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Hypophosphatasia and the risk of atypical femur fractures: a case–control study

Overview of attention for article published in BMC Musculoskeletal Disorders, August 2016
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Title
Hypophosphatasia and the risk of atypical femur fractures: a case–control study
Published in
BMC Musculoskeletal Disorders, August 2016
DOI 10.1186/s12891-016-1191-8
Pubmed ID
Authors

Timothy Bhattacharyya, Smita Jha, Hongying Wang, Daniel L. Kastner, Elaine F. Remmers

Abstract

Case reports have linked adult hypophosphatasia as a possible cause of atypical femur fractures (AFF) associated with bisphosphonate use. Adult hypophosphatasia is an asymptomatic genetic condition which results in low alkaline phosphatase and elevated pyridoxal phosphate. We conducted a case-control study to assess the role of hypophosphatasia and atypical femur fracture. We recruited 13 control patients who took long term bisphosphonates without complication and 10 patients who sustained atypical femur fractures (mean bisphosphonate use, 9 years both cohorts). Patients underwent clinical exam and measurement of alkaline phosphatase and pyridoxal phosphate (PLP) levels. In addition, DNA was extracted and the ALPL gene was sequenced in both cohorts. Low alkaline phosphatase levels (<55 U/L) were seen in 5/10 AFF patients and 5/13 control patients. Two control patients demonstrated low alkaline phosphatase levels and elevated PLP. The alkaline phosphatase (ALPL) gene exons and intron splice sites were sequenced in the atypical femur fracture and control cohorts and no coding mutations were identified in any subjects. Atypical femur fracture patients demonstrated more varus hip alignment (p < 0.048) with no significant difference in mechanical axis. We found no evidence of hypophosphatasia as a risk factor for atypical femur fractures. Laboratory findings of mildly low alkaline phosphatase activity were equally common in atypical and control cohorts and may be due to long term bisphosphonate use. Clinicaltrials.gov number NCT01360099 . Prospectively registered May 20, 2011. First patient enrolled June 14, 2011.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 25 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 25 100%

Demographic breakdown

Readers by professional status Count As %
Other 5 20%
Student > Postgraduate 3 12%
Researcher 3 12%
Student > Ph. D. Student 3 12%
Professor 2 8%
Other 4 16%
Unknown 5 20%
Readers by discipline Count As %
Medicine and Dentistry 12 48%
Biochemistry, Genetics and Molecular Biology 3 12%
Pharmacology, Toxicology and Pharmaceutical Science 2 8%
Agricultural and Biological Sciences 1 4%
Unknown 7 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 August 2016.
All research outputs
#4,382,023
of 8,243,836 outputs
Outputs from BMC Musculoskeletal Disorders
#1,278
of 2,091 outputs
Outputs of similar age
#139,643
of 253,828 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#40
of 77 outputs
Altmetric has tracked 8,243,836 research outputs across all sources so far. This one is in the 27th percentile – i.e., 27% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,091 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.0. This one is in the 28th percentile – i.e., 28% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 253,828 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 34th percentile – i.e., 34% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 77 others from the same source and published within six weeks on either side of this one. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.