Application of the fracture risk assessment tool (FRAX®) and determination of suitable cut-off values during primary screening in specific health check-ups in Japan

Specific health check-ups, which do not include osteoporosis screening, are conducted more frequently than periodic osteoporosis screening in Japan. In this study, we investigated the usefulness of the fracture risk assessment tool (FRAX^®) during specific health check-ups, evaluated the variations in its usefulness for 2 consecutive years, and determined FRAX^® cut-off values for osteoporosis screening. FRAX^® questionnaires were distributed to subjects who underwent specific health check-ups in 2009 and 2010 at Asahi-machi. Subjects who exhibited FRAX^® cut-off values of ≥10 % were advised to be screened at a medical institution. Bone mineral densities (BMDs) were measured in 201 subjects in 2009 and 105 subjects in 2010 after specific health check-ups, and treatment was initiated for 79 subjects in 2009 and 24 subjects in 2010. The number of subjects examined and the rate of treatment initiation following specific health check-ups were higher than those in subjects following periodic osteoporosis screening in 2009. However, the number and the rate following specific health check-ups dropped in 2010. According to receiver operating characteristic curves analyses, the sensitivity and specificity of FRAX^® to determine osteoporosis treatment were highest when the cut-off values were 8 % for men and 10.5 % for women. In conclusion, the combination of FRAX^® and specific health check-ups was more useful than periodic osteoporosis screening to narrow down the subjects and to motivate them to seek follow-up. Cut-off values for specific health check-up using FRAX^® should be approximately 8 % for men and 10.5 % for women     

Anthropometric characteristics and comorbidities in Japanese patients with neurofibromatosis type 1: A single institutional case–control study

Neurofibromatosis type 1 (NF1) is a well‐known genetic disorder characterized by café‐au‐lait spots and neurofibromas, but many other clinical characteristics and associated comorbidities also have been reported. This study aimed to characterize NF1 further by investigating its association with anthropometric characteristics and other diseases. We performed a case–control study of 227 NF1 patients (101 male, 126 female) and a randomly selected age‐ and sex‐matched control group of 681 non‐NF1 patients (303 male, 378 female) who visited our institution in Japan. We examined adult (≥20 years) height and body mass index (BMI), and, in the total sample, allergic diseases (bronchial asthma [BA], atopic dermatitis [AD] and allergic rhinitis) and other respiratory cardiovascular and psychiatric disorders. In adults, the mean BMI was lower in the NF1 group than in the control group, and was significantly statistically different among men (P = 0.0238). In the whole sample, the prevalences of BA (P = 0.0184), AD (P = 0.0144) and valvular heart disease (P = 0.0166) were significantly greater in the NF1 group than in the control group. To date, no similar research on the BMI or the prevalence of allergic disease in NF1 patients has been reported. Our results suggest that NF1 patients tend to have lower BMI and may have alterations in specific metabolic pathways and altered allergic immunity.