Osteoporosis is a progressive bone illness defined by low bone density and increased risk of fractures, frequently impacting older people, especially postmenopausal ladies. The researchers looked for to compare the capability of FRAX and OST to forecast fracture threat in postmenopausal women aged 50 to 64 years in each of 4 racial/ethnic categories: Asian, Black, Latino, and white. Neither OST nor FRAX identified females who had a fracture throughout the subsequent 10 years. OST is an excellent tool for identifying ladies with osteoporosis-level bone mineral density, which puts them at danger for fractures, while FRAX is not.
Approach
Between May and August 2022, the scientists took a look at 10 years of follow-up information from nearly 67,200 more youthful postmenopausal individuals in the Womens Health Initiative for major osteoporotic fractures of the hip, lower arm, spine, and shoulder. Of those women, almost 5,600 experienced a fracture. The researchers examined a subset of 4,600 participants for bone mineral density.
Impact
The U.S. version of FRAX, which needs race/ethnicity info, need to not be regularly utilized to make screening decisions in younger postmenopausal ladies, the scientists compose. Neither OST nor FRAX determined ladies who had a fracture throughout the subsequent 10 years. But OST is an excellent tool for determining ladies with osteoporosis-level bone mineral density, which puts them at risk for fractures, while FRAX is not.
Commentary
” Identifying ladies with osteoporosis by bone density is the goal of screening because those females are potential prospects for osteoporosis drug treatment,” said Dr. Carolyn Crandall, teacher of medicine in the division of basic internal medicine and health services research study at the David Geffen School of Medicine at UCLA and the research studys lead author. “For that function, OST performs much better than FRAX, is easier to utilize, and doesnt require the inclusion of race or ethnic background details.”
Referral: “Race and Ethnicity and Fracture Prediction Among Younger Postmenopausal Women in the Womens Health Initiative Study” by Carolyn J. Crandall, MD, MS, MACP, Joseph C. Larson, MS, John T. Schousboe, MD, Ph.D., JoAnn E. Manson, MD, DrPH, Nelson B. Watts, MD, John A. Robbins, MD, Peter Schnatz, DO, Rami Nassir, Ph.D., Aladdin H. Shadyab, Ph.D., Karen C. Johnson, MD, MPH, Jane A. Cauley, DrPH and Kristine E. Ensrud, MD, MPH, 22 May 2023, JAMA Internal Medicine.DOI: 10.1001/ jamainternmed.2023.1253.
The Womens Health Initiative program is funded by the National Institutes of Healths National Heart, Lung, and Blood Institute.
A 3D rendering of a cross-section of the spinal column showing bone loss due to osteoporosis. Osteoporosis is a progressive bone illness identified by low bone density and increased risk of fractures, commonly impacting older people, especially postmenopausal ladies. It is often asymptomatic up until a fracture occurs, making early diagnosis and preventive steps essential in handling this condition.
The Fracture Risk Assessment Tool (FRAX), regularly made use of in examining fracture danger, integrates self-identified race and ethnic background details. Nevertheless, its efficiency in properly determining the risk of major osteoporotic fractures among more youthful postmenopausal females throughout different racial and ethnic groups was found to be suboptimal.
On the other hand, the Osteoporosis Self-Assessment Tool (OST), which does rule out race and ethnicity, showed excellent effectiveness in determining people with osteoporosis within each racial and ethnic classification.
Background
The researchers sought to compare the capability of FRAX and OST to anticipate fracture risk in postmenopausal females aged 50 to 64 years in each of four racial/ethnic categories: Asian, Black, Latino, and white. Both tools are amongst those advised by the U.S. Preventive Services Task Force to identify ladies within the more youthful age group who should go through bone mineral density screening. The FRAX calculator requires the user to select one of those four racial/ethnic categories, but their inclusion in scientific risk forecast tools is questionable and the subject of much dispute.