Potential Extensions of the US FRAX Algorithm
To determine if the revised US FRAX can identify those at high risk for fractures at any skeletal site, we studied 250 women and 249 men ≥40 years old from an age-stratified random sample of Rochester, MN residents. At baseline, femoral neck (FN) bone density was assessed, as were the clinical risk...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Journal of Osteoporosis |
| Online Access: | http://dx.doi.org/10.1155/2012/528790 |
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| _version_ | 1832551479378968576 |
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| author | L. Joseph Melton Elizabeth J. Atkinson Sara J. Achenbach John A. Kanis Terry M. Therneau Helena Johansson Sundeep Khosla Shreyasee Amin |
| author_facet | L. Joseph Melton Elizabeth J. Atkinson Sara J. Achenbach John A. Kanis Terry M. Therneau Helena Johansson Sundeep Khosla Shreyasee Amin |
| author_sort | L. Joseph Melton |
| collection | DOAJ |
| description | To determine if the revised US FRAX can identify those at high risk for fractures at any skeletal site, we studied 250 women and 249 men ≥40 years old from an age-stratified random sample of Rochester, MN residents. At baseline, femoral neck (FN) bone density was assessed, as were the clinical risk factors included in FRAX, along with additional fracture risk factors such as bone turnover markers and fall history. Fracture ascertainment through periodic interviews and comprehensive medical record review was performed over 10 years of followup. In both women and men, a higher FRAX probability at baseline was associated with greater subsequent likelihood of a major osteoporotic fracture. However, a relative 10% increase in the FRAX 10-year fracture probability was also associated with a 1.4-fold increase (95% confidence interval (CI) 1.1–1.7) in other fractures in women and a 1.7-fold increase (95% CI 0.8–3.1) in men. Furthermore, FRAX predicted asymptomatic vertebral fractures and fractures generally in both sexes. The addition of risk factors not currently included in FRAX did not appear to improve the accuracy of fracture risk prediction. FRAX may provide a conservative estimate of risk for major osteoporotic fractures, but it also predicts fractures generally. |
| format | Article |
| id | doaj-art-a5854972b9b249d68fe042124ab75c4b |
| institution | Kabale University |
| issn | 2090-8059 2042-0064 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Osteoporosis |
| spelling | doaj-art-a5854972b9b249d68fe042124ab75c4b2025-02-03T06:01:21ZengWileyJournal of Osteoporosis2090-80592042-00642012-01-01201210.1155/2012/528790528790Potential Extensions of the US FRAX AlgorithmL. Joseph Melton0Elizabeth J. Atkinson1Sara J. Achenbach2John A. Kanis3Terry M. Therneau4Helena Johansson5Sundeep Khosla6Shreyasee Amin7Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN 55905, USADivision of Biomedical Statistics and Informatics, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN 55905, USADivision of Biomedical Statistics and Informatics, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN 55905, USAWHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield S10 2RX, UKDivision of Biomedical Statistics and Informatics, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN 55905, USAWHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield S10 2RX, UKDivision of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55905, USADivision of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN 55905, USATo determine if the revised US FRAX can identify those at high risk for fractures at any skeletal site, we studied 250 women and 249 men ≥40 years old from an age-stratified random sample of Rochester, MN residents. At baseline, femoral neck (FN) bone density was assessed, as were the clinical risk factors included in FRAX, along with additional fracture risk factors such as bone turnover markers and fall history. Fracture ascertainment through periodic interviews and comprehensive medical record review was performed over 10 years of followup. In both women and men, a higher FRAX probability at baseline was associated with greater subsequent likelihood of a major osteoporotic fracture. However, a relative 10% increase in the FRAX 10-year fracture probability was also associated with a 1.4-fold increase (95% confidence interval (CI) 1.1–1.7) in other fractures in women and a 1.7-fold increase (95% CI 0.8–3.1) in men. Furthermore, FRAX predicted asymptomatic vertebral fractures and fractures generally in both sexes. The addition of risk factors not currently included in FRAX did not appear to improve the accuracy of fracture risk prediction. FRAX may provide a conservative estimate of risk for major osteoporotic fractures, but it also predicts fractures generally.http://dx.doi.org/10.1155/2012/528790 |
| spellingShingle | L. Joseph Melton Elizabeth J. Atkinson Sara J. Achenbach John A. Kanis Terry M. Therneau Helena Johansson Sundeep Khosla Shreyasee Amin Potential Extensions of the US FRAX Algorithm Journal of Osteoporosis |
| title | Potential Extensions of the US FRAX Algorithm |
| title_full | Potential Extensions of the US FRAX Algorithm |
| title_fullStr | Potential Extensions of the US FRAX Algorithm |
| title_full_unstemmed | Potential Extensions of the US FRAX Algorithm |
| title_short | Potential Extensions of the US FRAX Algorithm |
| title_sort | potential extensions of the us frax algorithm |
| url | http://dx.doi.org/10.1155/2012/528790 |
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