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Osteoporosis International

, Volume 29, Issue 3, pp 707–715 | Cite as

FRAX-based intervention and assessment thresholds in seven Latin American countries

  • P. Clark
  • E. Denova-GutiérrezEmail author
  • C. Zerbini
  • A. Sanchez
  • O. Messina
  • J. J. Jaller
  • C. Campusano
  • C. H. Orces
  • G. Riera
  • H. Johansson
  • J. A. Kanis
Original Article

Abstract

Summary

Age-specific intervention and assessment thresholds were developed for seven Latin American countries. The intervention threshold ranged from 1.2% (Ecuador) to 27.5% (Argentina) at the age of 50 and 90 years, respectively. In the Latin American countries, FRAX offers a substantial advance for the detection of subjects at high fracture risk.

Introduction

Intervention thresholds are proposed using the Fracture Risk Assessment (FRAX) tool. We recommended their use to calculate the ten-year probability of fragility fracture (FF) in both, men and women with or without the inclusion of bone mineral density (BMD). The purpose of this study is to compute FRAX-based intervention and BMD assessment thresholds for seven Latin American countries in men and women ≥ 40 years.

Methods

The intervention threshold (IT) was set at a 10-year probability of a major osteoporotic fracture (MOF) equivalent to a woman with a prior FF and a body mass index (BMI) equal to 25.0 kg/m2 without BMD or other clinical risk factors. The lower assessment threshold was set at a 10-year probability of a MOF in women with BMI equal to 25.0 kg/m2, no previous fracture and no clinical risk factors. The upper assessment threshold was set at 1.2 times the IT.

Results

For the seven LA countries, the age-specific IT varied from 1.5 to 27.5% in Argentina, 3.8 to 25.2% in Brazil, 1.6 up to 20.0% in Chile, 0.6 to 10.2% in Colombia, 0.9 up to 13.6% in Ecuador, 2.6 to 20.0% in Mexico, and 0.7 up to 22.0% in Venezuela at the age of 40 and 90 years, respectively.

Conclusions

In the LA countries, FRAX-based IT offers a substantial advance for the detection of men and women at high fracture risk, particularly in the elderly. The heterogeneity of IT between the LA countries indicates that country-specific FRAX models are appropriate rather than a global LA model.

Keywords

Assessment thresholds FRAX Intervention threshold Latin American countries Osteoporosis Ten-year fracture probability 

Notes

Compliance with ethical standards

Conflicts of interest

None.

Supplementary material

198_2017_4341_MOESM1_ESM.docx (17 kb)
Supplementary figure 1 (DOCX 16 kb)

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2017

Authors and Affiliations

  • P. Clark
    • 1
    • 2
  • E. Denova-Gutiérrez
    • 1
    • 2
    Email author
  • C. Zerbini
    • 3
  • A. Sanchez
    • 4
  • O. Messina
    • 5
    • 6
  • J. J. Jaller
    • 7
  • C. Campusano
    • 8
  • C. H. Orces
    • 9
  • G. Riera
    • 10
  • H. Johansson
    • 11
  • J. A. Kanis
    • 11
    • 12
  1. 1.Clinical Epidemiology Research UnitHospital Infantil de México Federico GomezMexico CityMexico
  2. 2.School of MedicineUniversidad Nacional Autónoma de México (UNAM)Mexico CityMexico
  3. 3.Centro Paulista de Investigação ClinicaSão PauloBrazil
  4. 4.Centro de EndocrinologíaRosarioArgentina
  5. 5.Servicio de ReumatologíaHospital ArgerichBuenos AiresArgentina
  6. 6.Unidad de Postgrado en ReumatologíaUniversidad de Buenos AiresBuenos AiresArgentina
  7. 7.Centro de Reumatología y OrtopediaBarranquillaColombia
  8. 8.Clínica de la Universidad de los AndesSantiagoChile
  9. 9.Department of MedicineLaredo Medical CenterLaredoUSA
  10. 10.Unidad Metabolica, Universidad de CaraboboValenciaVenezuela
  11. 11.Institute for Health and AgeingCatholic University of AustraliaMelbourneAustralia
  12. 12.Medical School, Sheffield, UK Centre for Metabolic Bone DiseasesUniversity of SheffieldSheffieldEngland

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