Osteoporosis is a condition that does not exhibit symptoms until there is a bone fracture, so it is said that there is a high percentage of people who remain unaware of their condition. When people are unaware their bones have weakened, the condition is left untreated, and the recent rise of the elderly population has caused an increase in bone fractures. This has a large societal impact, such as overwhelming medical costs and long-term care. Simple screenings at resident health exams are one way for an increase in osteoporosis detecting without having to go to the hospital. When suspected osteoporosis and osteopenia is properly detected and patients are encouraged to get further evaluation at the hospital, it can receive appropriate treatment. This study developed a novel method to detect untreated osteoporosis through a low-cost, physical function test during a routine health checkup.
Osteoporosis is under-diagnosed and when left untreated, it can lead to serious fractures that can reduce mobility, living function, and is directly linked to life expectancy. With proper treatment, people are more likely to avoid serious fractures. Doctors and physical therapists at Shinshu University Hospital developed a method to detect possible osteoporosis before going to the hospital. If this detection determines that a patient is likely to have osteoporosis, patients will then be encouraged to have a bone-density test at the hospital.
This study was conducted by a random sampling of the Resident Register. Results are expected to be closer to the actual demographic of the general population than surveys targeting hospital patients and specific volunteers. The osteoporosis detection method used the combination of BMI and a two-step test which is performed by taking two maximum-stride steps and calculating the distance in centimeters divided by the body height in centimeters. This showed a high osteoporosis detection capability that even FOSTA could not achieve, despite the cost of the test being close to zero. The study which targeted postmenopausal women who are at high risk for primary osteoporosis found that if any of the following is true, TST <= 1.30 and BMI <= 23.4, TST <= 1.32 and BMI <= 22.4, TST <= 1.34 and BMI <= 21.6, or TST < 1.24 and any BMI, you are more than five times more likely to have osteoporosis than someone who is not. (Abbreviation: TST, two-step test; BMI, body mass index.)
The epidemiological survey "Obuse Study" is a large cohort study, and the second screening will continue. The ultimate goal, says the corresponding author, Dr. Shota Ikegami is "to present a new model for realizing a healthy society in a super-aged society while conducting a comprehensive health evaluation, not limited to osteoporosis, centered on locomotor examinations and sharing this finding with the world."
Author Information: Ryuji Osawa 1, Shota Ikegami 1,2, Hiroshi Horiuchi 1,2, Ryosuke Tokida 1, Hiroyuki Kato 2 and Jun Takahashi 2
1 Rehabilitation Center, Shinshu University Hospital
2 Department of Orthopaedic Surgery, Shinshu University School of Medicine
Correspondence: Shota Ikegami
Author Contributions: S.I. and J.T. designed the study and wrote the manuscript. R.O. and S.I. performed the data analysis and wrote the manuscript. H.H. and R.T. provided clinical experience and wrote the manuscript. H.K. and J.T. supervised the whole study.
Funding: This work was supported by a grant from the Japan Orthopaedics and Traumatology Research Foundation, Inc. (number: 339) as well as research funds from the Promotion Project of Education, Research, and Medical Care from Shinshu University Hospital, the Japanese Orthopaedic Association, the Japanese Society for Musculoskeletal Medicine, the Shinshu Public Utility Foundation for Promotion of Medical Sciences, and The Nakatomi Foundation.
Data Availability Statement: The complete database of the cohort can be accessed at the Zenodo repository (doi.org/10.5281/zenodo.4722536).
Acknowledgments: We thank Hironobu Sato of the Obuse Town Institute for Community Health Promotion, Takashi Igarashi of the Center for Clinical Research at Shinshu University Hospital, and the Obuse town office for sample selection in this study.
Institutional Review Board Statement: This study was approved by the investigational review board of our hospital (approval number: 2792). Written consent was obtained from all participants. All research was conducted in accordance with the STROBE guidelines for observational research.
Informed Consent Statement: Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patients to publish this paper.
Journal of Clinical Medicine