Association between movement control during one-leg standing and femoral BMD in patients with hip fractures.

INTRODUCTION: Prior studies have focused only on the temporal component of one-leg standing, no reports have examined the relationship between the qualitative components of one-leg standing and femoral BMD. Thus, this study investigated whether quality (i.e., movement control) of one-leg standing also associated femoral BMD. MATERIALS AND METHODS: A total of 80 patients with unilateral hip fracture were included in a cross-sectional study. Basic and medical information and physical functions including movement control during one-leg standing were assessed at admission and 2 weeks after surgery, respectively. Hierarchical multiple regression analysis was performed to identify predictors of femoral BMDs on the non-fractured side. Dependent variables included femoral neck and total hip BMDs in models 1 and 2, respectively. RESULTS: Hierarchical multiple regression analysis (standardized partial regression coefficients) in model 1 identified age (- 0.18), sex (0.38), body mass index (BMI) (0.41), movement control during one-leg standing on the non-fractured side (0.19), and life-space assessment (0.17) as factors associating femoral neck BMD. Meanwhile, hierarchical multiple regression analysis (standardized partial regression coefficients) in model 2 identified age (- 0.12), sex (0.36), BMI (0.37), and movement control during one-leg standing on the non-fractured side (0.25) as factors associating total hip BMD. The coefficients of determination adjusted for degrees of freedom (R2) were 0.529 and 0.470 for models 1 and 2, respectively. CONCLUSION: Our results suggest that improving movement control during one-leg standing may be important for maintaining and improving femoral BMD on the non-fractured side.

Incidence of clinical vertebral fractures and hip fractures of the elderly (65 years or over) population-large-scale data analysis using claim database in Kure City, Hiroshima, Japan.

Using the claim database, we investigated the incidence rate of clinical vertebral fractures per 1,000 in the elderly residents, over 65 years of age, in Kure city. The incidence rate, of clinical vertebral fractures, was 15.58 (7.29 male, 21.17 female, 2.90 female/male ratio). PURPOSE: To elucidate the incidence of clinical vertebral and hip fractures using the claim database, in those over 65 years of age in Kure city, and to compare with the previous reports. METHODS: We used, for residents in 2015, the medical care information of the National Health Insurance or Senior Elderly Care System in Kure City (Hiroshima Prefecture, Japan). Those with vertebral fractures as disease name, and either treatment/operation/hospitalization were defined as clinical vertebral fractures. Among the claim database, we extracted the clinical vertebral fracture and investigated the number of occurrences and the incidence rate per 1,000. We also investigated the incidence rate of hip fractures and compared those to the clinical vertebral fractures. RESULT: The incidence rate of clinical vertebral fractures of the elderly population (65 years or over) per 1,000 was 15.58 (7.29 male, 21.17 female, 2.90 female/male ratio). In both men and women, the incidence rate increased with aging. The incidence rate of hip fractures per 1,000 was 9.17 (3.55 male, 12.96 female, 3.65 male/female ratio). Clinical vertebral fractures were more frequent than hip fractures, and the ratio of incidence rate of vertebral fractures to hip fractures was 1.70 (male, 2.05, female, 1.63). For both fractures, the incidence rate increases with age, apart from the women where the incidence of vertebral fracture reduces slightly in the older age group CONCLUSION: This is the first report that investigated the incidence rate of the clinical vertebral fractures using the claim database, which covered almost the whole number of 230,000 population area.

Efficacy of non-steroidal anti-inflammatory drugs on zoledronic acid-induced acute-phase reactions: randomized, open-label, Japanese OZ study.

INTRODUCTION: Zoledronic acid infusion is used to treat osteoporosis but patients, especially Japanese patients, often experience acute-phase reactions (APRs). In this multicenter, randomized, open-label, parallel-group study, we examined the efficacy of the most commonly used non-steroidal anti-inflammatory drug loxoprofen in Japan in reducing the incidence rate of zoledronic acid-induced APRs and body temperature, and investigated risk/protective factors for APRs in this population. MATERIALS AND METHODS: Patients aged ≥ 60 years with primary osteoporosis (n = 368) were allocated randomly to zoledronic acid plus loxoprofen (ZOL + LOX) or zoledronic acid alone (ZOL). All patients received 5-mg zoledronic acid infusion on day 1, and patients in the ZOL + LOX group also received 120 mg and 180 mg of oral loxoprofen on days 1 and 2, respectively. Adverse events and body temperature were recorded during the 7-day observation period. RESULTS: The incidence rates of APRs were 34.4% (64/186 patients) and 47.8% (87/182 patients) in the ZOL + LOX and ZOL groups, respectively (P = 0.0109). The proportions of patients with increased body temperature (≥ 1 °C and ≥ 37.5 °C) were similar in both groups (P = 0.1186). Past bisphosphonate users had a significantly lower incidence rate of APRs than treatment-naïve patients (odds ratio 0.444, 95% confidence interval 0.285-0.692, P = 0.0003). CONCLUSIONS: Zoledronic acid-induced APRs appeared to be suppressed by loxoprofen. Known risk/protective factors, including prior osteoporosis treatment, were applicable to Japanese patients.