key: cord-0858414-ld281rbx
authors: nan
title: IOF REGIONAL 2021 8th Asia Pacific Osteoporosis Conference : Poster Abstracts
date: 2022-04-12
journal: Osteoporos Int
DOI: 10.1007/s00198-022-06343-9
sha: f62b9ca9c4a11f322c9c5ef92e45f7d62905abd6
doc_id: 858414
cord_uid: ld281rbx

nan

Prior fragility fracture, a well-established risk factor for a future fracture which is accommodated within FRAX. The population relative risk of having a hip fracture or other osteoporotic fracture is approximately 2fold higher for most types of prior fracture. However, the increase in risk is not constant with time or age. The risk of a subsequent osteoporotic fracture is particularly acute immediately after an index fracture and wanes progressively with time. The early phase of particularly high risk has been termed imminent risk. The question arises how to accommodate the impact of a recent fracture on conventional estimates of fracture probability with FRAX. To address this question, data were extracted from the Reykjavik Study fracture register that documented prospectively all fractures at all skeletal sites in a large sample of the population of Iceland. Fracture probabilities were determined after a sentinel fracture (humeral, clinical vertebral, forearm and hip fracture) from the hazards of death and fracture. Fracture probabilities were computed on the one hand for sentinel fractures occurring within the previous two years and on the other hand, probabilities for a prior osteoporotic fracture irrespective of recency. The probability ratios provided adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures. Probability ratios to adjust 10-year FRAX probabilities of a major osteoporotic fracture for recent sentinel fractures were age dependent, decreasing with age in both men and women. Probability ratios varied according to the site of sentinel fracture with higher ratios for hip and vertebral fracture than for humerus or forearm fracture. Probability ratios to adjust 10-year FRAX probabilities of a hip fracture for recent sentinel fractures were also age dependent, decreasing with age in both men and women with the exception of humerus fractures. There was a significant correlation between spine osteoporosis and BMI (P-value<0.05), and the decrease of BMI leads to an increase in the potential of spine osteoporosis. There was a significant correlation between neck of femur osteoporosis and BMI (P-value<0.05), and the decrease of BMI leads to an increase in the potential of neck of femur osteoporosis. Conclusion: Lower BMI increased the risk of osteoporosis. It was caused by poor nutritional state, which could result in decreasing bone density. 1 Meanwhile, high BMI had a linear correlation with high BMD because of the conversion of androgen to estrogen, which increased bone mass in both men and women. Objective: Limited and controversial data are available on relationships between osteoporosis and anemia. Therefore, we evaluated BMD and its relationship with erythropoiesis in patients with coronary artery disease (CAD) over 90 years of age (long-livers).

Methods: This work was cross-sectional study performed in the War Veterans Hospital. The study enrolled 197 patients (138 women and 59 men) aged 90-106 y (mean age 92.4±2.3 y) hospitalized with CAD. BMD was analyzed by DXA.

Results: Patients with osteoporosis had lower hemoglobin and erythrocyte counts compared to patients with normal BMD: hemoglobin -117.3 and 125.9 g/l, respectively (p=0.003), erythrocytes -3.8x10 12 /l and 4,1x10 12 /l (p=0.04), MCV -88.7 and 93.5 fl (p=0.02), MCH -30.6 and 31.0 pg (p=0.07). Patients with anemia had lower total BMD (973 and 1036 mg/cm 3 , p=0.001), BMD of upper (772 and 845 mg/cm 3 , p=0.001) and lower (956 and 1059 mg/cm 3 , p=0.0003) extremities, BMD of trunk (805 and 851 mg/cm 3 , p=0.004), ribs (607 and 642 mg/cm 3 , p=0.005), pelvis (889 and 935 mg/cm 3 , p=0.03) and spine (973 and 1034 mg/cm 3 , p=0.02). Correlation analysis revealed significant direct relationships between hemoglobin level and all BMD parameters (r=0.3; p=0.00003). Significant correlations were also established between all BMD parameters and erythrocytes MCV (r=0.27; p=0.0001) as well as MCH (r=0.22; p=0.002). Significant direct relationships between blood iron concentration and all BMD parameters were found (r=0.28; p=0.003).

