Objective: Fractures associated with bone fragility represent a major public health concern. Although the risk of bone fracture is higher among patients with osteoporosis, the number of fractures is usually higher among patients with osteopenia due to its higher prevalence.
Methods: This is an observational case series study that compares the frequencies of nonskeletal risk factors for osteoporotic fractures in osteopenic postmenopausal women with previous clinical fragility fractures (FFs) and osteopenic postmenopausal women without previous FF. Risk factors included in the FRAX algorithm and other selected risk factors, including asymptomatic vertebral fractures, were evaluated.
Results: A total of 735 (50.3% with prior FF and 49.7% without prior FF) postmenopausal women were evaluated (median age, 60 y; mean bone mineral density [BMD] femoral neck T score of −1.67). The frequency of the following risk factors was significantly higher among women with FF—FRAX algorithm: age, use of corticosteroids, and BMD femoral neck T score; other factors: Hispanic ethnicity, falls during the last year, and BMD lumbar T score. In addition, the frequency of previously undetected asymptomatic vertebral fractures was four times higher among women with a history of FF.
Conclusions: The results of the present study support the need to assess the presence of asymptomatic vertebral fractures and BMD T scores in osteopenic postmenopausal women. The risk evaluation of this subpopulation can be accomplished by using some of the risk factors included in the FRAX algorithm combined with other conventional risk factors.
From the 1Menopause Unit, Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain; 2Department of Pediatrics, Obstetrics, and Gynecology, Universidad de Valencia y Fundación para la Investigación, Hospital Universitario Dr Peset, Valencia, Spain; 3Gynecology and Obstetrics Department, Clínica Diatros Salud de la Mujer, Barcelona, Spain; 4Gynecology and Obstetrics Department, Hospital Central de Asturias, Asturias, Spain; 5Gabinete Médico Velázquez, Madrid, Spain; 6Gynecology and Obstetrics Service, Hospital Universitario de Cruces, Baracaldo, Spain; 7Centro San Andrés, Barcelona, Spain; 8Medical Department, Merck Sharp& Dohme Corp., Madrid, Spain; and 9Hospital Clínico San Carlos, Madrid, Spain.
Received December 19, 2011; revised and accepted March 13, 2012.
Funding/support: This work was supported, in part, by a restricted grant from Merck Sharp & Dohme Corp., Madrid, Spain. Editorial support was provided by Sofía Perea, Pharm D, PhD, and Merck Sharp & Dohme Corp., Madrid, Spain.
Financial disclosure/conflicts of interest: V. Inaraja, C. Corral, and C. Sancho are employees of Merck Sharp & Dohme Corp., Madrid, Spain.
Address correspondence to: Verónica Inaraja, C/ Josefa Valcárcel, 38, 28027 Madrid, Spain. E-mail: firstname.lastname@example.org