1Rheumatology Ward, Loghman Hospital, Shahid Beheshti Medical University (SBMU), Tehran, Iran
2Nephrology Ward, Taleghani Hospital, Shahid Beheshti Medical University (SBMU), Tehran, Iran
3Biochemistry Department, Pasteur Institute of Iran
Bone mineral densitometry (BMD) has been well known as a practical method in the detection of osteoporosis. However, it is not accurate in the identification of fracture risk in non- osteoporotic patients because of its low sensitivity. Fracture Risk Assessment Tool (FRAX) is a sensitive WHO recommended risk assessment tool for the prediction of the risk of fracture in order to diagnose patients who would benefit the most from pharmacological treatment. This cross-sectional study included a sample of 361 Iranian women aged 40 to 80 years- old who, for any reason, were referred for humeral BMD. Femoral BMD and FRAX were performed on all of the subjects and the results were compared to one another to figure out the accuracy of FRAX to detect the patients at high risk of fracture. There were 361 participants in the study with a mean age of 56.4 ± 5.5 years, and comprised of 89 (24.7%) osteoporotic (T-score -2.5), 125 (34.7%) osteopenic (T-Score between -1 and -2.5) and 147 (40.7%) subjects with T-score > -1. A 10-year probability of hip fracture of more than 3% was detected in only in six women (1.6%) and a major osteoporotic fracture risk (of higher than 20%) was not detected in any subject. Applying FRAX in osteopenic and osteoporotic Iranian women showed no extra benefit in comparison to using BMD alone. It seems that FRAX is not accurate in our population as it underestimates the number of patients that could benefit from osteoporosis treatment.
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