Medications as a Risk Factor for Fragility Hip Fractures: A Systematic Review and Meta-analysis

AbstractFragility hip fractures and their associated morbidity and mortality pose a global healthcare problem. Several pharmaceutical products have been postulated to alter bone architecture and contribute to fragility hip fractures. We searched four electronic databases from inception to September 2017. Inclusion criteria were the following: (1) adult patients with fragility hip fractures, (2) full text in English, (3) minimum one-year follow-up, and (4) reporting of at least one risk factor. To minimize heterogeneity among the studies, we performed subgroup analyses. Whenever heterogeneity remained significant, we employed random effect meta-analysis for data pooling. Thirty-eight studies were included, containing 1,244,155 subjects and 188,966 cases of fragility hip fractures. Following medications were significantly associated with fragility hip fractures: Antidepressants (OR 2.07, 95% CI 1.98 –2.17), antiparkinsonian drugs (OR 2.21, 95% CI 1.15–4.24), antipsychotic drugs (OR 2.0, 95% CI 1.50–2.66), anxiolytic drugs (OR 1.44, 95% CI 1.19–1.75), benzodiazepines (OR 1.84, 95% CI 1.26–2.69), sedatives (OR 1.33, 95% CI 1.14–1.54), systemic corticosteroids (OR 1.65, 95% CI 1.37–1 .99), H2 antagonists (OR 1.21, 95% CI 1.18 –1.24), proton pump inhibitors (OR 1.41, 95% CI 1.16–1.71), and thyroid hormone (OR 1.29, 95% CI 1.13–1.47). Hormone replacement therapy with estrogen (HRT) was associated with decreased risk of hip ...
Source: Calcified Tissue International - Category: Orthopaedics Source Type: research

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CONCLUSION: On the basis of a broadly based research and participatory development process, a set of indicators has been developed that enables comprehensive evaluation of the regional quality of care of cross-indication, integrated care models focusing on common diseases. In order to be able to increasingly evaluate aspects of care coordination and patient orientation, health promotion as well as nursing, palliative and emergency care in the future, it would be helpful if routine data were collected or made accessible in these areas as well. PMID: 32467041 [PubMed - as supplied by publisher]
Source: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen - Category: Health Management Tags: Z Evid Fortbild Qual Gesundhwes Source Type: research
We examined the associations between socioeconomic status-related factors, unhealthy lifestyle, and the coexistence of MetS and osteopenia or OP. Methods: One thousand nine hundred ninety-one postmenopausal women aged 45 to 65 years were used to select a representative sample of the civilian, noninstitutionalized South Korean population from the 2008 to 2011 Korea National Health and Nutrition Examination Survey data. Women were grouped as neither MetS nor OP (normal), MetS, OP, and both MetS and OP (MetS + OP). Socioeconomic status (education, household income, place of residence, employment status), health-related...
Source: Menopause - Category: OBGYN Tags: Original Studies Source Type: research
Objectives: To investigate the association of genetic polymorphisms of endothelial nitric oxide synthase (eNOS) gene with endothelial dysfunction associated osteoporosis in postmenopausal women of Punjab, India. Methods: The study involved 456 postmenopausal women having endothelial dysfunction categorized according to women with (n = 236) and without osteoporosis (n = 220). Bone mineral density (BMD) and reactive hyperemia index (RHI) were evaluated together with six single-nucleotide polymorphisms (SNPs) within the eNOS gene (rs2070744, rs1799983, rs1800780, rs3918181, rs891512, and rs1808593). Results: A...
Source: Menopause - Category: OBGYN Tags: Original Studies Source Type: research
Purpose of review The field of osteoporosis research has been active for the past 20 years and has allowed significant advancement in the management of osteoporosis. This review will give an overview of the latest data from international cohorts that relate to current and recent osteoporosis research. Recent findings The clinical diagnosis of osteoporosis relies heavily on bone mineral density (BMD) measured at femoral neck or spine and although BMD has excellent predictive value for future fractures, fracture risk assessment has evolved over the years, resulting in the birth of fracture prediction tools. Fracture ris...
Source: Current Opinion in Rheumatology - Category: Rheumatology Tags: SPECIAL COMMENTARY Source Type: research
CONCLUSIONS: Our results indicate that TTW distance, measured using a standardized procedure, is a reliable method of quantifying forward flexed posture. TTW distance is greater in relaxed standing, older individuals, and those with greater BMI. PMID: 32466740 [PubMed - as supplied by publisher]
Source: Physiotherapy Theory and Practice - Category: Physiotherapy Authors: Tags: Physiother Theory Pract Source Type: research
ConclusionOur results help to identify the risk factors of ANM via a genetics approach and future research into the biological mechanism could further help with targeted prevention for early menopause.
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
The loss of bone quality and/or density is a para-physiological phenomenon observed in perimenopause and postmenopause, as well as in other conditions involving ageing, inflammatory and/or autoimmune diseases, chronic drug consumption (e.g. glucocorticoids, chemotherapies, etc) and/or nutritional deficiencies [1]. Data extensively agree with the key role of calcium (Ca) and vitamin D (vitD) supplementation for the prevention of osteopenia/osteoporosis in subjects at a higher risk of fragility fractures and for the treatment of bone strength reduction in association with antiresorptive [bisphosphonates (BPs), denosumab (Dma...
Source: Maturitas - Category: Primary Care Authors: Source Type: research
ConclusionIn men with documented LOH a specific clinical work ‐up should be addressed to the diagnosis of osteoporosis in order to program subsequent follow‐up and consider specific bone active therapy. TRT should be started according to guidelines of male hypogonadism while keeping in mind that it may also have positive effects also on bone health in men with LOH.
Source: Andrology - Category: Urology & Nephrology Authors: Tags: REVIEW ARTICLE Source Type: research
With China's social development and intensified aging population, the number of fractures caused by high-energy injuries and low-energy violence related to osteoporosis has been increasing [1-4]. The distribution of fractures in different populations and different locations of the body is changing. Previous epidemiological studies of traumatic fractures have focused on the demographic characteristics of patients, distribution of fractured sites, classification or type, injury mechanism, incidence and risk factors [1, 5-10].
Source: Injury - Category: Orthopaedics Authors: Tags: Review Source Type: research
Celiac disease (CD), triggered by the ingestion of gluten, occurs in people genetically predisposed to develop the chronic autoimmune condition. During the past few decades, doctors have learned much about how the disease develops, including genetic and other risk factors. However, results from studies on whether people with CD have an increased risk of premature death linked to the condition have been mixed. A recent study shows a small but statistically significant increased mortality rate. Celiac disease can affect the entire body Until recently, CD was considered a mainly pediatric gastrointestinal disorder, associated...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Allergies Autoimmune diseases Source Type: blogs
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