title: Influence of bone mineral density measurement on fracture risk assessment tool® scores in postmenopausal Indian women.
abstract: OBJECTIVE
  Fracture risk assessment tool® calculations can be performed with or without addition of bone mineral density; however, the impact of this addition on fracture risk assessment tool® scores has not been studied in Indian women. Given the limited availability and high cost of bone mineral density testing in India, it is important to know the influence of bone mineral density on fracture risk assessment tool® scores in Indian women. Therefore, our aim was to assess the contribution of bone mineral density in fracture risk assessment tool® outcome in Indian women.
  
  
  METHODS
  Apparently healthy postmenopausal Indian women (n = 506), aged 40-72 years, without clinical risk factors for bone disease, were retrospectively selected, and their fracture risk assessment tool® scores calculated with and without bone mineral density were compared.
  
  
  RESULTS
  Based on WHO criteria, 30% women were osteoporotic, 42.9% were osteopenic and 27.1% had normal bone mineral density. Fracture risk assessment tool® scores for risk of both major osteoporotic fracture and hip fracture significantly increased on including bone mineral density (P < 0.0001). When criteria of National Osteoporosis Foundation, US was applied number of participants eligible for medical therapy increased upon inclusion of bone mineral density, (for major osteoporotic fracture risk number of women eligible without bone mineral density was 0 and with bone mineral density was 1, P > 0.05, whereas, for hip fracture risk number of women eligible without bone mineral density was 2 and with bone mineral density was 17, P < 0.0001).
  
  
  CONCLUSIONS
  Until the establishment of country-specific medication intervention thresholds, bone mineral density should be included while calculating fracture risk assessment tool® scores in Indian women.
authors.affiliation: Division of Molecular Immunodiagnostics, National Institute for Research in Reproductive Health (ICMR), J.M. Street, Parel, Mumbai - 400012, India.
authors.forename: Bhavna
authors.initials: B
authors.lastname: Daswani
authors.affiliation: Division of Molecular Immunodiagnostics, National Institute for Research in Reproductive Health (ICMR), J.M. Street, Parel, Mumbai - 400012, India.
authors.forename: Meena
authors.initials: M
authors.lastname: Desai
authors.affiliation: Division of Molecular Immunodiagnostics, National Institute for Research in Reproductive Health (ICMR), J.M. Street, Parel, Mumbai - 400012, India.
authors.forename: Sumegha
authors.initials: S
authors.lastname: Mitra
authors.affiliation: Division of Molecular Immunodiagnostics, National Institute for Research in Reproductive Health (ICMR), J.M. Street, Parel, Mumbai - 400012, India.
authors.forename: Shubhangi
authors.initials: S
authors.lastname: Gavali
authors.affiliation: Division of Clinical Research, National Institute for Research in Reproductive Health (ICMR), J. M. Street, Parel, Mumbai - 400012, India.
authors.forename: Anushree
authors.initials: A
authors.lastname: Patil
authors.affiliation: University of Illinois, Chicago, IL 60612, USA.
authors.forename: Subhash
authors.initials: S
authors.lastname: Kukreja
authors.affiliation: Division of Molecular Immunodiagnostics, National Institute for Research in Reproductive Health (ICMR), J.M. Street, Parel, Mumbai - 400012, India khatkhatayi@nirrh.res.in.
authors.forename: M Ikram
authors.initials: MI
authors.lastname: Khatkhatay
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006620:Hip Fractures / Q000517:prevention & control*; D006801:Humans; D007194:India; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D058866:Osteoporotic Fractures / Q000517:prevention & control*; D017698:Postmenopause; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods
keywords: Bone mineral density; India; fracture risk assessment tool®; osteoporosis; postmenopausal women