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Summary <p>In alignment with previous studies using the densitometric vertebral fracture assessment tool, the prevalence of radiographic moderate-severe vertebral fractures in rural postmenopausal women was 34%. FRAXplus could bring one additional woman to treatment intervention thresholds who may have otherwise been missed had additional risk factors not been captured.</p> Purpose <p>To study the prevalence of radiographic vertebral fractures and the utility of FRAXplus® and FRAX® in predicting prevalent vertebral fractures in rural southern India.</p> Methods <p>This cross-sectional study involved 150 rural postmenopausal women, and they were assessed for radiographic vertebral fractures. FRAX® and FRAXplus® were utilized for computing a 10 year risk of major osteoporotic fractures (MOF) and hip fractures (HF) based on clinical risk factors.</p> Results <p>The mean (SD) age of the patients was 66.1 (6.5) years and BMI (kg/m<sup>2</sup>) was 23.1 (4.4). The prevalence of moderate to severe vertebral fractures was 34%. Forty-four subjects had FRAX-MOF cutoff ≥ 10.5 and 57 had FRAX-HF cutoff ≥ 3.5. FRAXplus® correction was utilized in 34 subjects (23%) for falls (n = 30) and glucocorticoids (<i>N</i> = 4). One additional patient reached the treatment threshold for FRAX-MOF and FRAX-HF when FRAXplus® was utilized. On ROC analysis, a cutoff of 6 had a sensitivity of 80% and 40% specificity for FRAX-MOF, and a cutoff of 1.5 for FRAX-HF had a sensitivity of 76% and 40% specificity.</p> Conclusion <p>One-third of rural postmenopausal women had fragility fractures detected on a lateral spine X-ray. Although FRAX® at established Indian cut-offs does help in identifying most women who require anti-osteoporotic treatment, the utilization of FRAX plus® will help in further detecting women who are at borderline risk and may otherwise miss out on treatment if additional risk factors are not captured.</p>

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Utility of FRAX® and FRAXplus® in predicting prevalent radiographic vertebral fractures in postmenopausal women from a rural hospital in Southern India—FRACHAMB study (FRActure Christian Hospital AMBilikkai)

  • 期刊论文

  • 发表日期：

    2025年11月15日

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  • Jacob Cherian,
  • Kripa Elizabeth Cherian,
  • Cynthia Susan John,
  • Dharmasivam Vinodhini,
  • Baren Minz,
  • Shiela Cherian,
  • P. O. Esmy ,
  • Vinay Kuruvilla,
  • Palanisamy Manoranjan ,
  • Thomas V. Paul

摘要

Summary

In alignment with previous studies using the densitometric vertebral fracture assessment tool, the prevalence of radiographic moderate-severe vertebral fractures in rural postmenopausal women was 34%. FRAXplus could bring one additional woman to treatment intervention thresholds who may have otherwise been missed had additional risk factors not been captured.

Purpose

To study the prevalence of radiographic vertebral fractures and the utility of FRAXplus® and FRAX® in predicting prevalent vertebral fractures in rural southern India.

Methods

This cross-sectional study involved 150 rural postmenopausal women, and they were assessed for radiographic vertebral fractures. FRAX® and FRAXplus® were utilized for computing a 10 year risk of major osteoporotic fractures (MOF) and hip fractures (HF) based on clinical risk factors.

Results

The mean (SD) age of the patients was 66.1 (6.5) years and BMI (kg/m2) was 23.1 (4.4). The prevalence of moderate to severe vertebral fractures was 34%. Forty-four subjects had FRAX-MOF cutoff ≥ 10.5 and 57 had FRAX-HF cutoff ≥ 3.5. FRAXplus® correction was utilized in 34 subjects (23%) for falls (n = 30) and glucocorticoids (N = 4). One additional patient reached the treatment threshold for FRAX-MOF and FRAX-HF when FRAXplus® was utilized. On ROC analysis, a cutoff of 6 had a sensitivity of 80% and 40% specificity for FRAX-MOF, and a cutoff of 1.5 for FRAX-HF had a sensitivity of 76% and 40% specificity.

Conclusion

One-third of rural postmenopausal women had fragility fractures detected on a lateral spine X-ray. Although FRAX® at established Indian cut-offs does help in identifying most women who require anti-osteoporotic treatment, the utilization of FRAX plus® will help in further detecting women who are at borderline risk and may otherwise miss out on treatment if additional risk factors are not captured.