The study results indicate presence of relationships between BMD and erythropoiesis in centenarians. It is advisable to further study these relationships in long-livers involving a large sample of patients. Objective: Osteoporosis is a bone disorder and is currently a major global health issue. Ceruloplasmin (CP) is an acute phase reactant and antioxidant, characterized by ferroxidase activity and increases in inflammation. Creactive protein (CRP), an acute phase protein belonging to pentraxin family of proteins. This study was designed to investigate the role of acute phase reactants CP and CRP in the screening of osteoporosis. Our aim was to evaluate the role of serum CP and CRP as biomarkers of osteoporosis.

Methods: This study was conducted in the bone clinic and the biochemistry department of a tertiary care hospital. 120 participants were included in the study belonging to the age group of 50-80 y. Participants in the group were divided into two groups, group I comprising of patients with osteoporosis, and group II consisted of patients without osteoporosis (n=56) (control group) (n=64). Patients were classified into the two groups on the basis of BMD measurements using DXA scanning. CRP and serum CP levels were analyzed in blood samples by immunoturbidimetry.

Results: Serum CP levels were significantly higher in osteoporosis patients as compared to the control group. A significant positive correlation (r=0.92, p<0.05) was observed between higher serum levels of CP and higher levels of CRP in the osteoporosis patients. There was a significant difference in the CP levels of the osteoporosis group (68.4±7.2 mg/dl) and the control group (37.3±4.9 mg/dl) (p<0.05). CRP levels also differed significantly among the osteoporosis patients ( Objective: Osteoporosis (OP) represents a considerable threat to global health and national healthcare systems. OP in men is an underrecognized and undertreated disease. Methods: We analyzed the effectiveness of OP treatment in men with denosumab (Dmab) from August 2014 to January 2021. We studied BMD changes and fractures in the men retrospective cohorts in a realworld clinical setting using patient (pt) data from single-centre RECUH. We collected and analyzed at the beginning and end of the study: BMD changes of the spine L1/L4 and in some cases total spine, right and left femoral neck by using DXA and 1 case by QCT; risk factors; lab data (serum Ca, iPTH, vitamin D); comorbidities and concomitant medications. Men were divided into 6 groups according to the number of Dmab injections (inj): group (gr) nr. 1 (12-13 inj), gr nr. 2 (9-11 inj), gr nr. 3 (8 inj), gr nr. 4 (6-7 inj), gr nr. 5 (4-5 inj), gr nr. 6 (1-3 inj).

Results: Over the last 6 y, women with OP was 691 (89.2%) and men only 84 (10.8%). We analyzed a total of 37 (44% of 84 men, who received Dmab) men with an average age of 63.2±10.4 SD. DXA scans analyzed BMD in 36 pts (97.3%) and QCT in 1 pt (2.7%). Men with idiopathic OP were 83.8%, GIO 10.8%, secondary OP 5.4%. At the beginning of the study, men with at least 1 fracture were 56.7% (62.0% in the spine, 9.5% hip, 14.3% forearm, 28.6% ribs, 28.6% other types of fractures). At the end of the study, men with at least 1 fracture were 2 (5.4%). DXA was made for all pts at the beginning of the study (n=37) and at the end of the study 43.2% (n=16). The most significant BMD increased in the gr nr.1-12.8% (n=2). The least significant gain was in the gr nr. 3 -2.8% (n=2). Total right and left BMD was analyzed (n=12). The more significant BMD gain was in the gr nr.1-in the right hip 4.7% and left hip -5.9% (n=2). Lab data, data of comorbidities and concomitant medications will be presented later. During the study, no cardiovascular events were detected. Conclusion: Dmab is effective in increasing BMD at the lumbar spine and the hip. The most significant BMD increased after 12-13 Dmab injections. The study indicates that Dmab is effective and safe. Objective: To improve medication correction of disorders of the structural state and metabolism of bone tissue in patients with fibrous dysplasia. Methods: There were 16 patients with FD who were receiving medication treatment. Age of patients was 6-28 y. All patients underwent basic antiosteoporotic therapy, of which 10 were treated with pamidronic acid. Serum Ca and Vit D3 levels were screened before and during treatment. The structural state of bone tissue was studied according to the Z-and Tcriteria, bone metabolism -the study of bone markers: total P1NP, β-CTx, osteocalcin. Results: Based on paraclinical studies in patients with FD, depending on the clinical manifestations, form of the disease, age, indications for medication treatment with the use of pamidronic acid have been developed. Basic treatment and basic treatment in combination with pamidronic acid were used. Pamidronic acid medications were used at a dose of 0.5-1.0 mg/kg/d for 1-3 infusions, the interval between cycles was 3-4 months. Schemes, doses, combinations of pamidronic acid with other antiosteoporotic drugs depending on changes in the condition and metabolism of bone tissue in FD were determined. Indications for basic therapy were: β-CrossLaps up to 0.500 ng/ml and Z-test up to -1.0 SD. Basic therapy included: preparations of Ca "Osteogenon" 1-2 capsules 2 times a day and vitamin D3 in a dose of up to 2000 IU. Indications for basic therapy in combination with the use of pamidronic acid at a dose of 0.5-1.0 mg/kg/d were severe pain, a significant area of long bone lesions, changes in β-CrossLaps from 1.5 ng/ml and above, Z-test from -1.5 SD and below. The effectiveness of therapy was assessed by changes in the level of β-CrossLaps in the serum and the Z-test of the lumbar vertebrae. The effectiveness of the used treatment did not depend on the dose of pamidronic acid and the form of FD. The relation between changes in the marker of osteoresorption and its reduction depending on the initial values (Wilcoxon's test p=0.0045) was reliably found -the higher the rate, the more effective the treatment, the intensity of pain decreased, the bone structure improved.

