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FRAX calculated without BMD does not correctly identify Caucasian men with densitometric evidence of osteoporosis.
Osteoporos Int. 2018 04; 29(4):947-952.OI

Abstract

The FRAX algorithm assesses the patient's probability of sustaining an osteoporotic fracture and can be calculated with or without densitometric data. This study seeks to determine whether in men, FRAX scores calculated without BMD, correctly identify patients with BMD-defined osteoporosis.

INTRODUCTION

The diagnosis of osteoporosis is based on densitometric data, the presence of a fragility fracture or increased fracture risk. The FRAX algorithm estimates the patient's 10-year probability of sustaining an osteoporotic fracture and can be calculated with or without BMD data. The purpose of this study is to determine whether in men, FRAX calculated without BMD, can correctly identify patients with BMD-defined osteoporosis.

METHODS

Retrospectively retrieved data from 726 consecutive Caucasian males, 50 to 70 years old referred to our Osteoporosis Center.

RESULTS

In the population studied, 11.8 and 25.3% had BMD-defined osteoporosis when female and male reference populations were used respectively. When the National Osteoporosis Foundation thresholds to initiate treatment are used, only 27% of patients with BMD-defined osteoporosis, but 4% with normal BMD reached/exceeded these thresholds. Lowering the threshold increased sensitivity, but decreased specificity.

CONCLUSIONS

Our results suggest that FRAX without BMD is not sensitive/specific enough to be used to identify Caucasian men 50 to 70 years old with BMD-defined osteoporosis.

Authors+Show Affiliations

Osteoporosis Center, East Tennessee State University, Johnson City, TN, 37614, USA. Hamdy@etsu.edu.Department of Mathematics and Statistics, East Tennessee State University, Johnson City, TN, 37614, USA.Osteoporosis Center, East Tennessee State University, Johnson City, TN, 37614, USA.College of Clinical and Rehabilitative Health Sciences, Department of Allied Health Sciences, East Tennessee State University, Johnson City, TN, 37614, USA.Osteoporosis Center, East Tennessee State University, Johnson City, TN, 37614, USA.Osteoporosis Center, East Tennessee State University, Johnson City, TN, 37614, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29397409

Citation

Hamdy, R C., et al. "FRAX Calculated Without BMD Does Not Correctly Identify Caucasian Men With Densitometric Evidence of Osteoporosis." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 29, no. 4, 2018, pp. 947-952.
Hamdy RC, Seier E, Whalen K, et al. FRAX calculated without BMD does not correctly identify Caucasian men with densitometric evidence of osteoporosis. Osteoporos Int. 2018;29(4):947-952.
Hamdy, R. C., Seier, E., Whalen, K., Clark, W. A., Hicks, K., & Piggee, T. B. (2018). FRAX calculated without BMD does not correctly identify Caucasian men with densitometric evidence of osteoporosis. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 29(4), 947-952. https://doi.org/10.1007/s00198-017-4368-6
Hamdy RC, et al. FRAX Calculated Without BMD Does Not Correctly Identify Caucasian Men With Densitometric Evidence of Osteoporosis. Osteoporos Int. 2018;29(4):947-952. PubMed PMID: 29397409.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - FRAX calculated without BMD does not correctly identify Caucasian men with densitometric evidence of osteoporosis. AU - Hamdy,R C, AU - Seier,E, AU - Whalen,K, AU - Clark,W A, AU - Hicks,K, AU - Piggee,T B, Y1 - 2018/02/03/ PY - 2017/08/11/received PY - 2017/12/25/accepted PY - 2018/2/6/pubmed PY - 2019/2/26/medline PY - 2018/2/5/entrez KW - Bone mineral density KW - FRAX KW - Management KW - Men KW - Osteoporosis SP - 947 EP - 952 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 29 IS - 4 N2 - : The FRAX algorithm assesses the patient's probability of sustaining an osteoporotic fracture and can be calculated with or without densitometric data. This study seeks to determine whether in men, FRAX scores calculated without BMD, correctly identify patients with BMD-defined osteoporosis. INTRODUCTION: The diagnosis of osteoporosis is based on densitometric data, the presence of a fragility fracture or increased fracture risk. The FRAX algorithm estimates the patient's 10-year probability of sustaining an osteoporotic fracture and can be calculated with or without BMD data. The purpose of this study is to determine whether in men, FRAX calculated without BMD, can correctly identify patients with BMD-defined osteoporosis. METHODS: Retrospectively retrieved data from 726 consecutive Caucasian males, 50 to 70 years old referred to our Osteoporosis Center. RESULTS: In the population studied, 11.8 and 25.3% had BMD-defined osteoporosis when female and male reference populations were used respectively. When the National Osteoporosis Foundation thresholds to initiate treatment are used, only 27% of patients with BMD-defined osteoporosis, but 4% with normal BMD reached/exceeded these thresholds. Lowering the threshold increased sensitivity, but decreased specificity. CONCLUSIONS: Our results suggest that FRAX without BMD is not sensitive/specific enough to be used to identify Caucasian men 50 to 70 years old with BMD-defined osteoporosis. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/29397409/FRAX_calculated_without_BMD_does_not_correctly_identify_Caucasian_men_with_densitometric_evidence_of_osteoporosis_ L2 - https://doi.org/10.1007/s00198-017-4368-6 DB - PRIME DP - Unbound Medicine ER -