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Application of epidemiology to change health policy : defining age-related thresholds of bone mineral density for primary prevention of fracture
journal contribution
posted on 2008-10-01, 00:00 authored by Margaret Rogers, Julie PascoJulie Pasco, K Sanders, Mark KotowiczMark Kotowicz, G NicholsonIn Australia, benefits for antifracture therapies have been available for patients with osteoporosis and a prior fracture. No benefits were available to those with no prior fracture. We aimed to define, in women with no prior fracture, age-related thresholds of bone mineral density (BMD) associated with fracture risk equivalent to that of women with prior fracture and osteoporosis. A case-control study of women (≥50 yr) was conducted, including 291 fracture cases and 823 controls. BMD was measured at the proximal femur and posterior anterior (PA) spine. A fracture risk score (FRS) for the group with no prior fracture was calculated with discriminant analysis. The thresholds for equivalent fracture risk between those with no prior fracture and those with prior fracture were assessed using logistic regression. Increasing the FRS to +0.98 in women with no prior fracture resulted in equivalent odds of sustaining a fracture to those with prior fracture and osteoporosis. The corresponding T-score thresholds at the spine were −4.6 at 50 yr, −3.9 at 60 yr, −3.1 at 70 yr, and −2.4 at 80 yr. The femoral neck T-score thresholds were lower by 0.5 standard deviation. The high-risk individuals defined by this study should be considered for primary fracture prevention therapy.
History
Journal
Journal of clinical densitometryVolume
11Issue
4Pagination
494 - 497Publisher
Elsevier B.V.Location
Amsterdam, The NetherlandsPublisher DOI
ISSN
1094-6950eISSN
1559-0747Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2008, ElsevierUsage metrics
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