title: Increased fracture risk assessed by fracture risk assessment tool in Greek patients with Crohn's disease.
abstract: BACKGROUND
  The World Health Organization has recently developed the fracture risk assessment tool (FRAX) based on clinical risk factors and bone mineral density (BMD) for evaluation of the 10-year probability of a hip or a major osteoporotic fracture. The aim of this study was to evaluate the use of the FRAX tool in Greek patients with inflammatory bowel disease (IBD).
  
  
  METHODS
  FRAX scores were applied to 134 IBD patients [68 Crohn's disease (CD); 66 ulcerative colitis (UC)] who underwent dual-energy X-ray absorptiometry scans at the femoral neck and lumbar spine during the period 2007-2012. Calculation of the FRAX scores, with or without BMD, was made through a web-based probability model used to compute individual fracture probabilities according to specific clinical risk factors.
  
  
  RESULTS
  The median 10-year probability of a major osteoporotic fracture for IBD patients based on clinical data was 7.1%, and including the BMD was 6.2%. A significant overestimation with the first method was found (P = 0.01). Both scores with and without BMD were significantly higher in CD patients compared with UC patients (P = 0.02 and P = 0.005, respectively). The median 10-year probability of hip fracture based on clinical data was 0.8%, and including the BMD was 0.9%. The score with use of BMD was significantly higher in CD compared with UC patients (P = 0.04).
  
  
  CONCLUSIONS
  CD patients have significantly higher FRAX scores and possibly fracture risk compared with UC patients. The clinical FRAX score alone seems to overestimate the risk of osteoporotic fracture in Greek IBD patients.
authors.affiliation: Department of Gastroenterology, University Hospital of Heraklion, P.O. Box 1352, 71110, Heraklion, Crete, Greece.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Terzoudis
authors.forename: Christos
authors.initials: C
authors.lastname: Zavos
authors.forename: John
authors.initials: J
authors.lastname: Damilakis
authors.forename: John
authors.initials: J
authors.lastname: Neratzoulakis
authors.forename: Daphne Anna
authors.initials: DA
authors.lastname: Dimitriadi
authors.forename: Maria
authors.initials: M
authors.lastname: Roussomoustakaki
authors.forename: Elias A
authors.initials: EA
authors.lastname: Kouroumalis
authors.forename: Ioannis E
authors.initials: IE
authors.lastname: Koutroubakis
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D003093:Colitis, Ulcerative / Q000150:complications* / Q000453:epidemiology; D003424:Crohn Disease / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006115:Greece / Q000453:epidemiology; D006620:Hip Fractures / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D012307:Risk Factors