The added worth of trabecular bone rating to FRAX® to foretell main osteoporotic fractures for scientific use in Chinese language older individuals: the Mr. OS and Ms. OS cohort examine in Hong Kong.
Osteoporos Int. 2017 Jan;28(1):111-117
Authors: Su Y, Leung J, Hans D, Lamy O, Kwok T
The affiliation of trabecular bone rating (TBS) with fracture threat and its added predictive worth to FRAX® for scientific use have by no means been independently evaluated in a Chinese language inhabitants. TBS could enhance the predictive energy of FRAX® for scientific use in older Chinese language males.
INTRODUCTION: Trabecular bone rating (TBS) of lumbar backbone on Twin X-ray densitometry supplies data on bone structure. We due to this fact examined the additive worth of TBS to FRAX® in predicting main osteoporotic fractures (MOFs) in older Chinese language individuals.
METHODS: 4 thousand community-dwelling Chinese language women and men aged ?65 years have been adopted up for fracture incidence for a mean interval of 9.94 and eight.82 years, respectively. At baseline, areal BMD of hip and lumbar backbone have been measured by DXA, TBS was estimated for the lumbar backbone, and FRAX® for 10-year threat of MOFs (hip, scientific backbone, shoulder, and wrist) was estimated. Cox regression mannequin was used to judge the associations between TBS and FRAX® with the MOFs threat. The world below receiver-operating attribute curve (AUC), built-in discrimination enchancment (IDI), and category-based internet reclassification enchancment (NRI) have been utilized to judge the improved prediction capacity.
RESULTS: In the course of the follow-up, 126 males and 215 girls had a minimum of one incident MOF. Every SD lower in TBS was considerably related to incident MOFs, with HR (95%CI) of 1.53 (1.30-1.80) and 1.40 (1.22-1.61) in women and men, respectively. TBS-adjusted FRAX® predicts higher than FRAX® with a considerably elevated AUC and IDI in males. Utilizing particular intervention thresholds, TBS-adjusted FRAX® brings about 5 % total appropriate reclassification for MOFs prediction than FRAX® in males. The elevated appropriate MOFs threat classifications weren’t vital in older girls.
CONCLUSIONS: TBS-adjusted FRAX® could enhance the predictive energy of FRAX® on MOFs for scientific use in older Chinese language males.
PMID: 27565645 [PubMed – indexed for MEDLINE]