrossRef - Risk of osteoporotic fracture in women using the FRAX tool with and without bone mineral density score in patients followed at a tertiary outpatient clinic ‒ An observational study
Maria Helena Sampaio Favarato, Maria Flora de Almeida, Arnaldo Lichtenstein, Milton de Arruda Martins, Mario Ferreira Junior Clinics.2022; 77: 100015. CrossRef - Comparison of Trabecular Bone Score–Adjusted Fracture Risk Assessment (TBS-FRAX) and FRAX Tools for Identification of High Fracture Risk among Taiwanese Adults Aged 50 to 90 Years with or without Prediabetes and Diabetes
Tzyy-Ling Chuang, Mei-Hua Chuang, Yuh-Feng Wang, Malcolm Koo Medicina.2022; 58(12): 1766. CrossRef - Application of the Trabecular Bone Score in Clinical Practice
Sung Hye Kong, Namki Hong, Jin-Woo Kim, Deog Yoon Kim, Jung Hee Kim Journal of Bone Metabolism.2021; 28(2): 101. CrossRef
- Clinical Study
- Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery
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Hana Kim, Sung Hye Kong, Jae Hoon Moon, Sang Yoon Kim, Kay-Hyun Park, Jun Sung Kim, Joong Haeng Choh, Young Joo Park, Cheong Lim
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Endocrinol Metab. 2020;35(2):308-318. Published online June 24, 2020
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DOI: https://doi.org/10.3803/EnM.2020.35.2.308
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7,418
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- Background
The aim of this study was to determine the associations between subclinical hypothyroidism (SCH) and long-term cardiovascular outcomes after coronary artery bypass grafting (CABG) or heart valve surgery (HVS).
Methods We retrospectively reviewed and compared all-cause mortality, cardiovascular mortality, and cardiovascular events in 461 patients who underwent CABG and 104 patients who underwent HVS.
Results During a mean±standard deviation follow-up duration of 7.6±3.8 years, there were 187 all-cause deaths, 97 cardiovascular deaths, 127 major adverse cardiovascular events (MACE), 11 myocardial infarctions, one unstable angina, 70 strokes, 30 hospitalizations due to heart failure, 101 atrial fibrillation, and 33 coronary revascularizations. The incidence of all-cause mortality after CABG was significantly higher in patients with SCH (n=36, 55.4%) than in euthyroid patients (n=120, 30.3%), with a hazard ratio of 1.70 (95% confidence interval, 1.10 to 2.63; P=0.018) after adjustment for age, sex, current smoking status, body mass index, underlying diseases, left ventricular dysfunction, and emergency operation. Interestingly, low total triiodothyronine (T3) levels in euthyroid patients who underwent CABG were significantly associated with increased risks of all-cause mortality, cardiovascular mortality, and MACE, but those associations were not observed in HVS patients. Both free thyroxine and thyroid-stimulating hormone levels in euthyroid patients were not related with any cardiovascular outcomes in either the CABG or HVS group.
Conclusion SCH or low total T3 might be associated with a poor prognosis after CABG, but not after HVS, implying that preoperative thyroid hormonal status may be important in ischemic heart disease patients.
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Citations
Citations to this article as recorded by
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Michele Dell’Aquila, Camilla S. Rossi, Tulio Caldonazo, Gianmarco Cancelli, Lamia Harik, Giovanni J. Soletti, Kevin R. An, Jordan Leith, Hristo Kirov, Mudathir Ibrahim, Michelle Demetres, Arnaldo Dimagli, Mohamed Rahouma, Mario Gaudino JTCVS Open.2024; 18: 64. CrossRef - Impact of subclinical hypothyroidism on outcomes after coronary artery bypass grafting: a systematic review and meta-analysis
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Hiba Masri-Iraqi, Yaron Rudman, Carmel Friedrich Dubinchik, Idit Dotan, Talia Diker-Cohen, Liat Sasson, Tzipora Shochat, Ilan Shimon, Eyal Robenshtok, Amit Akirov Endocrine Research.2023; 48(2-3): 68. CrossRef - Mid-term outcomes of patients with subclinical hypothyroidism after coronary bypass surgery
Dong Zhao, Wei Zhao, Chuangshi Wang, Fei Xu, Wei Zhao, Xieraili Tiemuerniyazi, Hao Ma, Wei Feng Interdisciplinary CardioVascular and Thoracic Surgery.2023;[Epub] CrossRef - Thyroid Pathology in High-Risk Cardiac Surgery Patients with Coronary Artery Disease
Olena K. Gogayeva, Anatoliy V. Rudenko, Vasyl V. Lazoryshynets, Serhii A. Rudenko, Tetiana A. Andrushchenko Ukrainian Journal of Cardiovascular Surgery.2022; 30(1 (46)): 9. CrossRef - High-TSH Subclinical Hypothyroidism Is Associated With Postoperative Mortality in Acute Type A Aortic Dissection
Shi-Pan Wang, Yuan Xue, Hai-Yang Li, Wen-Jian Jiang, Hong-Jia Zhang Frontiers in Endocrinology.2022;[Epub] CrossRef - Triiodothyronine improves contractile recovery of human atrial trabeculae after hypoxia/reoxygenation
Petra Kleinbongard, Philipp Kuthan, Chantal Eickelmann, Philipp Jakobs, Joachim Altschmied, Judith Haendeler, Arjang Ruhparwar, Matthias Thielmann, Gerd Heusch International Journal of Cardiology.2022; 363: 159. CrossRef - Hypothyroidism Is Correlated with Ventilator Complications and Longer Hospital Days after Coronary Artery Bypass Grafting Surgery in a Relatively Young Population: A Nationwide, Population-Based Study
Jiun-Yu Lin, Pei-Chi Kao, Yi-Ting Tsai, Chi-Hsiang Chung, Wu-Chien Chien, Chih-Yuan Lin, Chieh-Hua Lu, Chien-Sung Tsai Journal of Clinical Medicine.2022; 11(13): 3881. CrossRef - Minor perturbations of thyroid homeostasis and major cardiovascular endpoints—Physiological mechanisms and clinical evidence
Patrick Müller, Melvin Khee-Shing Leow, Johannes W. Dietrich Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef - Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape
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