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Erschienen in: Endocrine 1/2019

20.05.2019 | Original Article

Comparison of strategies for setting intervention thresholds for Chinese postmenopausal women using the FRAX model

verfasst von: Shu-Ying Liu, Meng Huang, Rong Chen, Na Ding, Hong Liu, Zhong-Jian Xie, Zhi-Feng Sheng, Bi-Hua Luo, Yang-Na Ou

Erschienen in: Endocrine | Ausgabe 1/2019

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Abstract

Purpose

The two main strategies for managing osteoporosis using the Fracture Risk Assessment (FRAX®) are the fixed-probability threshold of the National Osteoporosis Foundation (NOF) and the age-dependent-probability threshold of the National Osteoporosis Guideline Group (NOGG), but there are no FRAX® Chinese-specific thresholds. This study examined the NOF and NOGG strategies for intervention thresholds using the Chinese FRAX® model for their appropriateness for Chinese postmenopausal women, and explored Chinese-specific thresholds.

Methods

Postmenopausal women (N = 264) >50 years old from community-medical centers in China were randomly selected. They completed a self-report questionnaire and underwent bone mineral density measurements and spinal X-rays. The 10-year risks for a major osteoporosis fracture and hip fracture were calculated using the Chinese FRAX® model. Using an osteoporosis diagnosis as the gold standard, we compared the abilities of the NOF and NOGG thresholds to detect osteoporosis by analyzing their sensitivity, specificity, accuracy, and positive and negative likelihood ratios.

Results

The 10-year risks for hip fracture and a major osteoporotic fracture increased with age. The NOF’s accuracy in detecting osteoporosis was 83.33% and the NOGG’s was 74.24%. The NOF thresholds showed higher accuracy and specificity than the NOGG thresholds.