The results of medication treatment in patients with FD indicate its significant effectiveness (Wilcoxon test p=0.0045): reduction and elimination of pain, improvement of the structural condition and metabolism of bone tissue. Objective: The efficacy of denosumab in the treatment of postmenopausal osteoporosis has been studied. Methods: We observed 83 patients (median age 64.1 years) with a diagnosis of postmenopausal osteoporosis who had been receiving denosumab therapy in combination with calcium and vitamin D for at least 1 year. The criteria for the effectiveness of the therapy were an assessment of the dynamics of the BMD of the lumbar spine (L1-L4) and the femoral neck (SB) before the introduction of denosumab and in dynamics after 12 months of therapy, the absence of new fractures. Objective: Probiotics are defined as viable microorganisms that upon administration in adequate amount confer various health benefits by inducing alterations in composition of gut microbiota (WHO). Very few bacterial strains have been studied till date in relation to their effect on bone health. The decrease in number of Tregs leads to various inflammatory conditions of the bone such as osteoporosis, rheumatoid arthritis, etc. Probiotics induce the differentiation of peripherally derived Treg (pTreg) cells from naive CD4 + T cells in GUT resulting in prevention of various inflammatory diseases by regulating immune homeostasis. Based on these facts we were interested in investigating the effect of probiotics intake on the modulation of bone health via its effect on the induction of pTregs in GUT. Thus, in present study we selected Bifidobacterium longum (BL) strain to examine its effect on bone health in ovariectomy (Ovx) induced osteoporotic mice model. We were interested in investigating the effect of BL intake on modulation of bone health via its effect on the induction of pTregs in GUT. We thus hypothesized to study the effect of BL on bone health in Ovx induced osteoporotic mice model. Methods: Female C57BL/6 mice were divided into three group's viz. Sham, Ovx and Ovx + BL. BL was administered orally (10 9 CFU/ml) and after 45 days mice were sacrificed and tissues were analyzed for accessing the role of BL on bone health via various cutting-edge technologies such as SEM, AFM, μCT, FACS and ELISA. Results: We observed that oral administration of BL protected mice from Ovx-induced bone loss, which was confirmed by SEM, AFM, FTIR and μCT analysis of bone samples. We further observed that BL-intake enhanced bone density in both cortical and trabecular bones of Ovx mice. Interestingly, it was observed that BL-intake enhances percentage of CD4 + Foxp3 + NRP -Treg cells (pTregs) in both GUT (mesenteric lymph nodes, peyer's patches, small intestine and large intestine) and bone marrow (prime sites of osteoclastogenesis). Furthermore, serum cytokine analysis revealed that Ovx mice administered with BL had significantly decreased levels of osteoclastogenic cytokines IL-6, IL-17 and TNF-α along with significantly enhanced levels of anti-osteoclastogenic cytokines IL-10, IL-4 and IFN-γ with respect to Ovx group. Conclusion: Taken together our results for the first time establish an osteoprotective role of BL on bone health via induction of pTregs in GUT of Ovx mice. Objective: Osteogenesis imperfecta (OI) is a rare genetic bone fragility disorder. Over 85% of OI cases are associated with mutations in the procollagen type I genes (COL1A1 or COL1A2). The purpose of the study was to analyses the spectrum of collagen mutations in Belarusian patients with OI and reveal their association with particular clinical phenotypes. Methods: 90 Belarusian patients, diagnosed with OI by clinical standards, were included in the study. Genomic DNA was extracted from peripheral blood leukocytes. The sequencing of COL1A1 and COL1A2 protein coding regions was performed using Illumina MiSeq (USA). The raw data were mapped to the human reference genome hg19 using Illumina MiSeq Reporter. The variants were confirmed by Sanger sequencing. Variants not described in OI variant database were analyzed in silico using predictive programs and described as novel mutations.

