title: Identification of patients with high osteoporosis risk: analysis of FRAX and phalangeal ultrasonography in a female population in North-East Italy.
abstract: OBJECTIVE
  Osteoporosis is a worldwide health problem and bone fractures from osteoporosis are among the major causes of disability, with a great impact on the national health budgets. The aim of our study was to analyze the efficacy of FRAX algorithm and phalanger ultrasound to predict the risk of osteoporotic fractures, in order to identify a high risk population to examine with a second level diagnostic analysis.
  
  
  METHODS
  The study population was composed of 1208 premenopausal, perimenopausal, and postmenopausal women, between 40 and 81 years. For each woman phalangeal QUS was performed and FRAX index was calculated. The FRAX index was evaluated according to standard plots available on web (http://www.shed.ac.uk/FRAX/index.htm).
  
  
  RESULTS
  Analysing the correlation between women age and phalanger bone ultrasound values we know that all parameter decrease with increasing of age. We found a significant difference between FRAX index and the ultrasound parameters (P<0.05) to predict a major osteoporotic fracture, we did not find differences between age and ultrasound parameters. Furthermore, we show that after correction per age of the women the ultrasound parameters lose their significant correlation with major osteoporotic fractures. Finally, FRAX index showed a good AUC and in our population and a 10-year probability over 9.4% of major osteoporotic fractures had a good specificity (88%) and sensitivity (83%) to predict osteoporotic fractures.
  
  
  CONCLUSIONS
  Our data suggest that FRAX index alone could be used to address high risk women to more invasive tests but we need more data about ultrasound parameters.
authors.affiliation: Obstetrics and Gynecologic Clinic University Hospital Santa Maria della MisericordiaUdine, Italy - vogrig.emanuela@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Vogrig
authors.forename: M
authors.initials: M
authors.lastname: Della Martina
authors.forename: S
authors.initials: S
authors.lastname: Xodo
authors.forename: L P
authors.initials: LP
authors.lastname: Ganzitti
authors.forename: A
authors.initials: A
authors.lastname: P Londero
authors.forename: G
authors.initials: G
authors.lastname: Fabiani
authors.forename: D
authors.initials: D
authors.lastname: Marchesoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D050278:Finger Phalanges / Q000000981:diagnostic imaging*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000209:etiology; D047648:Perimenopause; D017698:Postmenopause; D017697:Premenopause; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014463:Ultrasonography