Endocrine Abstracts

Introduction: The FRAX fracture risk assessment algorithm is able to integrate clinical risk factors independent of bone mineral density (BMD), evaluating the 10-years probability of fracture, therefore identifying patients in need for antiosteoporotic treatment, in which case bypassing the WHO (World Health Organization) criteria for densitometric diagnosis of osteoporosis.

Material and Methods: We retrospectively analysed a total of 91 scans of women aged between 65–75 years old, from authors’ DXA (dual X-ray absorptiometry) database, with no other medical records. We divided the patients in 3 groups according to Romanian FRAX intervention threshold and fracture risk prediction: low-risk, intermediate risk and high risk of fracture. Using DXA scan with Lunar IDXA, we extracted bone composition parameters like spine and hip BMD expressed as T-score. We analysed the obtained data using IBM SPSS Statistics 20.

Results: A total of 91 scans of postmenopausal women (mean age 69.9 ± 3.01) with no previous diagnosis of osteoporosis, nor previous antiosteoporotic treatment, were included in our study, from which 18 of them (19.8%) had spine or hip T-score consistent with osteoporosis diagnosis (T score ≤ −2.5 DS), 47 (51.64%) with osteopenia and 29 (31.86%) had normal osteodensitometric parameters. Based on the interpretation of the Romanian FRAX without BMD results, 15 patients, (16.48%) were considered to be in the high-risk group, therefore, eligible for treatment, 44 (48.35%), l in the intermediate risk group, needing hip BMD addition and 32 (35.16%) in the low-risk group, for witch non further inquiry wold be necessary. Regarding the fracture risk probability estimated by Romanian FRAX without BMD, In the low-risk group, 2 out of 32 women had densitometric osteoporosis, 19 had osteopenia and 11 had normal BMD; on the other hand, in the the FRAX high-risk group, 5 women had osteoporosis, 7 had osteopenia and 3 out of 15 had normal BMD.

Conclusions: Although FRAX nowadays is widely used, accessible and proved to be efficient screening tool, measuring the BMD still plays an important role for fracture risk prediction, in which case it’s value can be increased by combining it with more clinical factors. Considering the limited number of patients, the need of a more precise personal medical history, we cannot cast doubt on the utility of FRAX for screening patients at high or low-risk of osteoporosis, but because here is no 100% overlap between FRAX and densitometric results, BMD remains the core concept in the osteoporosis diagnosis and treatment.