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Poster Number 144 Epidemiology Under-Estimation and Under-Treatment of Osteoporosis: The Halves Phenomenon Chih-Hsing Wu, National Cheng Kung University Medical Center; Yin-Fan Chang, National Cheng Kung University Medical Center; Wei-Jen Yao, Naitonal Cheng Kung Univ Medical Center; Ta-Jen Wu, National Cheng Kung Univ Medical Center; Ruey-Mo Lin, National Cheng Kung Univ Medical Center Background: Osteoporosis is a prevailing health concern, but many people are not being diagnosed in time to receive effective therapy, even they already had vertebral fracture. This study was designed to show whether the inadequate management of osteoporosis is compatible to the “halves phenomenon” in Taiwan. Methods: A total of 559 males and 577 females aged 50 to 70 years old randomly sampled by the computer-assisted telephone interviews (CATI) based on the 2004 population and housing census data in Taiwan. A 10-minute structured questionnaires were delivered by the well-trained interviewers for each subject in two days of January 2004 ( cooperation rate =92.7%, 95% confidence sampling error +/-2.91%). Results: One thousand and twenty seven subjects (90.4%) had heard about the osteoporosis and 112 subjects (9.9%) claimed to be diagnosed as osteoporosis. Of the 1027 subjects, only 521 (50.7%) had received bone mineral density examinations (55.9% received quantitative ultrasound and 38.9% received dual-energy X-ray absorptiometry). Those who were females, lived at northern area, higher socioeconomic status would have more received examination. Nearly half of the examined subjects were abnormal (231 subjects, 46.7%). Of the 231 subjects, only 147 subjects (62.0%) had been initiated the doctor consultation for further management. The orthopedics, gynecology, internal medicine and family medicine were the 4 most commonly consulted departments. Conclusion: Less than 10% of the subjects were known to have osteoporosis reflects the underestimation of osteoporosis in Taiwan. About “half” of study population had been received osteoporotic examination, “half” of those examined subjects were abnormal results, and “half” of the abnormal subjects had been received doctor consultation. To the end, oneeighth or 12.9% of the 1136 study population had been consulted for osteoporotic problem by health professional. The” halves phenomenon” of inadequate management of osteoporosis is an inconvenient truth and warranted for extensive intervention in Taiwan. (The contents of the abstract had been submitted and accepted for WCO) Poster Number 145 Epidemiology Increasing Incidence of Hip Fracture in Chiang Mai, Thailand Prasit Wongtriratanachai, Instructor , Chiang Mai University; Sirichai Luevitoonvechkij, Chiang Mai University; Tanawat Vaseenon, Chiang Mai University; Thawee Songpatanasilp, Pramongkut-klao College of Medicine; Sattaya Rojanasthien, Chiang Mai University Aim: To examine the incidence of hip fracture and other epidemiological data in Chiang Mai, Thailand and to compare to the data collected 9 years before. Methods: Hospital based data were collected from all public and private hospital in Chiang Mai. All patients aged 50 years or over who lived in Chiang Mai province and got low-energy-trauma hip fractures (femoral neck or intertrochanteric region) during 1 August 2006 to 31 July 2007 were studied. Results: 690 hip fractures were reported during the 1-year study period including of 203 males and 487 females (male to female = 1 : 2.4). Mean age was 76.37 years (male = 76.35, female = 76.71) with a range of 50-99 years. The estimated cumulative incidence was 180.3 per 100,000 (95% CI 154.68-208.27). The cumulative incidence of hip fractures in male and female were 112.61 and 239.48 per 100,000 respectively. In female the number of events peaked in the 75-79 age group which was lower than that found in male (>80). Fall from standing height was the most common mechanism of fracture (79.04%). According to type of fracture, femoral neck fracture was reported in 215 (31.16%), intertrochanteric fracture was reported in 475 (68.84%). Most cases (91.74%) were able to walk before fracture. After treatment, the percentages of the patients who need walking aids for ambulation were 93.70 at 3-months and 70.85 at 6-months. Conclusions: As compared to the previous study done in 1997 by our colleagues, the incidence of hip fracture in Chiang Mai province increased significantly especially after the age of 70 years. It increased for 2 times after the age of 80 years. The average age also increased (76.37 vs. 74.70 years). After treatment most of the patients needed walking aids for ambulation. Hip fracture incidence in Chiang Mai, Thailand was increasing rapidly.Key words: cumulative incidence, hip fracture, Chiang Mai, Thailand, neck, intertrochanteric, walking aids. This abstract was acceptted by IOF-WCO in Bangkok, Thailand Poster Number 146 Epidemiology Relationship of Bone State and Hormonal Status in Men Vladyslav Povoroznyuk, Institute of Gerontology AMS Ukraine; Tetyana Orlyk, Institute of Gerontology AMS Ukraine; Yevgen Kreslov, Institute of Gerontology AMS Ukraine; Volodymyr Vayda, Institute of Gerontology AMS Ukraine The aim of the study was to determine the relationship of hormonal status and bone state in men. Materials and methods. We have examined 96 men aged from 30 to 79 years (M±m): age - 54,4±1,3 years; height - 1,75 ± 0,01 m; weight - 84,9 ± 1,5 kg), divided them into age dependent subgroups 30-49 (n=36; age - 41,2±1,2 years) and 50-79 years (n=60; age - 64,4±1,1 years). Levels of testosteron (Test, nmol\l) and sex hormonebinding globulin (SHBG, nmol\l) were determined by means of chemiluminescent immunoanalysis method. The bone mineral density (BMD, g/cm2) was evaluated for the total body, spine (L1-L4), femur (neck, trochanter and total) and radius (ultradistal, 33% and total) using dual energy x-ray absorptiometry by the Prodigy instrument (GE Medical systems, 2005). Results. The correlation analysis of age dependent sub-groups: in the group of 30-49 