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Assessment of non-vertebral fracture risk in post- menopausal women
  1. Christian Roux (christian.roux{at}cch.ap-hop-paris.fr)
  1. Cochin Hospital, Paris, France
    1. Karine Briot
    1. Cochin Hospital, Paris, France
      1. Stéphane Horlait
      1. Procter and Gamble, Neuilly/Seine, France
        1. Alex Varbanov
        1. Procter and Gamble, Cincinnatti, United States
          1. Nelson B Watts
          1. College of Medicine, University of Cincinnati, United States
            1. Steven Boonen
            1. Division of Geriatric Medicine, Center for Metabolic Bone Diseases, Leuven, Belgium

              Abstract

              Introduction: Nonvertebral (NV) fractures are responsible for the greatest amount of morbidity, mortality and cost attributable to osteoporosis.

              Objectives: The study aimed at identify risk factors for NV fractures in postmenopausal osteoporotic women, and design an assessment tool for prediction of these fractures in order to prescribe treatments.

              Methods: 2546 osteoporotic postmenopausal women included in the placebo groups of 3 risedronate controlled trials were included (mean age 72, mean femoral T score -2.5, 60 % and 53 % of patients with prevalent vertebral and NV fractures respectively). During 3 years, 222 NV fractures were observed. Baseline data on 14 risk factors were included in a logistic regression analysis.

              Results: 6 risk factors were associated with NV fracture risk: prevalent NV fracture (p=0.004), number of prevalent vertebral fractures (p<0.001), femoral T- score (p=0.031), serum level of 25-hydroxyvitamin D (p<0.001), age (p=0.012) and height (p=0.037). A NV risk index was developed by converting the equation in a score. In the group of women with a score ³ 2.1, the incidence of NV fracture was 13.2% (11.1-15.3), 1.5 times higher than in the population.

              Conclusions: This index is a convenient tool for selection of osteoporotic patients with a high risk for NV fractures, and may help to choose among treatments those with a proven NV fracture risk efficacy.

              • bone densitometry
              • non vertebral fracture
              • osteoporosis
              • postmenopausal
              • risk factors

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