Results: In total, 35 unique pathogenic COL1A1/2 variants were identified in 59 (64%) patients with OI. The whole spectrum of mutations included 32 missense, 8 nonsense, 11 frameshift, 7 splice site and 2 intronic mutations. The majority of the pathogenic variants were located in the COL1A1 gene (69.5%), 22% of them were novel (Table) . At the same time, 66.7% of the COL1A2 mutations were novel (Table) . All pathogenic variants were heterozygous, suggesting dominant inheritance. Glycine (Gly, G) substitutions, affecting triple-helical domains of collagen chains, were present in 19 (59.3%) of the missense variants and in 5 novel mutations. (Figure) . At least rs7975232, rs1544410, rs731236, and rs11568820 might help to identify individuals with increased PMO risk and vitamin D status. Revealed considerable variation in serum 25(OH)D in individuals with different VDR genotypes further suggest that a one-size-fits-all approach to vitamin D supplementation may not be appropriate. Figure. The association of serum 25(OH)D levels with VDR gene variation.

The data show that the increased level of circulating vitamin D level is observed in bearers of unfavorable VDR genotypes, associated with decreased receptor expression, possibly due to altered metabolic feedback loops or effectiveness of vitamin metabolism. VDR gene variants should be considered for personalized vitamin D supplementation. Epidermal growth factor-like domain multiple 6 (EGFL6) belongs to EGFlike ligands, is implied to play a role in tumor growth, migration and invasion of breast cancer, gastric cancer and nasopharyngeal carcinoma, etc. EGF-like ligands have been reported that they can stimulate osteoclastogenesis by affecting on osteoblastic cells through indirectly decreasing OPG expression and increasing MCP1 expression in an EGFR-dependent manner. Here, we proved that EGFL6 was a secreted protein and found that EGFL6 was highly expressed in lung adenocarcinoma tissues and positively correlated with bone metastasis of lung adenocarcinoma. Over-expressive EGFL6 obviously potentiated the proliferation, migration and invasion of lung adenocarcinoma cells partly through Wnt and PI3K/AKT/mTOR signaling pathways while silencing EGFL6 presented the opposite results. Intriguingly, EGFL6 promoted bone destruction of nude mice through enhancing osteoclast differentiation via NF-κB signaling pathway but affected little on osteoblast differentiation. Therefore, we elucidate that EGFL6 could be acknowledged as a precative factor in bone metastasis of lung adenocarcinoma. Objective: Osteoporosis causes fragility fractures that also occur in patients with BMD in the normal or osteopenic range, suggesting role of risk factors that are unrelated or partially related to BMD. The study aims at highlighting the link between 3 conditions, that are environment and occupation related risk factors and that are widely prevalent in India, and development of fragility fractures.

Methods: A case control study was done by recruiting 110 cases with history of recent fragility fractures and 84 controls with no history of recent fractures. 3 study parameters, village dwelling, conventional farming, and poverty, were chosen the presence or absence of which were documented in participants. This was followed by an odds ratio analysis.

Results: The odds of village dwellers, conventional farmers, and socioeconomically poor individuals to develop fragility fractures were both significant and large. Conclusion: Urbanization is a risk in the development of fragility fractures. However, this study points that village dwelling in India is associated with the development of fragility fractures. Similarly, odds of farmers exposed to pesticides and agrochemicals to develop fragility fractures is large and significant. Pesticides and agrochemicals act as endocrine disruptors and bone health is closely linked to endocrine system. Fragility fractures among farmers may be due to endocrine disrupting properties of pesticides and agrochemicals. Socioeconomic deprivation is a known risk in the development of osteoporosis. This study too highlights that the odds of individuals living in poverty to develop fragility fractures is significant and large. Objective: We investigated the 10-year differences in radiographic hip osteoarthritis (OA) prevalence in Japanese men and women based on data from a large-scale nationwide cohort study (Research on Osteoarthritis/ Osteoporosis Against Disability Study). Methods: We analyzed the data of 2924 participants (1026 men; 1898 women) aged 40-89 y (mean 70.7 y) from urban, mountainous, and coastal communities from a baseline survey conducted in 2005-2007. We also analyzed the data of 2347 participants (726 men; 1621 women) aged 40-89 y (mean 69.2 y) obtained from a fourth survey in 2015-2016. Anthropometric measurements such as height and weight were taken.

