Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep;7(3):98-102.
doi: 10.1016/j.afos.2021.09.003. Epub 2021 Sep 20.

Intervention thresholds to identify postmenopausal women with high fracture risk: A single center study based on the Philippines FRAX model

Julie Li-Yu  1 , Sarath Lekamwasam  2
Affiliations

Intervention thresholds to identify postmenopausal women with high fracture risk: A single center study based on the Philippines FRAX model

Julie Li-Yu et al. Osteoporos Sarcopenia. 2021 Sep.

Abstract

Objectives: This study is designed to estimate appropriate intervention thresholds for the Philippines Fracture Risk Assessment Tool (FRAX) model to identify postmenopausal women with high fracture risk.

Methods: Age dependent intervention thresholds were calculated for a woman of body mass index 25 kg/m2 aged 50-80 years with a previous fragility fracture without other clinical risk factors. Fixed thresholds were developed using a database of 1546 postmenopausal women who underwent dual-energy X-ray absorptiometry for clinical reasons. Major and hip fracture risks were estimated using clinical risk factors with and without bone mineral density (BMD) input. Women were categorized to high risk and low risk groups according to the age dependent thresholds. The best cut-points were determined considering the optimum sensitivity and specificity using receiver operating characteristic analysis.

Results: The age dependent intervention thresholds of major fracture risk ranged from 2.8 to 6.9% while hip fracture risk ranged from 0.4 to 3.0% between 50 and 80 years of age. Major fracture threshold of 3.75% and hip fracture threshold of 1.25% were the best fixed thresholds observed and non-inclusion BMD in the fracture risk estimations did not change the values. As a hybrid method, 3% major fracture and 1% hip fracture risks for those < 70 years old and age-dependent thresholds for those aged 70 years and above can be recommended.

Conclusions: The intervention thresholds estimated in the current study can be applied to identify Filipino postmenopausal women with a high fracture risk. Clinicians should decide on the type of thresholds most appropriate.

Keywords: FRAX; Fracture; Intervention thresholds; Osteoporosis; Philippines.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Age-dependent intervention thresholds of major fracture risk.
Fig. 2
Fig. 2
Age-dependent intervention thresholds of hip fracture risk.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Johansson H., Azizieh F., Al Ali N., Alessa T., Harvey N.C., McCloskey E. FRAX- vs. T-score-based intervention thresholds for osteoporosis. Osteoporos Int. 2017;28:3099–3105. - PMC - PubMed
    1. Johansson H., Kanis J.A., Oden A., Johnell O., McCloskey E. BMD, clinical risk factors and their combination for hip fracture prevention. Osteoporos Int. 2009;20:1675–1682. - PubMed
    1. Johansson H., Kanis J.A., McCloskey E.V., Odén A., Devogelaer J.P., Kaufman J.M. A FRAX® model for the assessment of fracture probability in Belgium. Osteoporos Int. 2011;22:453–461. - PubMed
    1. El-Hajj Fuleihan G., Chakhtoura M., Cauley J.A., Chamoun N. Worldwide fracture prediction. J Clin Densitom. 2017;20:397–424. - PubMed
    1. Kanis J.A., Harvey N.C., Cooper C., Johansson H., Odén A., McCloskey E.V. A systematic review of intervention thresholds based on FRAX. Arch Osteoporos. 2016;11:25. - PMC - PubMed