Conclusion

NOF thresholds are more appropriate for Chinese menopausal women.
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Literatur
1.
Zurück zum Zitat No author listed, Consensus Development Conference: Diagnosis, Prophylaxis, and Treatment of Osteoporosis. Am. J. Med. 94, 646–650 (1993).CrossRef No author listed, Consensus Development Conference: Diagnosis, Prophylaxis, and Treatment of Osteoporosis. Am. J. Med. 94, 646–650 (1993).CrossRef
2.
Zurück zum Zitat K.A. Magnusson, B. Gunnarsson, G.H. Sigurdsson, B. Mogensen, Y. Olafsson, S. Karason, Treatment and outcome of patients with hip fracture. Laeknabladid 102, 119–125 (2016).PubMed K.A. Magnusson, B. Gunnarsson, G.H. Sigurdsson, B. Mogensen, Y. Olafsson, S. Karason, Treatment and outcome of patients with hip fracture. Laeknabladid 102, 119–125 (2016).PubMed
3.
Zurück zum Zitat L. Si, T.M. Winzenberg, Q. Jiang, M. Chen, A.J. Palmer, Projection of osteoporosis-related fractures and costs in China: 2010–2050. Osteoporos. Int. 26, 1929–1937 (2015).CrossRefPubMed L. Si, T.M. Winzenberg, Q. Jiang, M. Chen, A.J. Palmer, Projection of osteoporosis-related fractures and costs in China: 2010–2050. Osteoporos. Int. 26, 1929–1937 (2015).CrossRefPubMed
4.
Zurück zum Zitat A. Svedbom, E. Hernlund, M. Ivergård, J. Compston, C. Cooper, J. Stenmark, E.V. McCloskey, B. Jönsson, J.A. Kanis; EU Review Panel of IOF, Osteoporosis in the European Union: a compendium of country-specific reports. Arch. Osteoporos. 8, 137 (2013).CrossRefPubMedPubMedCentral A. Svedbom, E. Hernlund, M. Ivergård, J. Compston, C. Cooper, J. Stenmark, E.V. McCloskey, B. Jönsson, J.A. Kanis; EU Review Panel of IOF, Osteoporosis in the European Union: a compendium of country-specific reports. Arch. Osteoporos. 8, 137 (2013).CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat J.A. Eisman, E.R. Bogoch, R. Dell, J.T. Harrington, R.J. McKinney, A. McLellan, P.J. Mitchell, S. Silverman, R. Singleton, E. Siris; ASBMR task force on secondary fracture prevention, Making the First Fracture the Last Fracture: ASBMR Task Force Report on Secondary Fracture Prevention. J. Bone Miner. Res. 27, 2039–2046 (2012).CrossRefPubMed J.A. Eisman, E.R. Bogoch, R. Dell, J.T. Harrington, R.J. McKinney, A. McLellan, P.J. Mitchell, S. Silverman, R. Singleton, E. Siris; ASBMR task force on secondary fracture prevention, Making the First Fracture the Last Fracture: ASBMR Task Force Report on Secondary Fracture Prevention. J. Bone Miner. Res. 27, 2039–2046 (2012).CrossRefPubMed
7.
Zurück zum Zitat J.A. Kanis, N.C. Harvey, C. Cooper, H. Johansson, A. Odén, E.V. McCloskey; Advisory Board of the National Osteoporosis Guideline Group, A systematic review of intervention thresholds based on FRAX: a report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch. Osteoporos. 11, 25 (2016).CrossRefPubMedPubMedCentral J.A. Kanis, N.C. Harvey, C. Cooper, H. Johansson, A. Odén, E.V. McCloskey; Advisory Board of the National Osteoporosis Guideline Group, A systematic review of intervention thresholds based on FRAX: a report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch. Osteoporos. 11, 25 (2016).CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat B. Dawson-Hughes, A.N. Tosteson, L.J. Melton, S. Baim, M.J. Favus, S. Khosla, R.L. Lindsay; National Osteoporosis Foundation Guide Committee, Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos. Int. 19, 449–458 (2008).CrossRefPubMed B. Dawson-Hughes, A.N. Tosteson, L.J. Melton, S. Baim, M.J. Favus, S. Khosla, R.L. Lindsay; National Osteoporosis Foundation Guide Committee, Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos. Int. 19, 449–458 (2008).CrossRefPubMed
9.