Handgrip strength was measured, and the larger value was noted as the maximum handgrip strength. Radiographs were scored using the Kellgren−Lawrence (KL) grading system; radiographic hip OA was defined as a KL score ≥2.

Results: The prevalence of radiographic hip OA in men and women was 18.4% and 14.4% in the baseline survey and 16.0% and 10.7% in the fourth survey, respectively. In the fourth survey on men and women in their 40s to 60s, the prevalence of radiographic hip OA was significantly lower than in the baseline survey, whereas height and handgrip strength measurements were significantly higher. The mean values of weight and BMI had nearly no difference between the baseline and fourth surveys. Logistic regression analysis performed after adjusting for age, sex, height, weight and residence showed that the prevalence of radiographic hip OA in the fourth survey was significantly lower than in the baseline survey (odds ratio 0.54, 95%Cl 0.45-0.65), and handgrip strength was significantly associated with radiographic hip OA (-1 kg, 1.02,1.00-1.04).

Conclusion: Two large-scale cross-sectional cohort studies reported 10year differences in radiographic hip OA prevalence. Handgrip strength might affect declining the prevalence of radiographic hip OA. Objective: Several evidence suggests that microbiota dependent metabolites and cometabolites, by acting as aryl hydrocarbon receptor (AHR) ligands facilitates the bidirectional communication between the host machinery and microbiota and thus modulates host physiology. In recent years, tryptophan metabolites viz. 5'-hydroxyindoleacetic acid (HIAA) by binding and activating AHR receptor play fundamental roles in various physiological mechanisms. But no study till date has reported the direct effect of HIAA on osteoclastogenesis. Thus, in the present study, we aim to investigate the direct effect of gut metabolite HIAA on osteoclastogenesis. The present study aims to examine the potential of gut metabolite (5'HIAA) in modulating osteoclastogenesis. Methods: To investigate the role of 5'-HIAA in regulating bone health, we carried out in vitro studies. For determining the direct effect of HIAA on osteoclastogenesis, we cultured bone marrow cells with different concentrations of HIAA in osteoclastogenic media supplemented with M-CSF and RANKL factors for 5 d. To assess the effect of HIAA on osteoclastogenesis, TRAP staining was performed. F-actin ring polymerization was performed for investigating the effect of HIAA on osteoclasts functional activity. Results: Our in vitro data clearly indicated that 5'-HIAA significantly inhibits osteoclastogenesis in a dose dependent manner. We observed significant reduction in number of multi-nucleated TRAP positive osteoclasts in HIAA treated cultures. 1.0;12.0] years. All patients underwent wholebody DXA (DXA). The appendicular muscle mass index (AMI) was calculated as the ratio of appendicular muscle mass (AMM) to height squared (kg/m 2 ). Muscle strength was measured using hand dynamometry and "chair rising" test. Physical performance was assessed using a gait speed test and the short battery of physical performance (SPPB). Sarcopenia (SP) was diagnosed according to the revised European consensus on definition and diagnosis (EWGSOP2). Results: Low BMD was found in 40 (78.4%) patients: 35 (92.1%) in postmenopausal and 5 (38,5%) in premenopausal women. Among postmenopausal persons osteoporosis was discovered in 26 (68,4%) and osteopenia in 9 (23.7%) cases, and among premenopausal women in 1 (7,7%) and 4 (30.8%) persons, respectively (p=0.03). Low muscle mass was discovered in 13 (25.5%) persons: 12 (31.6%) in postmenopausal and 1 (7.7%) in premenopausal women (p>0.05). All 13 (25.5%) SSc patients with low muscle mass had low BMD, 11 (21.6%) had also low muscle strength, so these women were classified as having SP, among them 6 (33.3%) patients with diffuse and 5 (27.8%) with limited form of the disease (p>0.05). SP had 1 (7.7%) premenopausal and 10 (26.3%) postmenopausal women (p>0.05). Patients with SP did not differ from patients without SP in age, BMD and the frequency of OP, number of fractures, skin score, positivity of Scl 70 and ACA, the nutritional status assessed by MNA-SF. At the same time, they had more often falls (p=0.044), a lower BMI (p=0.044), a longer disease duration (p=0.039) and a higher cumulative dose of glucocorticoids (GC) use (p=0.045). Conclusion: Low BMD was detected in 78.4% and low muscle mass in 25.5% cases. 