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FRAX calculated without BMD does not correctly identify Caucasian men with densitometric evidence of osteoporosis

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Abstract

Summary

The FRAX algorithm assesses the patient’s probability of sustaining an osteoporotic fracture and can be calculated with or without densitometric data. This study seeks to determine whether in men, FRAX scores calculated without BMD, correctly identify patients with BMD-defined osteoporosis.

Introduction

The diagnosis of osteoporosis is based on densitometric data, the presence of a fragility fracture or increased fracture risk. The FRAX algorithm estimates the patient’s 10-year probability of sustaining an osteoporotic fracture and can be calculated with or without BMD data. The purpose of this study is to determine whether in men, FRAX calculated without BMD, can correctly identify patients with BMD-defined osteoporosis.

Methods

Retrospectively retrieved data from 726 consecutive Caucasian males, 50 to 70 years old referred to our Osteoporosis Center.

Results

In the population studied, 11.8 and 25.3% had BMD-defined osteoporosis when female and male reference populations were used respectively. When the National Osteoporosis Foundation thresholds to initiate treatment are used, only 27% of patients with BMD-defined osteoporosis, but 4% with normal BMD reached/exceeded these thresholds. Lowering the threshold increased sensitivity, but decreased specificity.

Conclusions

Our results suggest that FRAX without BMD is not sensitive/specific enough to be used to identify Caucasian men 50 to 70 years old with BMD-defined osteoporosis.

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Authors and Affiliations

  1. Osteoporosis Center, East Tennessee State University, Johnson City, TN, 37614, USA

    R. C. Hamdy, K. Whalen, K. Hicks & T. B. Piggee

  2. Department of Mathematics and Statistics, East Tennessee State University, Johnson City, TN, 37614, USA

    E. Seier

  3. College of Clinical and Rehabilitative Health Sciences, Department of Allied Health Sciences, East Tennessee State University, Johnson City, TN, 37614, USA

    W. A. Clark

Authors
  1. R. C. Hamdy
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  2. E. Seier
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  3. K. Whalen
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  4. W. A. Clark
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  5. K. Hicks
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  6. T. B. Piggee
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Correspondence to R. C. Hamdy.

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Hamdy, R.C., Seier, E., Whalen, K. et al. FRAX calculated without BMD does not correctly identify Caucasian men with densitometric evidence of osteoporosis. Osteoporos Int 29, 947–952 (2018). https://doi.org/10.1007/s00198-017-4368-6

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  • DOI: https://doi.org/10.1007/s00198-017-4368-6

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