The Potential Impact of the National Osteoporosis Foundation Guidance on Treatment Eligibility in the USA: an Update in NHANES 2005-2008

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2011 Jul 1

PMID 21717247

Citations 45

Authors

B Dawson-Hughes

A C Looker

A N A Tosteson

H Johansson

J A Kanis

L J Melton 3rd

Affiliations

Soon will be listed here.

Abstract

Unlabelled: This analysis of National Health and Nutrition Examination Survey (NHANES) 2005-2008 data describes the prevalence of risk factors for osteoporosis and the proportions of men and postmenopausal women age 50 years and older who are candidates for treatment to lower fracture risk, according to the new Fracture Risk Assessment Tool (FRAX)-based National Osteoporosis Foundation Clinician's Guide.

Introduction: It is important to update estimates of the proportions of the older US population considered eligible for pharmacologic treatment for osteoporosis for purposes of understanding the health care burden of this disease.

Methods: This is a cross-sectional study of the NHANES 2005-2008 data in 3,608 men and women aged 50 years and older. Variables in the analysis included race/ethnicity, age, lumbar spine and femoral neck bone mineral density, risk factor profiles, and FRAX 10-year fracture probabilities.

Results: The prevalence of osteoporosis of the femoral neck ranged from 6.0% in non-Hispanic black to 12.6% in Mexican American women. Spinal osteoporosis was more prevalent among Mexican American women (24.4%) than among either non-Hispanic blacks (5.3%) or non-Hispanic whites (10.9%). Treatment eligibility was similar in Mexican American and non-Hispanic white women (32.0% and 32.8%) and higher than it was in non-Hispanic black women (11.0%). Treatment eligibility among men was 21.1% in non-Hispanic whites, 12.6% in Mexican Americans, and 3.0% in non-Hispanic blacks.

Conclusions: Nineteen percent of older men and 30% of older women in the USA are at sufficient risk for fracture to warrant consideration for pharmacotherapy.

Citing Articles

Physical activity attenuates the excess mortality risk from prolonged sitting time among adults with osteoporosis or osteopenia.

Liang Z, Lan J, Sun X, Guo R, Tian Y, Wang Y Endocrine. 2024; 85(3):1365-1378.

PMID: 38760616 DOI: 10.1007/s12020-024-03871-8.

Impact of metabolic syndrome on bone mineral density in men over 50 and postmenopausal women according to U.S. survey results.

Tan M, Zhu S, Wang G, Liu Z Sci Rep. 2024; 14(1):7005.

PMID: 38523143 PMC: 10961310. DOI: 10.1038/s41598-024-57352-z.

Schmorl's nodes are associated with prevalent osteoporotic vertebral fracture and low bone mineral density: a population-based thoracic spine MRI study in older men and women.

Wang Y, Wang X, Leung J, Yu B, Griffith J, Kwok T Quant Imaging Med Surg. 2023; 13(3):1914-1926.

PMID: 36915321 PMC: 10006149. DOI: 10.21037/qims-22-1410.

Effects of osteogenic growth peptide C-terminal pentapeptide and its analogue on bone remodeling in an osteoporosis rat model.

Ma Y, Zhang Y, Lin Y, Ding X, Zhang Y Open Med (Wars). 2023; 18(1):20230656.

PMID: 36874360 PMC: 9982741. DOI: 10.1515/med-2023-0656.

The role of the Smad2/3/4 signaling pathway in osteogenic differentiation regulation by ClC-3 chloride channels in MC3T3-E1 cells.

Lu X, Li W, Wang H, Cao M, Jin Z J Orthop Surg Res. 2022; 17(1):338.

PMID: 35794618 PMC: 9258226. DOI: 10.1186/s13018-022-03230-1.

