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Article: Clinical risk factor assessment had better discriminative ability than bone mineral density in identifying subjects with vertebral fracture

TitleClinical risk factor assessment had better discriminative ability than bone mineral density in identifying subjects with vertebral fracture
Authors
KeywordsEthnicity
Osteoporosis
Prevalence
Southern Chinese
Vertebral fracture
Issue Date2011
PublisherSpringer U K. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/198
Citation
Osteoporosis International, 2011, v. 22 n. 2, p. 667-674 How to Cite?
AbstractSummary: This study evaluated the characteristics of patients with vertebral fractures and examined the discriminative ability of clinical risk factors. The findings provide further insights into possible development of a simple, cost-effective scheme for fracture risk assessment using clinical risk factors to identify high-risk patients for further evaluation. Introduction: Vertebral fractures are the most common complication of osteoporosis. The aim of this study was to evaluate the characteristics of patients with vertebral fractures and to determine the discriminative ability of bone mineral density (BMD) and other clinical risk factors. Methods: Postmenopausal Southern Chinese women (2,178) enrolled in the Hong Kong Osteoporosis Study since 1995 were prospectively followed up for fracture outcome. Subjects (1,372) with lateral spine radiographs were included in this study. Baseline demographic, BMD, and clinical risk factor information were obtained from a structured questionnaire. Results: Subjects (299; 22%) had prevalent vertebral fractures. The prevalence of vertebral fractures increased with increasing age, number of clinical risk factors, and decreasing BMD. The odds of having a prevalent vertebral fracture per SD reduction in BMD after adjustment for age in Hong Kong Southern Chinese postmenopausal women was 1.5 for the lumbar spine and femoral neck. Analysis of the receiver operating characteristic curve revealed that bone mineral apparent density did not enhance fracture risk prediction. Subjects with ≥4 clinical risk factors had 2.3-fold higher odds of having a prevalent vertebral fracture while subjects with ≥4 clinical risk factors plus a low BMD (i.e., femoral neck T-score <-2.5) had 2.6-fold. Addition of BMD to clinical risk factors did not enhance the discriminative ability to identify subjects with vertebral fracture. Conclusions: Based on these findings, we recommend that screening efforts should focus on older postmenopausal women with multiple risk factors to identify women who are likely to have a prevalent vertebral fracture. © 2010 The Author(s).
Persistent Identifierhttp://hdl.handle.net/10722/144978
ISSN
2015 Impact Factor: 3.445
2015 SCImago Journal Rankings: 1.460
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Hong Kong University Foundation
University of Hong Kong
Funding Information:

The authors wish to thank the nursing and technical staff of the Osteoporosis Centre, Department of Medicine, Queen Mary Hospital for their help in carrying out this project. This study was funded by the Bone Health fund of the Hong Kong University Foundation and Osteoporosis Research Fund of the University of Hong Kong.

References

 

