Objectives To rate 10-year probability of osteoporotic fractures based on bone mineral density (BMD) at the femoral neck.
Methods The study included 70 patients (35 men and 35 women), aged 40-90 years, who applied to the largest clinics in Kazan for various reasons during the period from January to September 2014. In each of the 7 clinics (number locales) were randomly selected 10 patients (5 men and 5 women). All patients were invited for a visit to a rheumatologist for risk assessment and calculation of the 10-year probability of osteoporotic fractures (general and hip) through the FRAX validated for these purposes. Calculated on the basis taken epidemiological prevalence of risk factors in the Russian population. All the patients underwent dual-energy X-ray absorptiometry at Hologic densitometer with the definition of BMD at the femoral neck. Next was calculated the 10-year probability of fracture-adjusted BMD at the femoral neck. Threshold intervention (beginning antiosteoporotic therapy) was considered the 10-year probability of fracture over 20% for all sites of fractures and/or more than 3% for hip fractures.
Results The average age of the patients was 61,8±21,3 years (women - 59,2±23,5 years, men - 63,5±18,1 years). The probability of fracture in all locations in the next 10 years, more than 20% was observed in 15 (21.4%) patients: 11 (31.4%) women and 4 (11.4%) men. The probability of hip fracture within 10 years more than 3% was detected in 13 (18.5%) patients (10 (28.6%) women and 3 (8.6%) men). After adding in the program FRAX values at the femoral neck BMD increased number of patients with a 10-year probability of fracture in all locations more than 20% (19 (27.1%) patients: 13 (37.1%) women and 6 (17.1%) men) and the femoral neck over 3% (20 (28.6%) patients: 13 (34.3%) and 7 women (20%) men).
Conclusions The program allows to estimate the FRAX 10-year probability of osteoporotic fractures and to determine the threshold of intervention in individuals at risk. The advantage of this program is the ability to determine the likelihood of fractures in the absence of information about the BMD at the femoral neck. However, knowing the value of BMD significantly increases the sensitivity of the method.
Disclosure of Interest None declared