21.6% of SSc women had SP with no significant difference between the limited and diffuse forms of the disease. Patients with SP had a lower BMI, a longer SSc duration and a higher cumulative dose of GC use, they fell more often than women without SP. Objective: An effort to establish that zoledronic acid is the time tested, cost-effective, adherable, dependable antiosteporosis medication for both females and males. Methods: The principal author is Consultant Geriatrician. He is advising inj zoledronic acid to the elderly people having osteopenia and osteoporosis since 05 June 2012. The dose is given after doing DXA scan and knowing FRAX score. Before giving the infusion comprehensive geriatric assessment (CGA) of each patient is done. Also vit D 3 and serum calcium levels are corrected. The principal author has innovated a consent form for evaluation, education and information of the probable adverse events to the patient and the relatives. The beneficiaries are routinely given one strip of tab paracetamol 650 to take prophylactically. Also they are also given one strip each tab omprazole 20 mg and tab ibuprofen 400 mg to consume depending upon the symptoms postinfusion. Many deserving elderly patients were given the infusion by home visits. Total 230 patients were given inj zoledronic acid between 05 June 2012 to 10 Sep 2021. The monitoring visits by the trained orthgeriatric nursing staff routinely done for next 2-3 days in the "ZA PLAN". Results: The results of giving i.v. zoledronic acid are encouraging. The age groups was between 53-92 years in both male and female population. It is best medicine to adhere, remember, remind and also comparatively affordable to even elderly from lower S-E status. Conclusion: The PI author came to the conclusion over the study of last 10 yrs with 230 beneficiaries that the zoledronic acid is the most convenient, cost-effective, easy to administer, least time consuming and best to adhere antiosteoporosis medication available at present. the 109 RCTs, 63% of the identified RCTs (n=69) were related to rehabilitation or medication/nutrition supplementation, with the remaining RCTs focusing on osteoporosis management, optimization of clinical management, prevention of venous thromboembolism, fall prevention, multidisciplinary approaches, discharge support, management of postoperative anemia as well as group learning and motivational interviewing. 44 RCTs were carried out in the inpatient setting (40.4%), 28 RCTs in the outpatient setting (25.7%), and 37 RCTs in the inpatient to outpatient setting (33.9%). Conclusion: The identified RCTs regarding post-surgery interventions were heterogeneous in terms of type of interventions, settings and outcome measures. Recovery post-surgery usually spans from the acute inpatient stay to subacute to post-discharge. Greater improvement of various outcomes like physical function recovery, nutritional status recovery, reduction of various postoperative complications, shortening of length of stay etc., could be better achieved through combining various interventions across various settings instead of a specific setting.

A. Anggunadi 1 , A. Tobing 1 , A. A. Kurniawan 1 1 Perkumpulan Warga Tulang Sehat Indonesia, PERWATUSI, Jakarta, Indonesia

Objectives: To describe the demographic, osteoporosis risk factors and physical fitness characteristics of a virtual Perwatusi Osteoporosis group exercise program that will be analyzed to design further improvement for the program. Methods: An online survey was distributed on April 2021 for 3 weeks among the virtual Perwatusi Osteoporosis group exercise's participants to collect demographic and osteoporosis risk factors, and also asking the participants to do simple muscle endurance and flexibility test at home (Chair stand test and Apley Scratch test). The virtual group exercise was started due to COVID-19 pandemic on 2020.

