10-year probability of major osteoporotic fracturesand hip fractures according to Ukrainian model of FRAX®in women with vertebral fractures
Background. Vertebral fractures are one of the severe complications of systemic osteoporosis, which lead to the low-back pain, decrease or loss of efficiency and increase of mortality in older people. FRAX and dual-energy X-ray absorptiometry (DXA) are important methods in determining major osteoporotic fractures risk, including vertebral fractures. Materials and methods. We studied the parameters of Ukrainian model of FRAX in women depending on the presence of vertebral fractures. 652 patients aged 40-89 years examined at the Ukrainian Scientific Medical Center of Osteoporosis were divided into two groups: the first one - 523 women without any previous fractures, the second one - 129 patients with previous vertebral fractures. The assessment of bone mineral density (BMD) was performed using DXA (Prodigy, General Electric). The 10-year probability of major osteoporotic fractures (FRAX-MOF) and hip fractures (FRAX-HF) has been determined using Ukrainian model of FRAX according to two methods - with body mass index (FRAXBMI) and BMD. Results. According the distribution of FRAXBMI-MOF parameters in women depending on the presence of vertebral fractures, it was found that index of FRAXBMI-MOF was less than 20 % (the limit indicated as the criterion for treatment initiation in US guidelines) in 100 and 100 % of subjects, respectively. The indices of FRAX BMD-HF were less than 3 % (the limit for starting treatment in US guidelines) in 95 and 55 % of women, respectively. It was shown the significant moderate correlation between the indices of two methods in all groups for both parameters of the algorithm - FRAX-MOF and FRAX-HF. Conclusions. The study of the age-specific features of FRAX in women depending on the presence of vertebral fractures showed a significant increase in the risks for both major osteoporotic and hip fractures, regardless of the used technique (with BMI or BMD) in women with vertebral fractures or without any fractures. Our results should be taken into account when assessing the risk of osteoporotic fractures in postmenopausal women and planning treatment and prophylactic measures.