Usefulness of Fracture Risk Assessment Tool Using Lumbar Bone Mineral Density in Prediction of Osteoporotic Vertebral Fracture

Overview

Journal J Korean Neurosurg Soc

Date 2015 Nov 21

PMID 26587188

Citations 2

Authors

Heui Seung Lee

Sang Hyung Lee

Young Seob Chung

Hee-Jin Yang

Young-Je Son

Sung Bae Park

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the value of lumbar bone mineral density (BMD) in fracture risk assessment (FRAX) tool.

Methods: One hundred and ten patients aged over 60 years were enrolled and divided into 2 groups as non-osteoporotic vertebral fracture (OVF) and OVF groups. The 10-year-risk of major osteoporotic vertebral fracture of each group was calculated by FRAX tool with femoral and lumbar spine BMDs to compare the usefulness of lumbar spine BMD in prediction of OVF. The blood level of osteocalcin and C-terminal telopeptide (CTX) as markers of activities of osteoblast and osteoclast, respectively were analyzed using the institutional database.

Results: In the OVF group, the ratio of patients with previous fracture history or use of glucocorticoid was higher than those in non-OVF group (p=0.000 and 0.030, respectively). The levels of T-score of femur neck and lumbar spine in OVF group were significantly lower than those in non-OVF group (p=0.001 and 0.000, respectively). The risk of OVF in FRAX using femur BMD in non-OVF and OVF groups was 6.7±6.13 and 11.4±10.06, respectively (p=0.007). The risk of using lumbar BMD in the 2 groups was 6.9±8.91 and 15.1±15.08, respectively (p=0.002). The areas under the receiver operator characteristic curve in the FRAX risk with lumbar and femur neck BMD were 0.726 and 0.684, respectively. The comparison of osteocalcin and CTX was not significant (p=0.162 and 0.369, respectively).

Conclusion: In our study, the 10-year risk of major osteoporotic fracture in the OVF group of our study was lower than the recommended threshold of intervention for osteoporosis. Hence, a lower threshold for the treatment of osteoporosis may be set for the Korean population to prevent OVF. In the prediction of symptomatic OVF, FRAX tool using lumbar spine BMD may be more useful than that using femur neck BMD.

Citing Articles

Discriminatory Accuracy of Fracture Risk Assessment Tool in Asian Populations: A Systematic Review and Meta-Analysis.

Jha D, Chandran M, Hong N, Rhee Y, Baek S, Ferguson S J Bone Metab. 2024; 31(4):296-315.

PMID: 39701109 PMC: 11658842. DOI: 10.11005/jbm.24.781.

Correlations of Serum Hormones and Bone Mineral Density with Fracture and Balance Ability of Postmenopausal Patients and Effects of Calcitriol.

Xu L, Liu B, Li P, Li J, Wang J, Han J Med Sci Monit. 2018; 24:7309-7315.

PMID: 30315646 PMC: 6196597. DOI: 10.12659/MSM.910792.

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