7 research outputs found
FRAX (R): Prediction of Major Osteoporotic Fractures in Women from the General Population: The OPUS Study
Purposes: The aim of this study was to analyse how well FRAXH predicts the risk of major osteoporotic and vertebral
fractures over 6 years in postmenopausal women from general population.
Patients and methods: The OPUS study was conducted in European women aged above 55 years, recruited in 5 centers
from random population samples and followed over 6 years. The population for this study consisted of 1748 women (mean
age 74.2 years) with information on incident fractures. 742 (43.1%) had a prevalent fracture; 769 (44%) and 155 (8.9%) of
them received an antiosteoporotic treatment before and during the study respectively. We compared FRAXH performance
with and without bone mineral density (BMD) using receiver operator characteristic (ROC) c-statistical analysis with ORs and
areas under receiver operating characteristics curves (AUCs) and net reclassification improvement (NRI).
Results: 85 (4.9%) patients had incident major fractures over 6 years. FRAXH with and without BMD predicted these
fractures with an AUC of 0.66 and 0.62 respectively. The AUC were 0.60, 0.66, 0.69 for history of low trauma fracture alone,
age and femoral neck (FN) BMD and combination of the 3 clinical risk factors, respectively. FRAXH with and without BMD
predicted incident radiographic vertebral fracture (n = 65) with an AUC of 0.67 and 0.65 respectively. NRI analysis showed a
significant improvement in risk assignment when BMD is added to FRAXH.
Conclusions: This study shows that FRAXH with BMD and to a lesser extent also without FN BMD predict major osteoporotic
and vertebral fractures in the general population
Influence of obesity on vertebral fracture prevalence and vitamin D status in postmenopausal women
Combining bone resorption markers and heel quantitative ultrasound to discriminate between fracture cases and controls.
This nested case-control analysis of a Swiss ambulatory cohort of elderly women assessed the discriminatory power of urinary markers of bone resorption and heel quantitative ultrasound for non-vertebral fractures. The tests all discriminated between cases and controls, but combining the two strategies yielded no additional relevant information. INTRODUCTION: Data are limited regarding the combination of bone resorption markers and heel quantitative bone ultrasound (QUS) in the detection of women at risk for fracture. METHODS: In a nested case-control analysis, we studied 368 women (mean age 76.2 +/- 3.2 years), 195 with low-trauma non-vertebral fractures and 173 without, matched for age, BMI, medical center, and follow-up duration, from a prospective study designed to predict fractures. Urinary total pyridinolines (PYD) and deoxypyridinolines (DPD) were measured by high performance liquid chromatography. All women underwent bone evaluations using Achilles+ and Sahara heel QUS. RESULTS: Areas under the receiver operating-characteristic curve (AUC) for discriminative models of the fracture group, with 95% confidence intervals, were 0.62 (0.56-0.68) and 0.59 (0.53-0.65) for PYD and DPD, and 0.64 (0.58-0.69) and 0.65 (0.59-0.71) for Achilles+ and Sahara QUS, respectively. The combination of resorption markers and QUS added no significant discriminatory information to either measurement alone with an AUC of 0.66 (0.60-0.71) for Achilles+ with PYD and 0.68 (0.62-0.73) for Sahara with PYD. CONCLUSIONS: Urinary bone resorption markers and QUS are equally discriminatory between non-vertebral fracture patients and controls. However, the combination of bone resorption markers and QUS is not better than either test used alone