References

Zingmond D, Melton 3rd L, Silverman S . Increasing hip fracture incidence in California Hispanics, 1983 to 2000. Osteoporos Int. 2004; 15(8):603-10. DOI: 10.1007/s00198-004-1592-7. View

Looker A, Melton 3rd L, Borrud L, Shepherd J . Changes in femur neck bone density in US adults between 1988-1994 and 2005-2008: demographic patterns and possible determinants. Osteoporos Int. 2011; 23(2):771-80. DOI: 10.1007/s00198-011-1623-0. View

Kanis J, Johansson H, Oden A, Dawson-Hughes B, Melton 3rd L, McCloskey E . The effects of a FRAX revision for the USA. Osteoporos Int. 2009; 21(1):35-40. DOI: 10.1007/s00198-009-1033-8. View

Dawson-Hughes B, Looker A, Tosteson A, Johansson H, Kanis J, Melton 3rd L . The potential impact of new National Osteoporosis Foundation guidance on treatment patterns. Osteoporos Int. 2009; 21(1):41-52. DOI: 10.1007/s00198-009-1034-7. View

McKinlay S . Issues in design, measurement, and analysis for menopause research. Exp Gerontol. 1994; 29(3-4):479-93. DOI: 10.1016/0531-5565(94)90029-9. View

Jaglal S, Weller I, Mamdani M, Hawker G, Kreder H, Jaakkimainen L . Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong?. J Bone Miner Res. 2005; 20(6):898-905. DOI: 10.1359/JBMR.041231. View

Burge R, Dawson-Hughes B, Solomon D, Wong J, King A, Tosteson A . Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2006; 22(3):465-75. DOI: 10.1359/jbmr.061113. View

Kanis J, Melton 3rd L, Christiansen C, JOHNSTON C, Khaltaev N . The diagnosis of osteoporosis. J Bone Miner Res. 1994; 9(8):1137-41. DOI: 10.1002/jbmr.5650090802. View

Araujo A, Travison T, Harris S, Holick M, Turner A, McKinlay J . Race/ethnic differences in bone mineral density in men. Osteoporos Int. 2007; 18(7):943-53. DOI: 10.1007/s00198-006-0321-9. View

10.

Looker A, Wahner H, Dunn W, Calvo M, Harris T, Heyse S . Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int. 1998; 8(5):468-89. DOI: 10.1007/s001980050093. View

11.

Baim S, Binkley N, Bilezikian J, Kendler D, Hans D, Lewiecki E . Official Positions of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD Position Development Conference. J Clin Densitom. 2008; 11(1):75-91. DOI: 10.1016/j.jocd.2007.12.007. View

12.

Donaldson M, Cawthon P, Lui L, Schousboe J, Ensrud K, Taylor B . Estimates of the proportion of older white men who would be recommended for pharmacologic treatment by the new US National Osteoporosis Foundation guidelines. J Bone Miner Res. 2010; 25(7):1506-11. PMC: 3153995. DOI: 10.1002/jbmr.55. View

13.

Siris E, Pasquale M, Wang Y, Watts N . Estimating bisphosphonate use and fracture reduction among US women aged 45 years and older, 2001-2008. J Bone Miner Res. 2010; 26(1):3-11. DOI: 10.1002/jbmr.189. View

14.

Siris E, Miller P, Barrett-Connor E, Faulkner K, Wehren L, Abbott T . Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA. 2001; 286(22):2815-22. DOI: 10.1001/jama.286.22.2815. View

15.

Dawson-Hughes B, Tosteson A, Melton 3rd L, Baim S, Favus M, Khosla S . Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos Int. 2008; 19(4):449-58. DOI: 10.1007/s00198-008-0559-5. View

16.

Donaldson M, Cawthon P, Lui L, Schousboe J, Ensrud K, Taylor B . Estimates of the proportion of older white women who would be recommended for pharmacologic treatment by the new U.S. National Osteoporosis Foundation Guidelines. J Bone Miner Res. 2008; 24(4):675-80. PMC: 2659514. DOI: 10.1359/jbmr.081203. View

17.

Berry S, Kiel D, Donaldson M, Cummings S, Kanis J, Johansson H . Application of the National Osteoporosis Foundation Guidelines to postmenopausal women and men: the Framingham Osteoporosis Study. Osteoporos Int. 2009; 21(1):53-60. PMC: 2889692. DOI: 10.1007/s00198-009-1127-3. View