Applicability Of Fracture Risk Assessment Tool(FRAX) For Fracture Risk Assessment

Objective:To explore whether the Fracture Risk Assessment Tool(FRAX)can be applied to the assessment of the risk of osteoporotic fractures in postmenopausal women in Hecheng District of Huaihua City.Provide guidance for clinical intervention of postmenopausal women with osteoporosis,and provide clinical evidence for further promotion and application of FRAX.Methods:Selected randomly 256 female residents aged 45-90 years in Hecheng District of Huaihua City from April 2018 to May 2018.The subjects completed bone mineral density measurement at the First People’s Hospital of Huaihua City and filled in basic information and FRAX-related fracture clinical risk factor data.A total of 155 postmenopausal women were included in the study after screening for subjects who did not meet the requirements.The last subjects were divided into normal bone mass group(T≥-1)and abnormal bone mass group(T<-1)according to bone density T value.Use the FRAX Chinese mainland model to calculate the main site of osteoporotic fractures(spinal,hip,forearm and tibia fractures)and hip fractures within 10 years of each subject with or without femoral neck bone mineral density.Analyze the regional specificity and analyze statistically the correlation between the fracture probability predicted by FRAX and BMD,the correlation between the T value calculated by FRAX and the T value obtained by the bone densitometer,and the accuracy of FRAX recognition of bone abnormality.Result:1.The subjects with abnormal bone mass had higher age(P<0.05),lighter weight(P<0.05),lower height(P<0.05),and lower body mass index(P<0.05)compared with normal bone mass group and the difference was statistically significant(P<0.05).There were no significant differences in clinical risk factors between the two groups(P>0.05).2.The probability of major osteoporotic fractures within 10 years and the probability of hip fracture within 10 years were significantly higher than those with normal bone masswith or withoutBMD of femoral neck,and the difference was statistically significant(P<0.01).3.There was a significant negative correlation between PMOF,PHF and T-value with or without femoral neck bone mineral density(P<0.001),and there was also a significant positive correlation within FARX predictive value with and without femoral neck BMD.P<0.001).The T value obtained by FRAX was significantly positively correlated with the T value of the bone density meter(P<0.001).4.With the increase of age,the incidence of abnormal bone mass increased gradually(P<0.001),and the probability of osteoporotic fracture in the main site and hip was significantly increased within 10 years(P<0.001).5.The area under the curve of the ROC curve of the main part of the osteoporotic fracture within 10 years is 0.750(95% confidence interval: 0.666-0.834,P < 0.001),and the critical value is 2.65%,then the accuracy is higher;The area under the curve of the ROC curve ofhip fracture within 10 years is 0.788(95% confidence interval : 0.707-0.868,P < 0.001),and the critical value was 0.35%,then the accuracy is higher.Conclusion:The Fracture Risk Assessment Tool(FRAX)is applicable to the assessment of the risk of osteoporotic fractures in postmenopausal women in Hecheng District of Huaihua City.