title: FRAX®: prediction of major osteoporotic fractures in women from the general population: the OPUS study.
abstract: OBJECTIVE
  The aim of this study was to analyse how well FRAX® predicts the risk of major osteoporotic and vertebral fractures over 6 years in postmenopausal women from general population.
  
  
  METHODS
  The OPUS study was conducted in European women aged above 55 years, recruited in 5 centers from random population samples and followed over 6 years. The population for this study consisted of 1748 women (mean age 74.2 years) with information on incident fractures. 742 (43.1%) had a prevalent fracture; 769 (44%) and 155 (8.9%) of them received an antiosteoporotic treatment before and during the study respectively. We compared FRAX® performance with and without bone mineral density (BMD) using receiver operator characteristic (ROC) c-statistical analysis with ORs and areas under receiver operating characteristics curves (AUCs) and net reclassification improvement (NRI).
  
  
  RESULTS
  85 (4.9%) patients had incident major fractures over 6 years. FRAX® with and without BMD predicted these fractures with an AUC of 0.66 and 0.62 respectively. The AUC were 0.60, 0.66, 0.69 for history of low trauma fracture alone, age and femoral neck (FN) BMD and combination of the 3 clinical risk factors, respectively. FRAX® with and without BMD predicted incident radiographic vertebral fracture (n = 65) with an AUC of 0.67 and 0.65 respectively. NRI analysis showed a significant improvement in risk assignment when BMD is added to FRAX®.
  
  
  CONCLUSIONS
  This study shows that FRAX® with BMD and to a lesser extent also without FN BMD predict major osteoporotic and vertebral fractures in the general population.
authors.affiliation: Paris-Descartes University, Rheumatology Department, Cochin Hospital, Paris, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Briot
authors.affiliation: Paris-Descartes University, Rheumatology Department, Cochin Hospital, Paris, France.
authors.forename: Simon
authors.initials: S
authors.lastname: Paternotte
authors.affiliation: Paris-Descartes University, Rheumatology Department, Cochin Hospital, Paris, France.
authors.forename: Sami
authors.initials: S
authors.lastname: Kolta
authors.affiliation: Department of Human Metabolism, University of Sheffield, Sheffield, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Eastell
authors.affiliation: Centre of Muscle and Bone Research, Charité - University Medicine Berlin, Campus Benjamin Franklin, Free and Humboldt University, Berlin, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Felsenberg
authors.affiliation: School of Medicine & Dentistry, University of Aberdeen, Aberdeen, United Kingdom.
authors.forename: David M
authors.initials: DM
authors.lastname: Reid
authors.affiliation: Biomedizinische Bildgebung, Klinik für Diagnostische Radiologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany.
authors.forename: Claus-C
authors.initials: CC
authors.lastname: Glüer
authors.affiliation: Paris-Descartes University, Rheumatology Department, Cochin Hospital, Paris, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Roux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000188:drug therapy; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D011159:Population Surveillance; D011446:Prospective Studies; D012372:ROC Curve; D011859:Radiography; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology