Skip to main content
Erschienen in: Osteoporosis International 3/2012

01.03.2012 | Original Article

The potential impact of the National Osteoporosis Foundation guidance on treatment eligibility in the USA: an update in NHANES 2005–2008

verfasst von: B. Dawson-Hughes, A. C. Looker, A. N. A. Tosteson, H. Johansson, J. A. Kanis, L. J. Melton III

Erschienen in: Osteoporosis International | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

Abstract

Summary

This analysis of National Health and Nutrition Examination Survey (NHANES) 2005–2008 data describes the prevalence of risk factors for osteoporosis and the proportions of men and postmenopausal women age 50 years and older who are candidates for treatment to lower fracture risk, according to the new Fracture Risk Assessment Tool (FRAX)-based National Osteoporosis Foundation Clinician’s Guide.

Introduction

It is important to update estimates of the proportions of the older US population considered eligible for pharmacologic treatment for osteoporosis for purposes of understanding the health care burden of this disease.

Methods

This is a cross-sectional study of the NHANES 2005–2008 data in 3,608 men and women aged 50 years and older. Variables in the analysis included race/ethnicity, age, lumbar spine and femoral neck bone mineral density, risk factor profiles, and FRAX 10-year fracture probabilities.

Results

The prevalence of osteoporosis of the femoral neck ranged from 6.0% in non-Hispanic black to 12.6% in Mexican American women. Spinal osteoporosis was more prevalent among Mexican American women (24.4%) than among either non-Hispanic blacks (5.3%) or non-Hispanic whites (10.9%). Treatment eligibility was similar in Mexican American and non-Hispanic white women (32.0% and 32.8%) and higher than it was in non-Hispanic black women (11.0%). Treatment eligibility among men was 21.1% in non-Hispanic whites, 12.6% in Mexican Americans, and 3.0% in non-Hispanic blacks.

Conclusions

Nineteen percent of older men and 30% of older women in the USA are at sufficient risk for fracture to warrant consideration for pharmacotherapy.
Literatur
1.
Zurück zum Zitat National Osteoporosis Foundation (2008) Clinician's guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington, D.C., pp 1–36 National Osteoporosis Foundation (2008) Clinician's guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington, D.C., pp 1–36
2.
Zurück zum Zitat Kanis J (2008) Assessment of osteoporosis at the primary health-care level. WHO Collaborating Centre, University of Sheffield, Sheffield Kanis J (2008) Assessment of osteoporosis at the primary health-care level. WHO Collaborating Centre, University of Sheffield, Sheffield
3.
Zurück zum Zitat Dawson-Hughes B, Looker AC, Tosteson AN, Johansson H, Kanis JA, Melton LJ 3rd (2010) The potential impact of new National Osteoporosis Foundation guidance on treatment patterns. Osteoporos Int 21:41–52PubMedCrossRef Dawson-Hughes B, Looker AC, Tosteson AN, Johansson H, Kanis JA, Melton LJ 3rd (2010) The potential impact of new National Osteoporosis Foundation guidance on treatment patterns. Osteoporos Int 21:41–52PubMedCrossRef
4.
Zurück zum Zitat AC Looker AC LMI, LG Borrud, JA Shepherd (2011) Changes in femur neck bone density in US adults between 1988–1994 and 2005–2008: demographic patterns and possible determinants. Osteoporosis International 22: doi:10.1007/s00198-011-1623-0 AC Looker AC LMI, LG Borrud, JA Shepherd (2011) Changes in femur neck bone density in US adults between 1988–1994 and 2005–2008: demographic patterns and possible determinants. Osteoporosis International 22: doi:10.​1007/​s00198-011-1623-0
5.
Zurück zum Zitat Centers for Disease Control and Prevention NCHS (1999–2011) National Health and Nutrition Examination Survey (NHANES). US Department of Health and Human Services, Centers for Disease Control and Prevention, Hyattsville Centers for Disease Control and Prevention NCHS (1999–2011) National Health and Nutrition Examination Survey (NHANES). US Department of Health and Human Services, Centers for Disease Control and Prevention, Hyattsville
6.
Zurück zum Zitat Baim S, Binkley N, Bilezikian JP, Kendler DL, Hans DB, Lewiecki EM, Silverman S (2008) Official Positions of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD Position Development Conference. J Clin Densitom 11:75–91PubMedCrossRef Baim S, Binkley N, Bilezikian JP, Kendler DL, Hans DB, Lewiecki EM, Silverman S (2008) Official Positions of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD Position Development Conference. J Clin Densitom 11:75–91PubMedCrossRef
7.
Zurück zum Zitat Centers of Disease Control and Prevention NCHS (2006) National Health and Nutrition Survey: body composition procedure manual. US Department of Health and Human Services, Centers for Disease Control and Prevention, Hyattsville Centers of Disease Control and Prevention NCHS (2006) National Health and Nutrition Survey: body composition procedure manual. US Department of Health and Human Services, Centers for Disease Control and Prevention, Hyattsville
8.
Zurück zum Zitat Centers for Disease Control and Prevention NCHS (2007) National Health and Nutrition Examination Survey: dual-energy x-ray absorptiometry (DXA) procedure manual. U.S Department of Health and Human Services, Centers for Disease Control and Prevention, Hyattsville Centers for Disease Control and Prevention NCHS (2007) National Health and Nutrition Examination Survey: dual-energy x-ray absorptiometry (DXA) procedure manual. U.S Department of Health and Human Services, Centers for Disease Control and Prevention, Hyattsville
9.
Zurück zum Zitat Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC Jr, Lindsay R (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489PubMedCrossRef Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC Jr, Lindsay R (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489PubMedCrossRef
10.
Zurück zum Zitat Kelly TJ (1990) Bone mineral density reference databases for American men and women. J Bone Miner Res 5(Suppl 1):S249 Kelly TJ (1990) Bone mineral density reference databases for American men and women. J Bone Miner Res 5(Suppl 1):S249
11.
Zurück zum Zitat Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141PubMedCrossRef Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141PubMedCrossRef
12.
Zurück zum Zitat McKinlay SM (1994) Issues in design, measurement, and analysis for menopause research. Exp Gerontol 29:479–493PubMedCrossRef McKinlay SM (1994) Issues in design, measurement, and analysis for menopause research. Exp Gerontol 29:479–493PubMedCrossRef
13.
Zurück zum Zitat Kanis JA, Johansson H, Oden A, Dawson-Hughes B, Melton LJ 3rd, McCloskey EV (2010) The effects of a FRAX revision for the USA. Osteoporos Int 21:35–40PubMedCrossRef Kanis JA, Johansson H, Oden A, Dawson-Hughes B, Melton LJ 3rd, McCloskey EV (2010) The effects of a FRAX revision for the USA. Osteoporos Int 21:35–40PubMedCrossRef