Zurück zum Zitat A.N. Tosteson, L.J. Melton, B. Dawson-Hughes, S. Baim, M.J. Favus, S. Khosla, R.L. Lindsay; National Osteoporosis Foundation Guide Committee, Cost-effective osteoporosis treatment thresholds: the United States perspective. Osteoporos. Int. 19, 437–447 (2008).CrossRefPubMedPubMedCentral A.N. Tosteson, L.J. Melton, B. Dawson-Hughes, S. Baim, M.J. Favus, S. Khosla, R.L. Lindsay; National Osteoporosis Foundation Guide Committee, Cost-effective osteoporosis treatment thresholds: the United States perspective. Osteoporos. Int. 19, 437–447 (2008).CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat F. Cosman, S.J. de Beur, M.S. LeBoff, E.M. Lewiecki, B. Tanner, S. Randall, R. Lindsay; National Osteoporosis Foundation, Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos. Int. 25, 2359–2381 (2014).CrossRefPubMedPubMedCentral F. Cosman, S.J. de Beur, M.S. LeBoff, E.M. Lewiecki, B. Tanner, S. Randall, R. Lindsay; National Osteoporosis Foundation, Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos. Int. 25, 2359–2381 (2014).CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat J. Compston, A. Cooper, C. Cooper, N. Gittoes, C. Gregson, N. Harvey, S. Hope, J.A. Kanis, E.V. McCloskey, K.E. Poole, D.M. Reid, P. Selby, F. Thompson, A. Thurston, N. Vine; National Osteoporosis Guideline Group (NOGG), UK clinical guideline for the prevention and treatment of osteoporosis. Arch. Osteoporos. 12, 43 (2017).CrossRefPubMedPubMedCentral J. Compston, A. Cooper, C. Cooper, N. Gittoes, C. Gregson, N. Harvey, S. Hope, J.A. Kanis, E.V. McCloskey, K.E. Poole, D.M. Reid, P. Selby, F. Thompson, A. Thurston, N. Vine; National Osteoporosis Guideline Group (NOGG), UK clinical guideline for the prevention and treatment of osteoporosis. Arch. Osteoporos. 12, 43 (2017).CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat J. Wang, Y. Wang, W.D. Liu, F. Wang, Z.S. Yin, Hip fractures in Hefei, China: the Hefei Osteoporosis Project. J. Bone Miner. Metab. 32, 206–214 (2014).CrossRefPubMed J. Wang, Y. Wang, W.D. Liu, F. Wang, Z.S. Yin, Hip fractures in Hefei, China: the Hefei Osteoporosis Project. J. Bone Miner. Metab. 32, 206–214 (2014).CrossRefPubMed
14.
Zurück zum Zitat Y. Jiang, W. Ni, Expected lifetime numbers, risks, and burden of osteoporotic fractures for 50-year old Chinese women: a discrete event simulation incorporating FRAX. J. Bone Miner. Metab. 34, 714–722 (2016).CrossRefPubMed Y. Jiang, W. Ni, Expected lifetime numbers, risks, and burden of osteoporotic fractures for 50-year old Chinese women: a discrete event simulation incorporating FRAX. J. Bone Miner. Metab. 34, 714–722 (2016).CrossRefPubMed
15.
Zurück zum Zitat Z. Zhang, Y. Ou, Z. Sheng, E. Liao, How to decide intervention thresholds based on FRAX in central south Chinese postmenopausal women. Endocrine 45, 195–197 (2014).CrossRefPubMed Z. Zhang, Y. Ou, Z. Sheng, E. Liao, How to decide intervention thresholds based on FRAX in central south Chinese postmenopausal women. Endocrine 45, 195–197 (2014).CrossRefPubMed
16.
Zurück zum Zitat X. Zhang, J. Lin, Y. Yang, H. Wu, Y. Li, X. Yang, Q. Fei, Comparison of three tools for predicting primary osteoporosis in an elderly male population in Beijing: a cross-sectional study. Clin. Interv. Aging 13, 201–209 (2018).CrossRefPubMedPubMedCentral X. Zhang, J. Lin, Y. Yang, H. Wu, Y. Li, X. Yang, Q. Fei, Comparison of three tools for predicting primary osteoporosis in an elderly male population in Beijing: a cross-sectional study. Clin. Interv. Aging 13, 201–209 (2018).CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat X.F. Chen, X.L. Li, H. Zhang, G.J. Liu, Were you identified to be at high fracture risk by FRAX® before your osteoporotic fracture occurred? Clin. Rheumatol. 33, 693–698 (2014).CrossRefPubMed X.F. Chen, X.L. Li, H. Zhang, G.J. Liu, Were you identified to be at high fracture risk by FRAX® before your osteoporotic fracture occurred? Clin. Rheumatol. 33, 693–698 (2014).CrossRefPubMed
