Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 24(3), 495-502, 2008
Vertebral fracture status and the World Health Organization risk factors for predicting osteoporotic fracture risk
John H Krege, Jonathan D Adachi, Jerilynn C Prior
Alan Tenenhouse , Emmanuel A Papadimitropoulos, Nancy Kreiger , W P Olszynski, Robert G Josse, David Goltzman, CaMOS Research Group , Pai-Lien Chen, J P Brown
Vertebral fractures are the most common osteoporotic fracture, and patients with prevalent vertebral fractures have a greater risk of future fractures. However, radiographically determined vertebral fractures are not identified as a distinct risk factor in the World Health Organization (WHO) fracture risk assessment tool. The objective of this study was to evaluate and compare potential risk factors including morphometric spine fracture status and the WHO risk factors for predicting 5-yr fracture risk. We hypothesized that spine fracture status provides prognostic information in addition to consideration of the WHO risk factors alone. A randomly selected, population-based community cohort of 2761 noninstitutionalized men and women > or =50 yr of age living within 50 km of one of nine regional centers was enrolled in the Canadian Multicentre Osteoporosis Study (CaMOS), a prospective and longitudinal cohort study following subjects for 5 yr. Prevalent and incident spine fractures were identified from lateral spine radiographs. Incident nonvertebral fragility fractures were determined by an annual, mailed fracture questionnaire with validation, and nonvertebral fragility fracture was defined by investigators as a fracture with minimal trauma. A model considering the WHO risk factors plus spine fracture status provided greater prognostic information regarding future fracture risk than a model considering the WHO risk factors alone. In univariate analyses, age, BMD, and spine fracture status had the highest gradient of risk. A model considering these three risk factors captured almost all of the predictive information provided by a model considering spine fracture status plus the WHO risk factors and provided greater predictive information than a model considering the WHO risk factors alone. The use of spine fracture status along with age and BMD predicted future fracture risk with greater simplicity and higher prognostic accuracy than consideration of the risk factors included in the WHO tool.
vertebral fracture risk factors, WHO fracture risk assessment, osteoporotic fracture prediction, morphometric vertebral fracture, FRAX risk tool, bone mineral density screening, five-year fracture prediction, prevalent vertebral deformity, CaMos osteoporosis study, clinical risk factor fracture
PMID 19016585 19016585 DOI 10.1359/jbmr.081103 10.1359/jbmr.081103
Cite this article
Chen, P., Krege, J. H., Adachi, J. D., Prior, J. C., Tenenhouse, A., Brown, J. P., Papadimitropoulos, E., Kreiger, N., Olszynski, W. P., Josse, R. G., Goltzman, D., & CaMOS Research Group (2009). Vertebral fracture status and the World Health Organization risk factors for predicting osteoporotic fracture risk. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 24(3), 495-502. https://doi.org/10.1359/jbmr.081103
Chen P, Krege JH, Adachi JD, Prior JC, Tenenhouse A, Brown JP, et al. Vertebral fracture status and the World Health Organization risk factors for predicting osteoporotic fracture risk. J Bone Miner Res. 2009;24(3):495-502. doi:10.1359/jbmr.081103
Chen, P., et al. "Vertebral fracture status and the World Health Organization risk factors for predicting osteoporotic fracture risk." Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, vol. 24, no. 3, 2009, pp. 495-502.
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