years there is a positive correlation between Test and BMD ultradistal radius (r=0,49, p < 0,05), along with the negative correlation between SHBG and Total body in the group of 50-79 years (r=-0,31, p < 0,05). In the group of 60-79 years (n=38; age - 69,7±1,0 years) we have found a negative correlation between SHBG and Total body (r=- 0,60, p < 0,001), SHBG and trochanter (r=- 0,47, p < 0,05), SHBG and Total femur (r=- 0,48, p < 0,05). Patients of 50-79 year age group with normal bone, osteopenia and osteoporosis were chosen in correspondence to the WHO criteria. For analysis’ sake, we have joint the osteopenia and osteoporosis patients. Normal mineral density of lumbar spine was found in 83,3%, osteopenia and osteoporosis – 17,7%, while in total femur – 75% & 25% respectively. SHBG in normal femur BMD subgroup (41,1 ± 2,6) was considerably lower than in osteopenia and osteoporosis subgroup (54,4 ± 5,6, p < 0,05). Conclusion. We have revealed a positive correlation between testosterone levels and ultradistal radius BMD and negative correlation between SHBG and total body BMD in patients of 50 – 79 year age group, trochanter and total femur in patients of 60 – 79 year age group. Poster Number 147 Epidemiology Reproductive Parameters and Fractures Prevalence in 700 Women Treated for Osteoporosis Catalina Poiana, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Carmen Barbu, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Mara Carsote, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Alina Roman, Elias Hospital, Bucharest, Romania; Madalina Paunescu, Elias Hospital, Bucharest, Romania; Simona Fica, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania It is accepted the important role of menstrual history as a predictive factor for low bone mineral density in postmenopausal women, but extensive differences among geographic or ethnic groups have been reported. The aim of our study was to evaluate the association between fractures prevalence and some reproductive parameters like years of menstruation, age at menopause, number of pregnancies, and duration of hormone replacement therapy (HRT) in a group of women with postmenopausal osteoporosis.Subjects were 700 postmenopausal women (age between 35 and 84 yrs) diagnosed with osteoporosis and treated in two Endocrinology Departments in Bucharest between 2000-2006. Medical records from the baseline evaluation were retrospectively analyzed. We selected bone mineral density (BMD) values, T- and Z-scores, reproductive parameters, body mass index (BMI), prevalent fractures and previous HRT (hormonal replacement therapy).37% in our study group had osteoporotic prevalent fractures at baseline from which 20% were radius, 15% femoral neck and 65% vertebral fractures.We found a significant positive correlation between lumbar BMD and endogenous estrogen exposure (p
Poster Number 148 Epidemiology Ultrasound Densitometry Evaluation in Postmenopausal Women with Colles’ Fracture Vladyslav Povoroznyuk, Institute of Gerontology AMS Ukraine; Volodymyr Vayda, Institute of Gerontology AMS Ukraine This research was aimed at studying the bone tissue state among women with Colles’ fracture by means of the ultrasound densitometry method. Materials and methods. The total of 34 healthy postmenopausal women 42–74 years old (62,1±7,5) with Colles’ fracture in their anamnesis (CF) were examined by ultrasound bone densitometer “Achilles+” (Lunar Corp., Madison, WI). The control group included postmenopausal women without any osteoporotic fractures in their anamnesis (WF), being standardized by age, BMI, etc. The speed of sound (SOS, m/s), broadband ultrasound attenuation (BUA, dB/MHz) and a calculated “Stiffness” index (SI, %) were measured. The main risk factors for the osteoporotic Colles’ fracture turned out to be a menarche after 15 years, an early and late menopause. 29,3% of patients with Colles’ fractures had a bone tissue Stiffness index coinciding with the baseline of fracture risk or under it. Results. There was no revealed relation among the age and the ultrasound densitometry indices among women of posmenopausal age without fractures. Only 12,5% of patients with Colles’ fractures were noticed to have a normal bone tissue. The ultrasound parameters were veritably lower among postmenopausal women with CF than among WF (SOS: CF – 1524±28,4; WF – 1543±24,3, p < 0,05; BUA: CF – 102±17,8; WF – 109±12,0, p < 0,05; SI: CF – 76±14,9; WF – 85±13,5, p < 0,05; all values are the mean ± SD). It is caused by the decrease of bone tissue mineral density, accelerated aging, and the development of osteopaenia and osteoporosis. Conclusion. The most tangible differences in these indices were noticed among the elderly patients. Colles’ fracture indicates osteopaenia and osteoporosis in postmenopausal period. In summary, ultrasound densitometry is an effective screening method to reveal the women of risk group with future osteoporotic Colles’ fracture in postmenopausal period. Poster Number 149 Epidemiology Ultrasound Densitometry of the Calcaneus in Children and Adolescents of Ukraine Vladyslav Povoroznyuk, Institute of Gerontology AMS Ukraine The bone tissue state in children and adolescents of Ukraine, subjects of both sexes, was studied. The purpose of this study is to determine normal values in Ukrainian children and adolescents. The total of 577 healthy children and adolescents (205 males and 372 females; 7–18 years old) were examined by means of ultrasound bone densitometer «Achilles+» (Lunar Corp., Madison, WI). The speed of sound (SOS, m/s), broadband ultrasound attenuation (BUA, dB/MHz) and a calculated «Stiffness» index (SI, %) were measured. Ultrasound parameters increased with age in both sexes (fig.1). It was found out that the ultrasound parameters characterizing state of spongy bone tissue and its density increase during the age of 10–14 years. Results of linear regression analysis revealed a significant correlation between ultrasound parameters and height (SOS=1413+0,99Height; r=0,45; R 2 =20,2; p
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