P Clark1,2, E Denova-Gutiérrez3,4, C Zerbini5, A Sanchez6, O Messina7,8, J J Jaller9, C Campusano10, C H Orces11, G Riera12, H Johansson13, J A Kanis13,14. 1. Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gomez, Dr. Márquez #164, Col. Doctores, Mexico City, Mexico. 2. School of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico. 3. Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gomez, Dr. Márquez #164, Col. Doctores, Mexico City, Mexico. edenovag@gmail.com. 4. School of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico. edenovag@gmail.com. 5. Centro Paulista de Investigação Clinica, São Paulo, Brazil. 6. Centro de Endocrinología, Rosario, Argentina. 7. Servicio de Reumatología, Hospital Argerich, Buenos Aires, Argentina. 8. Unidad de Postgrado en Reumatología, Universidad de Buenos Aires, Buenos Aires, Argentina. 9. Centro de Reumatología y Ortopedia, Barranquilla, Colombia. 10. Clínica de la Universidad de los Andes, Santiago, Chile. 11. Department of Medicine, Laredo Medical Center, Laredo, TX, USA. 12. Unidad Metabolica, Universidad de Carabobo, Valencia, Venezuela. 13. Institute for Health and Ageing, Catholic University of Australia, Melbourne, Australia. 14. Medical School, Sheffield, UK Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, England.
Abstract
Age-specific intervention and assessment thresholds were developed for seven Latin American countries. The intervention threshold ranged from 1.2% (Ecuador) to 27.5% (Argentina) at the age of 50 and 90 years, respectively. In the Latin American countries, FRAX offers a substantial advance for the detection of subjects at high fracture risk. INTRODUCTION: Intervention thresholds are proposed using the Fracture Risk Assessment (FRAX) tool. We recommended their use to calculate the ten-year probability of fragility fracture (FF) in both, men and women with or without the inclusion of bone mineral density (BMD). The purpose of this study is to compute FRAX-based intervention and BMD assessment thresholds for seven Latin American countries in men and women ≥ 40 years. METHODS: The intervention threshold (IT) was set at a 10-year probability of a major osteoporotic fracture (MOF) equivalent to a woman with a prior FF and a body mass index (BMI) equal to 25.0 kg/m2 without BMD or other clinical risk factors. The lower assessment threshold was set at a 10-year probability of a MOF in women with BMI equal to 25.0 kg/m2, no previous fracture and no clinical risk factors. The upper assessment threshold was set at 1.2 times the IT. RESULTS: For the seven LA countries, the age-specific IT varied from 1.5 to 27.5% in Argentina, 3.8 to 25.2% in Brazil, 1.6 up to 20.0% in Chile, 0.6 to 10.2% in Colombia, 0.9 up to 13.6% in Ecuador, 2.6 to 20.0% in Mexico, and 0.7 up to 22.0% in Venezuela at the age of 40 and 90 years, respectively. CONCLUSIONS: In the LA countries, FRAX-based IT offers a substantial advance for the detection of men and women at high fracture risk, particularly in the elderly. The heterogeneity of IT between the LA countries indicates that country-specific FRAX models are appropriate rather than a global LA model.
Age-specific intervention and assessment thresholds were developed for seven Latin American countries. The intervention threshold ranged from 1.2% (Ecuador) to 27.5% (Argentina) at the age of 50 and 90 years, respectively. In the Latin American countries, FRAX offers a substantial advance for the detection of subjects at high fracture risk. INTRODUCTION: Intervention thresholds are proposed using the Fracture Risk Assessment (FRAX) tool. We recommended their use to calculate the ten-year probability of fragility fracture (FF) in both, men and women with or without the inclusion of bone mineral density (BMD). The purpose of this study is to compute FRAX-based intervention and BMD assessment thresholds for seven Latin American countries in men and women ≥ 40 years. METHODS: The intervention threshold (IT) was set at a 10-year probability of a major osteoporotic fracture (MOF) equivalent to a woman with a prior FF and a body mass index (BMI) equal to 25.0 kg/m2 without BMD or other clinical risk factors. The lower assessment threshold was set at a 10-year probability of a MOF in women with BMI equal to 25.0 kg/m2, no previous fracture and no clinical risk factors. The upper assessment threshold was set at 1.2 times the IT. RESULTS: For the seven LA countries, the age-specific IT varied from 1.5 to 27.5% in Argentina, 3.8 to 25.2% in Brazil, 1.6 up to 20.0% in Chile, 0.6 to 10.2% in Colombia, 0.9 up to 13.6% in Ecuador, 2.6 to 20.0% in Mexico, and 0.7 up to 22.0% in Venezuela at the age of 40 and 90 years, respectively. CONCLUSIONS: In the LA countries, FRAX-based IT offers a substantial advance for the detection of men and women at high fracture risk, particularly in the elderly. The heterogeneity of IT between the LA countries indicates that country-specific FRAX models are appropriate rather than a global LA model.
Entities:
Keywords:
Assessment thresholds; FRAX; Intervention threshold; Latin American countries; Osteoporosis; Ten-year fracture probability
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