DC FieldValueLanguage
dc.contributor.authorTsang, SWYen_HK
dc.contributor.authorBow, CHen_HK
dc.contributor.authorChu, EYWen_HK
dc.contributor.authorYeung, SCen_HK
dc.contributor.authorSoong, CCen_HK
dc.contributor.authorKung, AWCen_HK
dc.date.accessioned2012-02-21T05:43:18Z-
dc.date.available2012-02-21T05:43:18Z-
dc.date.issued2011en_HK
dc.identifier.citationOsteoporosis International, 2011, v. 22 n. 2, p. 667-674en_HK
dc.identifier.issn0937-941Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/144978-
dc.description.abstractSummary: This study evaluated the characteristics of patients with vertebral fractures and examined the discriminative ability of clinical risk factors. The findings provide further insights into possible development of a simple, cost-effective scheme for fracture risk assessment using clinical risk factors to identify high-risk patients for further evaluation. Introduction: Vertebral fractures are the most common complication of osteoporosis. The aim of this study was to evaluate the characteristics of patients with vertebral fractures and to determine the discriminative ability of bone mineral density (BMD) and other clinical risk factors. Methods: Postmenopausal Southern Chinese women (2,178) enrolled in the Hong Kong Osteoporosis Study since 1995 were prospectively followed up for fracture outcome. Subjects (1,372) with lateral spine radiographs were included in this study. Baseline demographic, BMD, and clinical risk factor information were obtained from a structured questionnaire. Results: Subjects (299; 22%) had prevalent vertebral fractures. The prevalence of vertebral fractures increased with increasing age, number of clinical risk factors, and decreasing BMD. The odds of having a prevalent vertebral fracture per SD reduction in BMD after adjustment for age in Hong Kong Southern Chinese postmenopausal women was 1.5 for the lumbar spine and femoral neck. Analysis of the receiver operating characteristic curve revealed that bone mineral apparent density did not enhance fracture risk prediction. Subjects with ≥4 clinical risk factors had 2.3-fold higher odds of having a prevalent vertebral fracture while subjects with ≥4 clinical risk factors plus a low BMD (i.e., femoral neck T-score <-2.5) had 2.6-fold. Addition of BMD to clinical risk factors did not enhance the discriminative ability to identify subjects with vertebral fracture. Conclusions: Based on these findings, we recommend that screening efforts should focus on older postmenopausal women with multiple risk factors to identify women who are likely to have a prevalent vertebral fracture. © 2010 The Author(s).en_HK
dc.languageengen_US
dc.publisherSpringer U K. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/198en_HK
dc.relation.ispartofOsteoporosis Internationalen_HK
dc.rightsThe Author(s)en_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong Licenseen_US
dc.subjectEthnicityen_HK
dc.subjectOsteoporosisen_HK
dc.subjectPrevalenceen_HK
dc.subjectSouthern Chineseen_HK
dc.subjectVertebral fractureen_HK
dc.subject.meshBone Density - physiology-
dc.subject.meshSpinal Fractures - epidemiology-
dc.subject.meshAbsorptiometry, Photon-
dc.subject.meshAsian Continental Ancestry Group - ethnology-
dc.subject.meshFemur Neck - radiography-
dc.titleClinical risk factor assessment had better discriminative ability than bone mineral density in identifying subjects with vertebral fractureen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4551/resserv?sid=springerlink&genre=article&atitle=Clinical risk factor assessment had better discriminative ability than bone mineral density in identifying subjects with vertebral fracture&title=Osteoporosis International&issn=0937941X&date=2011-02-01&volume=22&issue=2& spage=667&authors=S. W. Y. Tsang, C. H. Bow, E. Y. W. Chu, <i>et al.</i>en_US
dc.identifier.emailKung, AWC:awckung@hku.hken_HK
dc.identifier.authorityKung, AWC=rp00368en_HK
dc.description.naturepublished_or_final_versionen_US
dc.identifier.doi10.1007/s00198-010-1260-zen_HK
dc.identifier.pmid20503038-
dc.identifier.pmcidPMC3020297-
dc.identifier.scopuseid_2-s2.0-78651514623en_HK
dc.identifier.hkuros175024-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-78651514623&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume22en_HK
dc.identifier.issue2en_HK
dc.identifier.spage667en_HK
dc.identifier.epage674en_HK
dc.identifier.eissn1433-2965en_US
dc.identifier.isiWOS:000286207800027-
dc.publisher.placeUnited Kingdomen_HK
dc.description.otherSpringer Open Choice, 21 Feb 2012en_US
dc.identifier.scopusauthoridTsang, SWY=35182014900en_HK
dc.identifier.scopusauthoridBow, CH=36055977600en_HK
dc.identifier.scopusauthoridChu, EYW=26666500500en_HK
dc.identifier.scopusauthoridYeung, SC=35958996000en_HK
dc.identifier.scopusauthoridSoong, CC=36946377400en_HK
dc.identifier.scopusauthoridKung, AWC=7102322339en_HK
dc.identifier.citeulike7263654-

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