Risk Factors Identified for Nonvertebral Fracture in Postmenopausal Women

[Admin]

March 6, 2007 — Six risk factors are effective in identifying postmenopausal women at high risk for nonvertebral fractures, according to the results of a study reported in the February 21 Online First issue of Annals of the Rheumatic Diseases.

"Nonvertebral (NV) fractures are responsible for the greatest amount of morbidity, mortality and cost attributable to osteoporosis," write Christian Roux, of the Cochin Hospital in Paris, France, and colleagues. "The assessment of NV fracture risk in postmenopausal women is difficult and the relationship between risk factors and fractures differ by type of fracture."

The investigators analyzed data from 2546 osteoporotic postmenopausal women included in the placebo groups of 3 risedronate controlled trials. Mean age was 72 years, mean femoral T score was -2.5, and 60% and 53% of patients had prevalent vertebral and nonvertebral fractures, respectively. During a 3-year period, 222 nonvertebral fractures were reported. Logistic regression analysis included baseline data on 14 risk factors.

Six risk factors were associated with nonvertebral fracture risk: prevalent nonvertebral fracture (P = .004), number of prevalent vertebral fractures (P < .001), femoral T score (P = .031), serum level of 25-hydroxyvitamin D (25OHD3; P < .001), age (P = .012), and height (P = .037). A nonvertebral risk index was developed by converting the equation in a score. In the group of women with a score of 2.1 or higher, the incidence of nonvertebral fracture was 13.2% (11.1 - 15.3) or 1.5 times higher than in the overall population.

Study limitations include lack of information on falls.

"Our study suggests that among osteoporotic women, a proportion of patients with a high risk of NV fractures can be selected and an index is a convenient tool for this selection in clinical practice," the authors conclude. "First intention treatment for these patients must be chosen among those with a proven NV fracture risk efficacy."

Procter & Gamble employs 2 of the authors.

Ann Rheum Dis. Published online February 21, 2007

Source: http://www.medscape.com/viewarticle/553172?src=mp