Osteoporosis International

, Volume 23, Issue 9, pp 2321–2327 | Cite as

FRAX® probabilities and risk of major osteoporotic fracture in France

  • C. M. Couris
  • R. D. ChapurlatEmail author
  • J. A. Kanis
  • H. Johansson
  • N. Burlet
  • P. D. Delmas
  • A. M. Schott
Original Article



The incidence of hip fracture, death and the estimated incidence of major osteoporotic fracture in France were used to determine the lifetime and 10-year probability of fracture and incorporated into a probability model (FRAX®) calibrated to the French population.


Fracture probabilities in the French population have not been determined. Our aim was to determine the incidence of hip fracture in France and the estimated 10-year probabilities of hip and major osteoporotic fractures.


The study population included adults over 50 years living in France in 2004. Incident hip fracture cases were identified from the French PMSI database. Incidence of the other major osteoporotic fractures was imputed from the relationship between hip fracture incidence and other major fracture in Sweden. These data were used to calculate population-based fracture probabilities according to age and BMD using cutoff values for femoral neck T-scores from the NHANES III data in Caucasian women. The probability model (FRAX®) calibrated to the French population was used to compute individual fracture probabilities according to specific clinical risk factors.


We identified 15,434 men and 51,469 women with an incident hip fracture. The remaining lifetime probability of hip fracture at 50 years was approximately 10 and 30% respectively. With a femoral neck T-score of −2 SD, one in two women and one in five men would sustain a major osteoporotic fracture in their lifetime. The 10-year probability of other major osteoporotic fractures increased with declining T-score and increasing age. Low body mass index and other clinical risk factors had an independent effect on fracture probability whether or not BMD was included in the FRAX® model.


This analysis provides detailed estimation on the risk of fracture in the French population and may help to define therapeutic guidelines.


Fracture France Frax Men Osteoporosis Women 


Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • C. M. Couris
    • 1
    • 2
    • 3
    • 4
  • R. D. Chapurlat
    • 5
    Email author
  • J. A. Kanis
    • 6
  • H. Johansson
    • 6
  • N. Burlet
    • 7
  • P. D. Delmas
    • 5
  • A. M. Schott
    • 1
    • 2
    • 5
  1. 1.Pole IMERHospices Civils de LyonLyonFrance
  2. 2.RECIF, Universite LyonLyonFrance
  3. 3.Toronto Rehabilitation InstituteTorontoCanada
  4. 4.Department of Physical TherapyUniversity of TorontoTorontoCanada
  5. 5.INSERM Research UMR 1033Université de Lyon, Hôpital E HerriotLyon, cedex 03France
  6. 6.WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of Sheffield Medical SchoolSheffieldUK
  7. 7.IOF (International Osteoporosis Foundation)NyonSwitzerland

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