18.
Zurück zum Zitat S. Li, Y. Ou, H. Zhang, Z. Zhang, H. Zhou, L. Liu, Z. Sheng, E. Liao, Vitamin D status and its relationship with body composition, bone mineral density and fracture risk in urban central south Chinese postmenopausal women. Ann. Nutr. Metab. 64, 13–19 (2014).CrossRefPubMed S. Li, Y. Ou, H. Zhang, Z. Zhang, H. Zhou, L. Liu, Z. Sheng, E. Liao, Vitamin D status and its relationship with body composition, bone mineral density and fracture risk in urban central south Chinese postmenopausal women. Ann. Nutr. Metab. 64, 13–19 (2014).CrossRefPubMed
19.
Zurück zum Zitat Z. Sheng, K. Xu, Y. Ou, R. Dai, X. Luo, S. Liu, X. Su, X. Wu, H. Xie, L. Yuan, E. Liao, Relationship of body composition with prevalence of osteoporosis in central south Chinese postmenopausal women. Clin. Endocrinol. 74, 319–324 (2011).CrossRef Z. Sheng, K. Xu, Y. Ou, R. Dai, X. Luo, S. Liu, X. Su, X. Wu, H. Xie, L. Yuan, E. Liao, Relationship of body composition with prevalence of osteoporosis in central south Chinese postmenopausal women. Clin. Endocrinol. 74, 319–324 (2011).CrossRef
20.
Zurück zum Zitat H.K. Genant, C.Y. Wu, C.K. van, M.C. Nevitt, Vertebral fracture assessment using a semiquantitative technique. J. Bone Miner. Res. 8, 1137–1148 (1993).CrossRefPubMed H.K. Genant, C.Y. Wu, C.K. van, M.C. Nevitt, Vertebral fracture assessment using a semiquantitative technique. J. Bone Miner. Res. 8, 1137–1148 (1993).CrossRefPubMed
21.
Zurück zum Zitat F. Grados, C. Roux, M.C. de Vernejoul, G. Utard, J.L. Sebert, P. Fardellone, Comparison of four morphometric definitions and a semiquantitative consensus reading for assessing prevalent vertebral fractures. Osteoporos. Int. 12, 716–722 (2011).CrossRef F. Grados, C. Roux, M.C. de Vernejoul, G. Utard, J.L. Sebert, P. Fardellone, Comparison of four morphometric definitions and a semiquantitative consensus reading for assessing prevalent vertebral fractures. Osteoporos. Int. 12, 716–722 (2011).CrossRef
22.
Zurück zum Zitat E. Cheung, C.L. Cheung, A.W. Kung, K.C. Tan, Possible FRAX-based intervention thresholds for a cohort of Chinese postmenopausal women. Osteoporos. Int. 25, 1017–1023 (2014).CrossRefPubMed E. Cheung, C.L. Cheung, A.W. Kung, K.C. Tan, Possible FRAX-based intervention thresholds for a cohort of Chinese postmenopausal women. Osteoporos. Int. 25, 1017–1023 (2014).CrossRefPubMed
23.
Zurück zum Zitat Office of the Surgeon General (US). Bone Health and Osteoporosis: A Report of the Surgeon General. (Office of the Surgeon General (US), Rockville), 2004). Office of the Surgeon General (US). Bone Health and Osteoporosis: A Report of the Surgeon General. (Office of the Surgeon General (US), Rockville), 2004).
24.
Zurück zum Zitat J. Xu, M. Sun, Z. Wang, Q. Fu, M. Cao, Z. Zhu, C. Meng, Y. Yan, J. Mao, H. Tao, X. Huang, Z. Lin, T. Yang, W. He, Awareness of osteoporosis and its relationship with calcaneus quantitative ultrasound in a large Chinese community population. Clin. Interv. Aging 8, 789–796 (2013).PubMedPubMedCentral J. Xu, M. Sun, Z. Wang, Q. Fu, M. Cao, Z. Zhu, C. Meng, Y. Yan, J. Mao, H. Tao, X. Huang, Z. Lin, T. Yang, W. He, Awareness of osteoporosis and its relationship with calcaneus quantitative ultrasound in a large Chinese community population. Clin. Interv. Aging 8, 789–796 (2013).PubMedPubMedCentral
Metadaten
Titel
Comparison of strategies for setting intervention thresholds for Chinese postmenopausal women using the FRAX model
verfasst von
Shu-Ying Liu
Meng Huang
Rong Chen
Na Ding
Hong Liu
Zhong-Jian Xie
Zhi-Feng Sheng
Bi-Hua Luo
Yang-Na Ou
Publikationsdatum
20.05.2019
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 1/2019
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-019-01951-8

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