Abstract
Background
A Moroccan
model for the FRAX tool to determine the absolute risk of osteoporotic fracture
at 10 years has been established recently. The study aimed to assess the
discriminative capacity of FRAX in identifying women with prevalent
asymptomatic vertebral fractures (VFs).
Methods
We
enrolled in this cross-sectional study 908 post-menopausal women with a mean
age of 60.9 years ±7.7 (50 to 91) with no prior known diagnosis of
osteoporosis. Subjects were recruited from asymptomatic women selected from the
general population. Lateral VFA (vertebral fracture assessment) images and scans of the lumbar spine and
proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer.
VFs were defined using a combination of Genantsemiquantitative (SQ) approach
and morphometry. We calculated the absolute risk of major fracture and hip
fracture with and without bone mineral density (BMD)using the FRAX website.The
overall discriminative value of the different risk scores was assessed by
calculating the areas under the ROC curve (AUC).
Results
VFA images
showed that 179 of the participants (19.7%) had at least one grade 2/3 VF. The
group of women with VFs had a statistically significant higher FRAX scores for
major and hip fractures with and without BMD, and lower weight, height, and
lumbar spine and hip BMD and T-scores than those without a VFA-identified VF.
The AUC ROC of FRAX for major fracture without BMD was 0.757 (CI 95%;
0.718-0.797) and 0.736 (CI 95%; 0.695-0.777) with BMD, being 0.756 (CI 95%;
0.716-0.796) and 0.747 (CI 95%; 0.709-0.785), respectively for FRAX hip
fracture without and with BMD. The AUC ROC of lumbar spine T-score and femoral
neck T-score were 0.660 (CI 95%; 0.611-0.708) and 0.707 (CI 95%; 0.664-0.751)
respectively.
Conclusion
In
asymptomatic post-menopausal women, the FRAX risk for major fracture without
BMD had a better discriminative capacity in identifying the women with
prevalent VFs than lumbar spine and femoral neck T-scores suggesting its
usefulness in identifying women in whom VFA could be indicated.
To read the full research article by Abdellah El Maghraoui, Siham
Sadni, Nabil Jbili, Asmaa Rezqi, Aziza Mounach and Imad
Ghozlani click on this link:
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