Results: From about 300 participants joining this 3 times/week (1 h/session) group exercise, a total of 164 subjects (mean age 68.2 y.o.; 93.9% of them are female) join the survey. Demographically, though about 62% of the subjects were in Jakarta, but the exercise program has succeeded to reach participants from outside of Java Island (8% of the subjects) mostly through the Zoom meeting media, but also through YouTube and Live Instagram (18.3% and 1.8%, respectively). About the osteoporosis risk factors, 50.6% of the subjects are obese, whereas <5% of them are underweight. The most frequent osteoporosis risk factors found were early menopause (20.1%), followed by smoking (17.3%), diabetes (15.9%), gastrointestinal disorders (15.9%), genetic factor (14%) and thyroid gland disorders (7.3%). Most of the subjects had poor flexibility (42.7%). On the other hand, most of the subjects had moderate muscle endurance (50.6%). Conclusion: Based on the results description, it is necessary to design strategies to: (1) invite the Perwatusi branches located in outside Java Island to actively participate and broadcast about the group exercise to society living outside Java Island; (2) increase the participants' knowledge about the osteoporosis risk factors and its management; (3) evaluate how routine is the participation to analyze their physical fitness improvement better.

The low-energy fractures were considered osteoporotic and non-traumatic. The criteria of non-inclusion were related diseases that affect bone metabolism, taking any glucocorticoids for >3 months. Results: It has been found that in women with OA knee joint, fractures at the minimum level of injury were statistically less frequent than in the control group: in 14 (33.3%) and 36 (55.5%) women respectively (p=0.048). There is no statistically significant impact of OA on reducing the chances of lowenergy fractures

Among the cases analysed, fractures of the forearm were most frequent, both in the group of women with OA of the knee joint and in the control group: 9 (20.9%) and 12 (30.2%) women, respectively. Compression fractures of the vertebrae were less common in 6 (16.2%) and 4 (9.3%) patients. The fracture of the humerus was found in 1 (12.3%) of women with OA and 4 (10.8%) of women without OA

Only 1 woman (2.7%) without OA has a femur fracture. There is no statistically significant difference in the location of fractures between the studied groups

Conclusion: The results indicate a statistically significantly lower incidence of low-energy fractures in women with OA knee joint compared to women without OA. The groups of women with OA knee joint and without OA were comparable in the localization of fractures. P137 MORBIDITY OF ANTICOAGULANT OR ANTIPLATELET MEDICATION

Data collected included demographics, time to surgery, length of stay, postoperative blood transfusion, acute coronary syndrome (ACS), stroke, hospital acquired infections and 120-day mortality. Patients were categorised based on the use of direct oral anticoagulants (DOAC), warfarin and antiplatelets medications. Categorical data was assessed with the chi-square test whilst continuous data were evaluated with the Kruskall-Wallis test and the independent samples median test. Results: 474 patients were included of which 43.5% were on an anticoagulant or antiplatelet. These patients had increased overall complication rate (p<0.001) which included a higher ACS risk (p=0.02), postoperative blood transfusion (p=0.021), and infection rate

Conclusion: There is a significantly higher incidence of complications in hip fracture patients on anticoagulant/antiplatelet medications as well as a greater time to surgery. This is significantly associated with greater morbidity and 120-day mortality. Patients on anticoagulant/antiplatelet medications are at increased risk of poor health outcomes. In a well resourced tertiary hospital outcomes may have room for improvement

India Objective: Osteoporosis is a prevalent condition in current developing era but undiagnosed or underdiagnosed condition in especially developing countries like India. The study aim was to evaluate computed tomography (CT)-derived BMD assessment compared DXA measures for identifying osteoporosis by using CT scans performed for other clinical indications

Sagittal CT images assessed for moderate-to-severe vertebral fractures. Results: CT-attenuation values were significantly lower at all vertebral levels for patients with DXA-defined osteoporosis (P<0.001). An L1 CTattenuation threshold of 160 HU or less was 90% sensitive and a threshold of 110 HU was more than 90% specific for distinguishing osteoporosis from osteopenia and normal BMD. Positive predictive values for osteoporosis were 68% or greater at L1 CT-attenuation thresholds less than 100 HU

Similar performance was seen at all vertebral levels. Intravenous contrast did not affect CT performance. Conclusion: Abdominal CT images obtained for other reasons that include the lumbar spine can be used to identify patients with osteoporosis or normal BMD without additional radiation exposure or cost. The potential benefits and costs of using the various CT-attenuation thresholds identified were not formally assessed

We included articles that were (1) randomized controlled trials (RCTs), (2) involved post-surgery interventions that were conducted in the acute, subacute or community settings and (3) conducted among older patients above 65 years old with any type of non-pathological hip fracture that was surgically treated, and who were able to walk without assistance prior to the fracture. We excluded (1) non-English language articles