10-year Probability Of Hip Fracture Research Articles

Translation, cultural adaptation and validation of the WHO fracture risk assessment tool (FRAX(®) ) into Bengali.

To develop a translated and culturally adapted Bengali version of the WHO Fracture Risk Assessment Tool (FRAX(®) ) and to test its feasibility, content validity and reliability. The English FRAX was translated and culturally adapted for use in Bangladeshi populations following established forward-backward translation methods and being extensively field-tested. The final version was interviewer-administered to 130 consecutive osteoporotic patients between 40 and 90years of age. For test-retest reliability, the questionnaire was re-administered after 14days in 60 odd serial-numbered patients. To better match with the Bengali culture, several adaptations were made to the FRAX items, including replacements and additions for tobacco, prednisolone and alcohol use. The response rate of the pre-final Bengali version of FRAX was 100% and all patients could understand the questions. Test-retest reliability (Pearson's r) in osteoporotic patients was >0.93 for all items. The culturally adapted Bengali version of the FRAX appears to be an acceptable and reliable instrument. Further studies are needed to confirm the ability of the tool to accurately predict the 10-year probability of hip and major osteoporotic fractures in the Bengali population.

AB0824 Improved Prediction of Hip Fracture Using the Health Assessment Questionnaire and FRAX in Japanese Patients with Rheumatoid Arhritis: A Prospective Observational Study

BackgroundThe World Health Organization Fracture Risk Assessment Tool (FRAX®) algorithm can be used to estimate 10-year probabilities of hip and major osteoporotic fractures. This tool has not yet been validated...

Were you identified to be at high fracture risk by FRAX® before your osteoporotic fracture occurred?

With the increasing longevity and the growing size of the aging population, China is among the developing countries with the greatest burden of osteoporotic fractures (OFs). Identification of individuals at high fracture risk to provide early treatment in developing countries with limited resources remains a challenge. Our aim was to calculate the FRAX® values in a selected mainland Chinese population the day before the occurrence of an OF and to compare the results with the Osteoporosis Foundation (NOF) thresholds. To define a population at high fracture risk, we selected patients in the orthopedic emergency cohort from Shanghai Sixth People's Hospital, China. To calculate the FRAX® the day before the actual OF, the actual fracture was not considered as a previous fracture. Subjects with a FRAX® value lower than the NOF thresholds were not considered at high risk. One-hundred ninety-eight patients were included with a mean age of 69.9 ± 10.1years old, and 78.8% were female. Major fracture sites included hip (41.9%), proximal humerus (22.2%), forearm (27.8%), spine (6.6%), and pelvis (1.5%). Overall, only two (1.0%) patients had a 10-year major fracture probability ≥20%, and 84 (42.4%) patients had a 10-year hip fracture probability ≥3%. More than half of the population was not identified to be at high risk by the FRAX® BMI (body mass index). For age groups 55-59, 60-69, 70-79, and 80-90years old, respectively, the mean FRAX® BMI values (major OF/hip fracture) were 3.5/0.7, 5.7/1.8, 8.2/4.7, and 8.6/4.8%. Dual-energy X-ray absorptiometry was available for 58 patients, and 41.2% had a T-score ≤ -2.5 standard deviation (lumbar spine and/or femoral neck and/or total hip). Only six (17.6%) patients with a normal or osteopenic BMD were classified at high risk by the FRAX® BMD (bone mineral density). The NOF thresholds could only identify fewer than half of the studied population to be at high risk the day before an actual OF, and the 10-year hip fracture probability seemed to perform better than the 10-year major fracture probability. Prospective population-based studies are needed to validate the prediction of Chinese FRAX® model and to establish ideal thresholds.

Impact of changes in mortality on FRAX-derived fracture probabilities

BackgroundAccurate hip fracture incidence and mortality rates are two essential requirements for FRAX calculators. PurposeTo investigate the effects of change in mortality on FRAX-derived fracture estimates. MethodsLebanese FRAX calculator was updated in 2012 from version 3.00 utilizing WHO mortality data from year 1999, and hip fracture incidence rates from 2007, to version 3.05 utilizing mortality data from 2009, but with identical hip fracture data. FRAX-derived estimates from 679 patients were computed using both FRAX versions and compared. Numbers presented as median [25th–75th] percentiles. ResultsThe 10-year FRAX-derived probability of major osteoporotic fracture and hip fracture increased substantially. Changes were most pronounced in high risk sub-groups. The relative increase in probability of major osteoporotic fracture in individuals with a baseline risk of 10–20% was 79% [19%–127%], and in individuals with a baseline risk >20% it was 125% (N=3). The numbers for relative increase in hip fracture probability were 98% [33%–135%], and 129%, respectively. Similarly, individuals older than 70years had a 125% [89%–150%] relative increase in probability of major osteoporotic fracture and a 122% [95%–145%] relative increase in hip fracture probability. Using the FRAX-based Lebanese guidelines, FRAX 3.05 led to an additional increase in treatment qualification of 3.8 patients per 100 patients, or a relative increase of 24%. ConclusionsUpdates in mortality values increased FRAX-derived estimates, most substantially in older patients, and those at high risk for fracture. The update results in altering individuals' treatment decisions and modifying country wide osteoporosis management. Our results are relevant to the development and update of FRAX models for countries worldwide, and more importantly those with increasing longevity and possible increase in fracture rates.

How many high risk korean patients with osteopenia could overlook treatment eligibility?

