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16. Outcomes post fragility fracture among members of an integrated healthcare organization

Author

Adams, Annette L, Ryan, Denison S, Li, Bonnie H, Williams, Setareh A, Wang, Yamei, Weiss, Richard J, and Black, Dennis M

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Aging, Physical Injury - Accidents and Adverse Effects, Clinical Research, Health Services, Osteoporosis, Injuries and accidents, Musculoskeletal, Good Health and Well Being, Aged, Aged, 80 and over, Bone Density, Delivery of Health Care, Integrated, Female, Hip Fractures, Humans, Male, Middle Aged, Osteoporotic Fractures, Retrospective Studies, Spinal Fractures, Fracture risk, Mortality, Subsequent fracture, Biomedical Engineering, Public Health and Health Services, Endocrinology & Metabolism, Clinical sciences, Epidemiology
Abstract

This study highlights an unmet need in osteoporosis management, suggesting that beyond bone mineral density and fracture history, gender, fracture type, and age should be considered for fracture risk assessment. Following fragility fracture, men, patients with a spine or hip fracture, and those aged ≥ 65 have a higher disease burden.IntroductionThe objective of this study was to characterize osteoporosis-related fracture incidence and identify predictors of subsequent fractures and mortality.MethodsThis retrospective cohort study, conducted within Kaiser Permanente Southern California, included patients aged ≥ 50 years with qualifying fractures from 1/1/2007 to 12/31/2016, identified from diagnosis/procedure codes. Rates for fracture incidence, mortality, and resource utilization in the year post-fracture are reported. Associations between index fracture types and demographic/clinical characteristics, and mortality, subsequent fracture, and rehospitalization outcomes were estimated.ResultsOf 63,755 eligible patients, 66.7% were ≥ 65 years and 69.1% female. Index fractures included nonhip/nonspine (64.4%), hip (25.3%), and spine (10.3%). Age-adjusted subsequent fracture rate/100 person-years was higher for those with an index spine (14.5) versus hip fracture (6.3). Hospitalization rate/100 person-years was highest for patients ≥ 65 (31.8) and for spine fractures (43.5). Men (vs women) had higher age-adjusted rates of hospitalization (19.4; 17.7), emergency room visits (73.8; 66.3), and use of rehabilitation services (31.7; 27.2). The 30-day age-adjusted mortality rate/100 person-years was 46.7, 32.4, and 15.5 for spine, hip, and nonspine/nonhip fractures. The 1-year age-adjusted mortality rate/100 person-years was 14.7 for spine and 15.6 for hip fractures. In multivariable analyses, spine and hip fractures (vs nonhip/nonspine fractures) were significant predictors of 1-year mortality, all-cause and osteoporosis-related hospitalization, and nursing home use (all P-values

Published
2022

29. OsAMT1.1 Expression by Nitrate-Inducible Promoter of OsNAR2.1 Increases Nitrogen Use Efficiency and Rice Yield

Author

Jiang Hongzhen, Wang Yamei, Lai Liuru, Liu Xintong, Miao Changjian, Liu Ruifang, Li Xiaoyun, Tan Jinfang, Gao Zhenyu, and Chen Jingguang

Subjects
OsAMT1.1, OsNAR2.1 promoter, nitrogen use efficiency, yield, rice, Plant culture, SB1-1110
Abstract

Nitrate (NO3–) and ammonium (NH4+) are two main inorganic nitrogen (N) sources during crop growth. Here, we enhanced the expression of OsAMT1.1, which encodes a NH4+ transporter, using the NO3–-inducible promoter of OsNAR2.1 and an ubiquitin promoter in transgenic rice plants. Under field condition of 120 kg /hm2 N, agronomic N use efficiency, N recovery efficiency and N transport efficiency, and grain yield of the pOsNAR2.1:OsAMT1.1 transgenic lines were increased compared with those of the wild type (WT) and the pUbi:OsAMT1.1 transgenic plants. Under 2.0 mmol/L NO3– + 0.5 mmol/L NH4+ and 0.5 mmol/L NO3– + 2.0 mmol/L NH4+ conditions of hydroponic culture, compared with the WT, both biomass and total N content were increased in the pOsNAR2.1:OsAMT1.1 transgenic lines. However, biomass was significantly reduced in pUbi:OsAMT1.1 transgenic plants under 0.5 mmol/L NO3– + 2.0 mmol/L NH4+ condition. The lines expressing pOsNAR2.1:OsAMT1.1 exhibited increased OsAMT1.1 expression and 15NH4+ influx in roots under both 2.0 mmol/L NO3– + 0.5 mmol/L NH4+ and 0.5 mmol/L NO3– + 2.0 mmol/L NH4+ conditions. Our study showed that expression of OsAMT1.1 can be promoted when driven by the OsNAR2.1 promoter, especially under high-level nitrate condition, leading to enhancement of NH4+ uptake, N use efficiency and grain yield.

Published
2023
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39. Abaloparatide in Postmenopausal Women With Osteoporosis and Type 2 Diabetes: A Post Hoc Analysis of the ACTIVE Study.

Author

Dhaliwal, Ruban, Hans, Didier, Hattersley, Gary, Mitlak, Bruce, Fitzpatrick, Lorraine, Wang, Yamei, Schwartz, Ann, Miller, Paul, and Josse, Robert

Subjects
ABALOPARATIDE, ANABOLICS, BONE MINERAL DENSITY, CLINICAL TRIALS, DXA, FRACTURE PREVENTION, OSTEOPOROSIS, TRABECULAR BONE SCORE, TYPE 2 DIABETES MELLITUS
Abstract

Type 2 diabetes mellitus (T2DM) increases fracture risk despite normal or increased BMD. Abaloparatide reduces fracture risk in patients with postmenopausal osteoporosis (PMO); however, its efficacy in women with T2DM is unknown. This post hoc analysis evaluated the efficacy and safety of abaloparatide in patients with T2DM. The analysis included patients with T2DM from the Abaloparatide Comparator Trial In Vertebral Endpoints (ACTIVE), a phase 3, double-blind, randomized, placebo- and active-controlled trial. In ACTIVE, participants were randomized 1:1:1 to daily s.c. injections of placebo, abaloparatide (80 μg), or open-label teriparatide (20 μg) for 18 months. A total of 198 women with PMO and T2DM from 21 centers in 10 countries were identified from ACTIVE through review of their medical records. The main outcomes measured included effect of abaloparatide versus placebo on BMD and trabecular bone score (TBS), with secondary outcomes of fracture risk and safety, in patients from ACTIVE with T2DM. Significant (p

Published
2020

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