EVALUATION OF BONE MINERAL DENSITY AND ASSOCIATION OF FRAX SCORE WITH FRACTURES AND DIABETES: A SINGLE-CENTRE CROSS-SECTIONAL REVIEW

Authors

  • Noor Ashikin Ismail
  • Abdullah Shamsir Abdul Mokti
  • Low Yen Nee
  • Carolina Shalini Singarayar
  • Lim Guat Yee
  • Chia Yong Kuang
  • Muhamad Riduan Daud
  • Dinehs Rao Ramakrishna Rao
  • Nirmalatiban Parthiban
  • Lio Jia Yin
  • Putri Arina Megat Mohamed Zainuddin
  • Chitra Devi Balasubramaniyam
  • Gowri Chandran
  • Gowri Chandran
  • Foo Siew Hui

Keywords:

bone mineral density, frax score, fractures, diabetes

Abstract

INTRODUCTION
Both osteoporosis and diabetes mellitus are highly prevalent among postmenopausal women and the elderly in Malaysia.
Individuals with diabetes are known to fracture at a relatively higher bone mineral density (BMD). We aimed to describe the
demographic, clinical characteristics and treatment regimen among patients screened for osteoporosis at Selayang Hospital
and examine the relationship between FRAX score and fracture in subjects with diabetes versus in those without diabetes.


METHODOLOGY
This is a cross-sectional review of patients aged 40 to 90 who underwent bone densitometry screening at Selayang Hospital.
Subjects who were commenced on osteoporosis medication for more than 12 months at the time of BMD assessment were
excluded. Demographic and clinical characteristics were obtained from electronic medical record. The 10-year risk of
fracture was estimated using FRAX-Singapore (www.sheffield.ac.uk/FRAX/tool.aspx).


RESULT
Three hundred thirty-four patients were included. The mean age was 64 ± 9.2 years old, 92% were women. Majority were
Chinese (47%) followed by Malay (35%) and Indian (18%). The mean BMI was 25 kg/m2. Diabetes was present in 22%.
Other common risk factors include rheumatoid arthritis (38%) and glucocorticoid exposure (14%). Forty patients (12%)
had a previous fracture. The mean FRAX scores for major osteoporotic and hip fractures were 10.9% and 4.5% respectively.
One hundred fifty-six subjects (47%) had FRAX score above the recommended treatment threshold for osteoporosis but
only 66% of them were commenced on treatment. Prevalent fracture was positively correlated with FRAX scores for both
major osteoporotic and hip fractures (p=0.01). This association did not differ significantly among individuals with diabetes
versus those without diabetes.


CONCLUSION
Osteoporosis is highly prevalent in this cohort with 12% already fractured before BMD evaluation. Forty-seven percent
(47%) fulfilled the recommended threshold for treatment, but more than one-third were not offered treatment. High FRAX
score was associated with a previous fracture. The presence of diabetes did not negatively impact this association.

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Author Biographies

Noor Ashikin Ismail

Endocrine Unit, Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Abdullah Shamsir Abdul Mokti

Endocrine Unit, Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Low Yen Nee

Endocrine Unit, Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Carolina Shalini Singarayar

Endocrine Unit, Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Lim Guat Yee

Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Chia Yong Kuang

Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Muhamad Riduan Daud

Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Dinehs Rao Ramakrishna Rao

Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Nirmalatiban Parthiban

Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Lio Jia Yin

Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Putri Arina Megat Mohamed Zainuddin

Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Chitra Devi Balasubramaniyam

Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Gowri Chandran

Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Gowri Chandran

Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

Foo Siew Hui

Endocrine Unit, Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia

References

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Published

2023-07-06

How to Cite

Ismail, N. A. ., Mokti, A. S. A. ., Nee, L. Y. ., Singarayar, C. S. ., Yee, L. G. ., Kuang, C. Y. ., … Hui, F. S. . (2023). EVALUATION OF BONE MINERAL DENSITY AND ASSOCIATION OF FRAX SCORE WITH FRACTURES AND DIABETES: A SINGLE-CENTRE CROSS-SECTIONAL REVIEW. Journal of the ASEAN Federation of Endocrine Societies, 38(S2), 6. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/3555

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Section

Abstracts for Oral Presentation | Adult