Authors: E Y N Cheung C H Bow C L Cheung C Soong S Yeung C Loong A Kung
Publish Date: 2011/05/12
Volume: 23, Issue: 3, Pages: 871-878
Abstract
We followed 2266 postmenopausal Chinese women for 45 years to determine which model best predicts osteoporotic fracture A model that contains ethnicspecific risk factors some of which reflect frailty performed as well as or better than the wellestablished FRAX modelClinical risk assessment with or without Tscore can predict fractures in Chinese postmenopausal women although it is unknown which combination of clinical risk factors is most effective This prospective study sought to compare the accuracy for fracture prediction using various models including FRAX our ethnicspecific clinical risk factors CRF and other simple modelsThis study is part of the Hong Kong Osteoporosis Study A total of 2266 treatment naïve postmenopausal women underwent clinical risk factor and bone mineral density assessment Subjects were followed up for outcome of major osteoporotic fracture and receiver operating characteristic ROC curves for different models were compared The percentage of subjects in different quartiles of risk according to various models who actually fractured was also comparedThe mean age at baseline was 621 ± 85 years and mean followup time was 45 ± 28 years A total of 106 new major osteoporotic fractures were reported of which 21 were hip fractures Ethnicspecific CRF with Tscore performed better than FRAX with Tscore based on both Chinese normative and National Health and Nutrition Examination Survey NHANES databases in terms of AUC comparison for prediction of major osteoporotic fracture The two models were similar in hip fracture prediction The ethnicspecific CRF model had a 10 higher sensitivity than FRAX at a specificity of 08 or aboveCRF related to frailty and differences in lifestyle between populations are likely to be important in fracture prediction Further work is required to determine which and how CRF can be applied to develop a fracture prediction model in our population
Keywords: