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Ten-year risk of osteoporotic fractures in postmenopausal Chinese women according to clinical risk factors and BMD T-scores: a prospective study.
J Bone Miner Res. 2007 Jul; 22(7):1080-7.JB

Abstract

Independent risk factors for osteoporotic fracture were identified for a Southern Chinese postmenopausal population. Clinical risk factor assessment with or without BMD measurement was shown to be an effective predictor of 10-yr risk of osteoporotic fracture and provides a more accessible tool for patient evaluation.

INTRODUCTION

Asian-specific data on risk factors for osteoporosis remain sparse. However, risk factor assessment, in addition to BMD measurement, is increasingly recognized as a reliable predictor of absolute osteoporotic fracture risk. The purpose of this prospective study was to determine the specific independent risk factors for osteoporotic fracture and to predict the 10-yr risk of osteoporotic fracture in the postmenopausal Southern Chinese population.

MATERIALS AND METHODS

A total of 1435 community-dwelling, postmenopausal, treatment-naive women were recruited. Baseline demographic characteristics and clinical risk factors were obtained, and BMD at the spine and hip was measured. Subjects were followed for outcomes of incident low trauma fracture. Ten-year risk of osteoporotic fracture was predicted from the risk factor assessment and BMD measurement by Cox proportional hazards models.

RESULTS

The mean age of subjects was 63.4 +/- 8.3 yr. After 5.0 +/- 2.3 yr (range, 1.0-11.0 yr) of follow-up, 80 nontraumatic new fractures were reported during follow-up. Eight independent clinical risk factors identified at baseline were found to be significant predictors of osteoporotic fracture, with the most important being use of walking aids (RR, 4.2; 95% CI, 2.7-6.7; p < 0.001) and a history of fall (RR, 4.0; 95% CI, 2.5-6.2; p < 0.001). Other predictive factors included being homebound, calcium intake < 400 mg/d, age > 65 yr, history of fracture, and BMI < 19 kg/cm(2). Subjects with three to eight clinical risk factors had a predicted 10-year risk of osteoporotic fracture of 25%, which increased to 30% if they also had total hip BMD T-score <or= -2.5.

CONCLUSIONS

Clinical risk factor assessment, with or without BMD measurement, is a reliable predictor of 10-year risk of osteoporotic fracture and may be particularly useful in regions or primary care clinics without access to bone densitometry equipment.

Authors+Show Affiliations

Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China. awckung@hkucc.hku.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17371165

Citation

Kung, Annie W C., et al. "Ten-year Risk of Osteoporotic Fractures in Postmenopausal Chinese Women According to Clinical Risk Factors and BMD T-scores: a Prospective Study." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 22, no. 7, 2007, pp. 1080-7.
Kung AW, Lee KK, Ho AY, et al. Ten-year risk of osteoporotic fractures in postmenopausal Chinese women according to clinical risk factors and BMD T-scores: a prospective study. J Bone Miner Res. 2007;22(7):1080-7.
Kung, A. W., Lee, K. K., Ho, A. Y., Tang, G., & Luk, K. D. (2007). Ten-year risk of osteoporotic fractures in postmenopausal Chinese women according to clinical risk factors and BMD T-scores: a prospective study. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 22(7), 1080-7.
Kung AW, et al. Ten-year Risk of Osteoporotic Fractures in Postmenopausal Chinese Women According to Clinical Risk Factors and BMD T-scores: a Prospective Study. J Bone Miner Res. 2007;22(7):1080-7. PubMed PMID: 17371165.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ten-year risk of osteoporotic fractures in postmenopausal Chinese women according to clinical risk factors and BMD T-scores: a prospective study. AU - Kung,Annie W C, AU - Lee,Ka-Kui, AU - Ho,Andrew Yy, AU - Tang,Grace, AU - Luk,Keith Dk, PY - 2007/3/21/pubmed PY - 2007/9/14/medline PY - 2007/3/21/entrez SP - 1080 EP - 7 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 22 IS - 7 N2 - UNLABELLED: Independent risk factors for osteoporotic fracture were identified for a Southern Chinese postmenopausal population. Clinical risk factor assessment with or without BMD measurement was shown to be an effective predictor of 10-yr risk of osteoporotic fracture and provides a more accessible tool for patient evaluation. INTRODUCTION: Asian-specific data on risk factors for osteoporosis remain sparse. However, risk factor assessment, in addition to BMD measurement, is increasingly recognized as a reliable predictor of absolute osteoporotic fracture risk. The purpose of this prospective study was to determine the specific independent risk factors for osteoporotic fracture and to predict the 10-yr risk of osteoporotic fracture in the postmenopausal Southern Chinese population. MATERIALS AND METHODS: A total of 1435 community-dwelling, postmenopausal, treatment-naive women were recruited. Baseline demographic characteristics and clinical risk factors were obtained, and BMD at the spine and hip was measured. Subjects were followed for outcomes of incident low trauma fracture. Ten-year risk of osteoporotic fracture was predicted from the risk factor assessment and BMD measurement by Cox proportional hazards models. RESULTS: The mean age of subjects was 63.4 +/- 8.3 yr. After 5.0 +/- 2.3 yr (range, 1.0-11.0 yr) of follow-up, 80 nontraumatic new fractures were reported during follow-up. Eight independent clinical risk factors identified at baseline were found to be significant predictors of osteoporotic fracture, with the most important being use of walking aids (RR, 4.2; 95% CI, 2.7-6.7; p < 0.001) and a history of fall (RR, 4.0; 95% CI, 2.5-6.2; p < 0.001). Other predictive factors included being homebound, calcium intake < 400 mg/d, age > 65 yr, history of fracture, and BMI < 19 kg/cm(2). Subjects with three to eight clinical risk factors had a predicted 10-year risk of osteoporotic fracture of 25%, which increased to 30% if they also had total hip BMD T-score <or= -2.5. CONCLUSIONS: Clinical risk factor assessment, with or without BMD measurement, is a reliable predictor of 10-year risk of osteoporotic fracture and may be particularly useful in regions or primary care clinics without access to bone densitometry equipment. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/17371165/Ten_year_risk_of_osteoporotic_fractures_in_postmenopausal_Chinese_women_according_to_clinical_risk_factors_and_BMD_T_scores:_a_prospective_study_ L2 - https://doi.org/10.1359/jbmr.070320 DB - PRIME DP - Unbound Medicine ER -