title: Clinical characteristics and incidence of first fracture in a consecutive sample of post-menopausal women attending osteoporosis centers: The PROTEO-1 study.
abstract: BACKGROUND
  Osteoporosis is a highly prevalent disease and fractures are a major cause of disability and morbidity.
  
  
  OBJECTIVE
  The purpose of this study was to characterize post-menopausal women attending osteoporosis centers in Italy, to evaluate physician management, and to determine the incidence of first osteoporotic fracture.
  
  
  METHODS
  PROTEO-1 was an observational longitudinal study with a 12-month follow-up. Data were collected from women attending osteoporosis centers. Women without prevalent fracture were eligible to enter the 1-yr follow-up phase: the clinical approach to patients according to their fracture risk profile and the incidence of fracture were recorded.
  
  
  RESULTS
  4269 patients were enrolled in 80 centers in the cross-sectional phase; 34.2% had an osteoporotic fracture at baseline. Patients with prevalent fractures were older and more likely to be treated compared with non-fractured patients. The incidence of vertebral or hip fracture after 1 yr was 3.84%, regardless of the calculated risk factor profile, and was significantly higher in patients with back pain at baseline (4.2%) compared with those without back pain (2.2%; p=0.023). Generally, physicians prescribed more blood exams and drugs to patients at higher risk of fracture. Among fractured patients only 24% were properly treated; the rate of non-responders to treatment was about 4%.
  
  
  CONCLUSIONS
  In a large, unselected sample of post-menopausal women attending osteoporosis centers, those without previous fracture were at substantial risk of future fracture, regardless of their theoretical low 10-yr fracture risk. The presence of back pain in women without previous fracture warrants close attention.
authors: Gerontology Section, Department of Surgical and Medical Disciplines, University of Turin, Turin, Italy. giancarlo.isaia@unito.it
authors: G C
authors: GC
authors: Isaia
authors: V
authors: V
authors: Braga
authors: S
authors: S
authors: Minisola
authors: G
authors: G
authors: Bianchi
authors: A
authors: A
authors: Del Puente
authors: L
authors: L
authors: Di Matteo
authors: G
authors: G
authors: Pagano Mariano
authors: V M
authors: VM
authors: Latte
authors: F
authors: F
authors: D'Amico
authors: C
authors: C
authors: Bonali
authors: P
authors: P
authors: D'Amelio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D001416:Back Pain / Q000453:epidemiology / Q000209:etiology; D015519:Bone Density; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000150:complications / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D017698:Postmenopause; D012307:Risk Factors; D016103:Spinal Fractures / Q000150:complications / Q000453:epidemiology* / Q000209:etiology*