Fracture risk assessment tool (FRAX) and for the diagnosis of osteoporosis in Japanese middle-aged and elderly women: Chiba bone survey

Abstract

Abstract. Osteoporosis not only increases bone fracture risk but also affects survival in postmenopausal women. Although osteoporosis is diagnosed based on low bone mineral density (BMD) determined by dual energy X-ray absorptiometry (DXA), BMD measurement is sometimes difficult because DXA is not widely available in the community. The Fracture Risk Assessment tool (FRAX) can predict 10-year major osteoporotic fracture risk and hip fracture risk with or without femoral neck BMD. The FRAX has not been investigated adequately in community-dwelling Japanese women. We administered the FRAX tool in 13,421 Japanese women who underwent DXA-based forearm BMD measurement in Chiba Bone Survey, a population-based, multicenter, cross-sectional study of postmenopausal osteoporosis conducted in Chiba, Japan. Mean age was 57.77 ± 9.24 years. Mean forearm BMD was 87.94 ± 17.00% of young adult mean (YAM). Mean FRAX major osteoporotic fracture risk without femoral neck BMD was 7.06 ± 5.22%. BMD decreased and percentage of osteoporosis increased from age 55 onward. Age distribution of percentage of subjects with FRAX major osteoporotic fracture risk >15% was similar to that of percentage of osteoporosis subjects. We identified the cutoff value of FRAX major osteoporotic fracture risk for diagnosis of osteoporosis as 7.2%. With this cutoff, the positive likelihood ratio was over 1.0 at age 55 and above but accuracy was low. In conclusion, FRAX without femoral neck BMD reflects bone status, and may be useful to diagnose osteoporosis in Japanese women aged 55 and above, although the sensitivity was low for osteoporosis screening, especially in middle-aged women.

Systemic immune‐inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture

“…According to the adjusted ORs evaluated in our analysis, the risk of PMOP caused by the higher SII is nearly equivalent to the risk caused by the long menopause duration, indicating that the up‐regulated SII can be regarded as a strong indicator for PMOP diagnosis. Considering that DEXA scanning is a relatively expensive and radioactive examination, sometimes postmenopausal women might have poor adherence to receive it . Compared to DEXA scanning, SII could be easily and economically obtained from blood routine examination.…”

Antiresorptive treatments for corticosteroid-induced osteoporosis: a Bayesian network meta-analysis

“… 23 , 24 The diagnosis is based on detecting changes in BMD through absorptiometry. 25 The fracture risk assessment tool (FRAX), combined with clinical risk factors for osteoporosis with or without BMD measurements, is used to evaluate the potential risk of sustaining a major osteoporotic fracture in patients over 40 years old within 10 years. 26 …”

Comparison between real-world practice and application of the FRAX algorithm in the treatment of osteoporosis

“…In light of this, the University of Sheffield developed the Fracture Risk Assessment tool (FRAX) to evaluate the 10-year probability of major osteoporotic fracture and hip fracture in men and women. The risks related to clinical variables (age, gender, body mass index, history of previous fractures, family history of fracture, smoking, alcohol use, rheumatoid arthritis, and glucocorticoid use) may be assessed by the FRAX algorithm alone or in combination with femoral neck BMD measured by DXA [ 16 ]. FRAX has been studied in different countries, and the tool should be calibrated on the basis of each country’s epidemiological data [ 16 , 17 ].…”