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Ability of FRAX Sri Lanka adjusted for trabecular bone score to discriminate between postmenopausal women with a recent fracture and without a fracture

Osteoporosis and Sarcopenia 2020년 6권 3호 p.106 ~ 110
Lekamwasam Sarath, Karunanayaka Madushani, Kaluarachchi Vidumini, Chandran Manju, Rathnayake Hasanga, Subasinghe Sewwandi,
소속 상세정보
 ( Lekamwasam Sarath ) - University of Ruhuna Faculty of Medicine Department of Medicine
 ( Karunanayaka Madushani ) - National Hospital of Sri Lanka Diabetes and Endocrinology Unit
 ( Kaluarachchi Vidumini ) - National Hospital of Sri Lanka Diabetes and Endocrinology Unit
 ( Chandran Manju ) - Singapore General Hospital Osteoporosis and Bone Metabolism Unit
 ( Rathnayake Hasanga ) - University of Ruhuna Faculty of Medicine Department of Biochemistry
 ( Subasinghe Sewwandi ) - University of Ruhuna Faculty of Allied Health Sciences Department of Pharmacy

Abstract


Objectives: We evaluated the ability of fracture risk assessment tool (FRAX) Sri Lanka to discriminate between women with a recent fracture and without a fracture, when trabecular bone score (TBS) is added to the calculation.

Methods: We studied 394 women without previous fractures and 87 women who underwent dual energy X-ray absorptiometry within 3 months after the first fragility fracture. Fracture probabilities (FP) were estimated with and without TBS using Sri Lankan FRAX model and their ability to discriminate those with and without fracture was tested.

Results: Women without fractures had higher bone mineral densities (BMDs) and lower FPs, compared to those with a recent fracture. Area under curves of receiver operating characteristic for FPs unadjusted were not different from those adjusted for TBS. The odd ratios of FPs unadjusted were not different from those of adjusted. The FPs estimated with TBS were higher, hence the intervention thresholds (ITs) were higher compared to FPs estimated without TBS. Thirty-two percent of women without previous fracture were above the ITs and the inclusion of TBS increased this to 36%. The integrated discriminatory index analysis showed a 8% increase in the discriminatory slope.

Conclusions: The inclusion of TBS to Sri Lankan FRAX did not show an added advantage in discriminating between postmenopausal women with a recent fracture and without a fracture. TBS inclusion in fracture risk calculation among those without previous fractures, however, showed a marginal increase in the number of women above ITs.

키워드

Bone density; Osteoporosis; Risk assessment; Trabecular bone score; Sri Lanka

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