14.
Zurück zum Zitat Dawson-Hughes B, Tosteson AN, Melton LJ 3rd, Baim S, Favus MJ, Khosla S, Lindsay RL (2008) Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos Int 19:449–458PubMedCrossRef Dawson-Hughes B, Tosteson AN, Melton LJ 3rd, Baim S, Favus MJ, Khosla S, Lindsay RL (2008) Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos Int 19:449–458PubMedCrossRef
16.
Zurück zum Zitat Donaldson MG, Cawthon PM, Lui LY, Schousboe JT, Ensrud KE, Taylor BC, Cauley JA, Hillier TA, Black DM, Bauer DC, Cummings SR (2009) Estimates of the proportion of older white women who would be recommended for pharmacologic treatment by the new U.S. National Osteoporosis Foundation Guidelines. J Bone Miner Res 24:675–680PubMedCrossRef Donaldson MG, Cawthon PM, Lui LY, Schousboe JT, Ensrud KE, Taylor BC, Cauley JA, Hillier TA, Black DM, Bauer DC, Cummings SR (2009) Estimates of the proportion of older white women who would be recommended for pharmacologic treatment by the new U.S. National Osteoporosis Foundation Guidelines. J Bone Miner Res 24:675–680PubMedCrossRef
17.
Zurück zum Zitat Donaldson MG, Cawthon PM, Lui LY, Schousboe JT, Ensrud KE, Taylor BC, Cauley JA, Hillier TA, Dam TT, Curtis JR, Black DM, Bauer DC, Orwoll ES, Cummings SR (2010) Estimates of the proportion of older white men who would be recommended for pharmacologic treatment by the new US National Osteoporosis Foundation guidelines. J Bone Miner Res 25:1506–1511PubMedCrossRef Donaldson MG, Cawthon PM, Lui LY, Schousboe JT, Ensrud KE, Taylor BC, Cauley JA, Hillier TA, Dam TT, Curtis JR, Black DM, Bauer DC, Orwoll ES, Cummings SR (2010) Estimates of the proportion of older white men who would be recommended for pharmacologic treatment by the new US National Osteoporosis Foundation guidelines. J Bone Miner Res 25:1506–1511PubMedCrossRef
18.
Zurück zum Zitat Berry SD, Kiel DP, Donaldson MG, Cummings SR, Kanis JA, Johansson H, Samelson EJ (2010) Application of the National Osteoporosis Foundation Guidelines to postmenopausal women and men: the Framingham Osteoporosis Study. Osteoporos Int 21:53–60PubMedCrossRef Berry SD, Kiel DP, Donaldson MG, Cummings SR, Kanis JA, Johansson H, Samelson EJ (2010) Application of the National Osteoporosis Foundation Guidelines to postmenopausal women and men: the Framingham Osteoporosis Study. Osteoporos Int 21:53–60PubMedCrossRef
19.
Zurück zum Zitat Siris ES, Miller PD, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, Berger ML, Santora AC, Sherwood LM (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 286:2815–2822PubMedCrossRef Siris ES, Miller PD, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, Berger ML, Santora AC, Sherwood LM (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 286:2815–2822PubMedCrossRef
20.
Zurück zum Zitat Araujo AB, Travison TG, Harris SS, Holick MF, Turner AK, McKinlay JB (2007) Race/ethnic differences in bone mineral density in men. Osteoporos Int 18:943–953PubMedCrossRef Araujo AB, Travison TG, Harris SS, Holick MF, Turner AK, McKinlay JB (2007) Race/ethnic differences in bone mineral density in men. Osteoporos Int 18:943–953PubMedCrossRef
21.
Zurück zum Zitat Zingmond D (2004) Increasing hip fracture incidence in California Hispanics, 1983 to 2000. Osteoporos Int 15:603–610PubMedCrossRef Zingmond D (2004) Increasing hip fracture incidence in California Hispanics, 1983 to 2000. Osteoporos Int 15:603–610PubMedCrossRef
22.
Zurück zum Zitat Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475PubMedCrossRef Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475PubMedCrossRef
23.
Zurück zum Zitat Siris ES, Pasquale MK, Wang Y, Watts NB (2011) Estimating bisphosphonate use and fracture reduction among US women aged 45 years and older, 2001–2008. J Bone Miner Res 26:3–11PubMedCrossRef Siris ES, Pasquale MK, Wang Y, Watts NB (2011) Estimating bisphosphonate use and fracture reduction among US women aged 45 years and older, 2001–2008. J Bone Miner Res 26:3–11PubMedCrossRef
24.
Zurück zum Zitat Jaglal SB, Weller I, Mamdani M, Hawker G, Kreder H, Jaakkimainen L, Adachi JD (2005) Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong? J Bone Miner Res 20:898–905PubMedCrossRef Jaglal SB, Weller I, Mamdani M, Hawker G, Kreder H, Jaakkimainen L, Adachi JD (2005) Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong? J Bone Miner Res 20:898–905PubMedCrossRef
Metadaten
Titel
The potential impact of the National Osteoporosis Foundation guidance on treatment eligibility in the USA: an update in NHANES 2005–2008
verfasst von
B. Dawson-Hughes
A. C. Looker
A. N. A. Tosteson
H. Johansson
J. A. Kanis
L. J. Melton III
Publikationsdatum
01.03.2012
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 3/2012
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-011-1694-y

Weitere Artikel der Ausgabe 3/2012

Osteoporosis International 3/2012 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.