The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women.
Journal article, 2007
SUMMARY: BMD and clinical risk factors predict hip and other osteoporotic fractures. The combination of clinical risk factors and BMD provide higher specificity and sensitivity than either alone. INTRODUCTION AND HYPOTHESES: To develop a risk assessment tool based on clinical risk factors (CRFs) with and without BMD. METHODS: Nine population-based studies were studied in which BMD and CRFs were documented at baseline. Poisson regression models were developed for hip fracture and other osteoporotic fractures, with and without hip BMD. Fracture risk was expressed as gradient of risk (GR, risk ratio/SD change in risk score). RESULTS: CRFs alone predicted hip fracture with a GR of 2.1/SD at the age of 50 years and decreased with age. The use of BMD alone provided a higher GR (3.7/SD), and was improved further with the combined use of CRFs and BMD (4.2/SD). For other osteoporotic fractures, the GRs were lower than for hip fracture. The GR with CRFs alone was 1.4/SD at the age of 50 years, similar to that provided by BMD (GR = 1.4/SD) and was not markedly increased by the combination (GR = 1.4/SD). The performance characteristics of clinical risk factors with and without BMD were validated in eleven independent population-based cohorts. CONCLUSIONS: The models developed provide the basis for the integrated use of validated clinical risk factors in men and women to aid in fracture risk prediction.
physiology
Area Under Curve
Middle Aged
etiology
complications
Risk Factors
Risk Assessment
Age Factors
Spontaneous
80 and over
Aged
Bone Density
Hip Fractures
Aged
physiopathology
Osteoporosis
Postmenopausal
Male
etiology
Female
physiopathology
etiology
Fractures
physiopathology
physiopathology
Osteoporosis
methods
Humans
Author
J A Kanis
Anders Odén
University of Gothenburg
Chalmers, Mathematical Sciences, Mathematical Statistics
O Johnell
Helena Johansson
University of Gothenburg
C De Laet
J Brown
P Burckhardt
C Cooper
C Christiansen
S Cummings
J A Eisman
S Fujiwara
C Glüer
D Goltzman
D Hans
M-A Krieg
A La Croix
E McCloskey
Dan Mellström
University of Gothenburg
L J Melton
H Pols
J Reeve
K Sanders
A-M Schott
A Silman
D Torgerson
T van Staa
N B Watts
N Yoshimura
Osteoporosis International
0937-941X (ISSN) 1433-2965 (eISSN)
Vol. 18 8 1033-46Subject Categories
Endocrinology and Diabetes
Physiology
DOI
10.1007/s00198-007-0343-y
PubMed
17323110