Assessment of Fracture Risk in A Population of Postmenopausal Italian Women: A Comparison of Two Different Tools.
The main objective of this study was to compare in the assessment of risk of fractures in postmenopausal women two algorithms for 10-year fracture risk evaluation, the WHO-endorsed FRAX(®) and the Italian FRAX-derived version (DeFRA), which considers BMD of different bone sites and allows the inclusion of other data. In a secondary analysis, we compared the performance of the tools in discriminating subjects who sustained previous major fractures from those who did not. The 10-year fracture risk score was evaluated in a sample of 989 climacteric women using FRAX and DeFRA tools. Bone mineral density was also included in the calculation of these algorithms. Comparing how the subjects were assigned to different risk classes by the two tools, we found that DeFRA attributed higher risk categories than FRAX, among women in the subgroups between 50 and 59 and, mostly, 60-69 years of age. ROC curve analysis showed that DeFRA had the same discriminative ability to identify previous major osteoporotic fractures compared to FRAX (AUC = 0.74 for both). If confirmed by prospective studies, our findings would suggest that DeFRA might be ascribed as at least equivalent to FRAX or perhaps slightly most appropriate in the categorization of the fracture risk, particularly in women aged 60-69 years, a period in which bone densitometry analysis is highly recommended.
Department of Morphology, Surgery and Experimental Medicine, Menopause and Osteoporosis Centre, University of Ferrara, Via Boschetto 29, 44124, Ferrara, Italy, bng@unife.it.
Gloria
G
Bonaccorsi
Enrica
E
Fila
Carlo
C
Cervellati
Arianna
A
Romani
Melchiore
M
Giganti
Maurizio
M
Rossini
Pantaleo
P
Greco
Leo
L
Massari
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015519:Bone Density / Q000502:physiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D017698:Postmenopause; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors