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Osteoporosis International

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01-11-2009 | Original Article

Ten-year fracture probability in Hong Kong Southern Chinese according to age and BMD femoral neck T-scores

Authors: S. W. Y. Tsang, A. W. C. Kung, J. A. Kanis, H. Johansson, A. Oden

Published in: Osteoporosis International | Issue 11/2009

Abstract

Summary

This study estimated the 10-year probability of osteoporotic fracture in Hong Kong Southern Chinese based on a simplified model of the recently developed WHO fracture risk prediction tool (FRAX®). Thus, the data provides further insights into potential development of a population-specific FRAX® model for Hong Kong in the future.

Introduction

The purpose of this paper was to estimate the 10-year probability of osteoporotic fracture in Hong Kong (HK) Southern Chinese according to age and bone mineral density (BMD) T-score at the femoral neck based on the methodology of the FRAX® risk assessment tool calibrated to the epidemiology of HK.

Methods

Hip fracture data was obtained from the Clinical Data Analysis Reporting System (CDAS) of the Hospital Authority of HK and population size and death rates were taken from the HK Government Census and Statistics Department. Fracture probability was calculated using the cut-off values for T-scores derived from the NHANES III data for Caucasian women aged 20–29 years for BMD at the femoral neck.

Results

In this study, the 10-year probability of osteoporotic fracture in HK Southern Chinese increased markedly with increasing age and decreasing femoral neck BMD T-scores in both women and men. Interestingly, at low T-scores, the increase in 10-year probability of osteoporotic fracture in women with age was greater than in men. Fracture probabilities were substantially higher than those from mainland China.

Conclusions

Based on this evidence, and until we have HK Southern Chinese population-specific information, we recommend the application of the Caucasian risk profile to calculate the absolute fracture risk for HK Southern Chinese subjects.

Consensus Development Conference (1993) Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 94:646–650CrossRef

NIH Consensus Statement (2000) Osteoporosis prevention, diagnosis, and therapy. 17:1-45

Cooper C, Campion G, Melton LJ III (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289CrossRefPubMed

Kanis JA, Melton LJ III, Christiansen C et al (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141PubMedCrossRef

Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259PubMed

Johnell O, Kanis JA, Oden A et al (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20:1185–1194CrossRefPubMed

Report of a WHO Study Group (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. World Health Organ Tech Rep Ser 843:1–129

Wainwright SA, Marshall LM, Ensrud KE et al (2005) Hip fracture in women without osteoporosis. J Clin Endocrinol Metab 90:2787–2793CrossRefPubMed

Black DM, Steinbuch M, Palermo L et al (2001) An assessment tool for predicting fracture risk in postmenopausal women. Osteoporos Int 12:519–528CrossRefPubMed

10.

De Laet C, Kanis JA, Oden A et al (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338CrossRefPubMed

11.

Kanis JA, Johansson H, Johnell O et al (2005) Alcohol intake as a risk factor for fracture. Osteoporos Int 16:737–742CrossRefPubMed

12.

Kanis JA, Johansson H, Oden A et al (2005) A meta-analysis of milk intake and fracture risk: low utility for case finding. Osteoporos Int 16:799–804CrossRefPubMed

13.

Kanis JA, Johansson H, Oden A et al (2004) A family history of fracture and fracture risk: a meta-analysis. Bone 35:1029–1037CrossRefPubMed

14.

Kanis JA, Johansson H, Oden A et al (2004) A meta-analysis of prior corticosteroid use and fracture risk. J Bone Miner Res 19:893–899CrossRefPubMed

15.

Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382CrossRefPubMed

16.

Kanis JA, Johnell O, Oden A et al (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16:155–162CrossRefPubMed

17.

Kanis JA, Borgstrom F, De Laet C et al (2005) Assessment of fracture risk. Osteoporos Int 16:581–589CrossRefPubMed

18.

Kanis JA, Burlet N, Cooper C et al (2008) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 19:399–428CrossRefPubMed

19.

De Laet CE, van Hout BA, Burger H et al (1997) Bone density and risk of hip fracture in men and women: cross sectional analysis. BMJ 315:221–225PubMed

20.

Hui SL, Slemenda CW, Johnston CC Jr (1988) Age and bone mass as predictors of fracture in a prospective study. J Clin Invest 81:1804–1809CrossRefPubMed

21.

Kanis JA, Johnell O, Oden A et al (2000) Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 27:585–590CrossRefPubMed

22.

Kanis J, Oden A, Johnell O et al (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–1046CrossRefPubMed

23.

Summary report of a WHO scientific group (2008) WHO scientific group on the assessment of osteoporosis at primary health care level. WHO, Geneva

24.

Dawson-Hughes B, Tosteson AN, Melton LJ III et al (2008) Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos Int 19:449–458CrossRefPubMed

25.

Fujiwara S, Nakamura T, Orimo H et al (2008) Development and application of a Japanese model of the WHO fracture risk assessment tool (FRAX™). Osteoporos Int 19:429–435CrossRefPubMed

26.

Kanis JA, Johnell O, Oden A et al (2008) FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397CrossRefPubMed

27.

Johnell O, Gullberg B, Allander E et al (1992) The apparent incidence of hip fracture in Europe: a study of national register sources. MEDOS Study Group. Osteoporos Int 2:298–302CrossRefPubMed

28.

Kanis JA, Johnell O, De Laet C et al (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17:1237–1244CrossRefPubMed

29.

Kung AW, Yates S, Wong V (2007) Changing epidemiology of osteoporotic hip fracture rates in Hong Kong. Arch Osteoporos 2:53–58CrossRef

30.

Kanis JA, Johnell O, Oden A et al (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674CrossRefPubMed

31.

Kanis JA, Oden A, Johnell O et al (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12(5):417–427CrossRefPubMed

32.

Looker AC, Wahner HW, Dunn WL et al (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489CrossRefPubMed

33.

Kanis JA, Johnell O, Oden A et al (2001) Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int 12:989–995CrossRefPubMed

34.

Lau EM, Cooper C (1996) The epidemiology of osteoporosis. The oriental perspective in a world context. Clin Orthop Relat Res 65-74

35.

Lau EM, Cooper C, Fung H et al (1999) Hip fracture in Hong Kong over the last decade—a comparison with the UK. J Public Health Med 21:249–250CrossRefPubMed

36.

Xu L, Lu A, Zhao X et al (1996) Very low rates of hip fracture in Beijing, People's Republic of China the Beijing Osteoporosis Project. Am J Epidemiol 144:901–907PubMed

37.

Yan L, Zhou B, Prentice A et al (1999) Epidemiological study of hip fracture in Shenyang, People's Republic of China. Bone 24:151–155CrossRefPubMed

38.

Kung AW, Tang GW, Luk KD et al (1999) Evaluation of a new calcaneal quantitative ultrasound system and determination of normative ultrasound values in southern Chinese women. Osteoporos Int 9:312–317CrossRefPubMed

39.

Kung AW, Lee KK, Ho AY et al (2007) Ten-year risk of osteoporotic fractures in postmenopausal Chinese women according to clinical risk factors and BMD T-scores: a prospective study. J Bone Miner Res 22:1080–1087CrossRefPubMed

Title: Ten-year fracture probability in Hong Kong Southern Chinese according to age and BMD femoral neck T-scores
Authors: S. W. Y. Tsang
A. W. C. Kung
J. A. Kanis
H. Johansson
A. Oden
Publication date: 01-11-2009
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 11/2009
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-009-0906-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ten-year fracture probability in Hong Kong Southern Chinese according to age and BMD femoral neck T-scores

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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