Study DesignRetrospective study.PurposeTo determine the prevalence of high risk patient with osteopenia requiring pharmacologic treatment and investigate the difference of 10-year fracture probability whether bone mineral density (BMD) include or not in Korean FRAX model.Overview of LiteratureMany people with the fracture have osteopenia rather than osteoporosis, and BMD alone could be considered as a chance to prevent fracture.MethodsThree hundred sixty-nine patients who was diagnosed as osteopenia were divided into two groups according to age (group 1, under 65 years; group 2, over 65 years), and 10-year fracture probabilities were calculated by FRAX algorithm with and without femur neck T-score.ResultsThe high risk patients of the fracture who had above 3% of 10-year hip fracture probability were 15 cases in group 1 and 121 cases in group 2. In 193 patients of group 1, the mean 10-year fracture probability with BMD was significantly higher than the results without BMD (hip fracture: p=0.04, major osteoporotic fracture: p=0.01). Unlike the results of the group 1, the mean 10-year fracture probability without BMD was significantly higher than the results with BMD in 176 patients of group 2 (hip fracture: p=0.01, major osteoporotic fracture: p=0.01).ConclusionsTotal of 136 cases (36.8%) as a high risk of the fracture with osteopenia could be overlooked treatment eligibility in Korean. The Korean FRAX model without BMD could be effective in predicting fracture risk especially in the individuals who were over 65 years.

How to decide intervention thresholds based on FRAX in central south Chinese postmenopausal women.

The FRAX tool has been used to determine possible thresholds for therapeutic intervention; however, there are no FRAX-based intervention thresholds available for China, we proposed that the 10-year probability of major osteoporotic fracture and hip fracture of about 4.0 and 1.3 %, respectively, may be acceptable intervention thresholds for central south Chinese postmenopausal women.

Strengthening the bones in primary biliary cirrhosis

Strengthening the bones in primary biliary cirrhosis

Frax Prediction without BMD for Assessment of Osteoporotic Fracture Risk

To compare Fracture Risk Assessment Tool (FRAX) calculations with and without bone mineral density (BMD) in predicting the 10-year probability of hip and major osteoporotic fractures (MOF). A cross-sectional review of patients requiring screening for osteoporosis as part of their routine medical care was conducted. Postmenopausal women and men over 50 years of age who were never diagnosed with osteoporosis or treated with U.S. Food and Drug Administration-approved agents for osteoporosis were included. Height, weight, FRAX questionnaire, femoral neck BMD, and T-score data were obtained. FRAX scores with BMD (FRAX/BMD) and without BMD (FRAX) were calculated. Subjects were separated on the basis of identical and different treatment recommendations. Fracture risk factors were compared between groups using simple Student's t test analysis of numerical variables and Fisher's exact test analysis of binary variables. Of 151 total subjects, 127 (84%) had identical fracture risk predictions with or without BMD included in the FRAX calculation. Thirty subjects met treatment criteria and 97 did not, but the FRAX prediction was the same with risk factors alone or with risk factors plus BMD. Age was the only risk factor that was significantly different between those with identical and different predictions (median age, 64.42 and 76.25 years, respectively; P<.001). In most cases, FRAX alone provides the same prediction as FRAX with BMD. Younger age is more indicative of an identical prediction.

Lumbar spine microarchitecture impairment evaluation in chronic kidney disease: a TBS study

Osteoporosis is a common bone disease characterized by low bone mass and altered bone microarchitecture, resulting in decreased bone strength with an increased risk of fractures. In clinical practice, physicians can assess the risk of fracture for a patient based on several risk factors. Some such as age, weight, and history of fractures after 50 years of age, parental fracture, smoking status, and alcohol intake are incorporated into FRAX, an assessment tool that estimates the 10-year probability of hip fracture and major osteoporotic fractures based on the individual's risk factors profile. The diagnosis of osteoporosis is currently based on bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry scans. Among other widely recognized limitations of BMD is that BMD considers only the density of the bone and fails in measuring bone microarchitecture, for which novel techniques, such as trabecular bone score (TBS), have been developed. TBS is a texture parameter related to bone microarchitecture that may provide skeletal information that is not captured from the standard BMD measurement. Several studies have examined the value of TBS on predicting osteoporotic fractures. Our study aimed to summarize a review of the current scientific literature with focus on fracture risk assessment and to present both its findings and its conclusions regarding how and when TBS should be used. The existing literature indicates that low lumbar spine TBS is associated with a history of fracture and the incidence of new fracture. The effect is largely independent of BMD and of sufficient magnitude to enhance risk stratification with BMD. The TBS effect is also independent of FRAX, with likely greatest utility for those individuals whose BMD levels lie close to an intervention threshold. The clinical and scientific evidence supporting the use of TBS, with the ability of this technology to be seamlessly integrated into a daily workflow, makes TBS an attractive and useful clinical tool for physicians to improve patient management in osteoporosis. Further research is ongoing and necessary to further clarify the role of TBS in additional specific disorders.

THU0064 Comparison of estimated fracture risk using the FRAX index calculated with and without bone densitometry in patients with early arthritis

BackgroundThe FRAX index is a tool developed by the WHO that estimates the 10-year probability of hip fracture and a major osteoporotic fracture. It is calculated using an algorithm that...

Bone metabolism and the 10-year probability of hip fracture and a major osteoporotic fracture using the country-specific FRAX algorithm in men over 50 years of age with type 2 diabetes mellitus: a case–control study

The aim of the study was to evaluate the 10-year probability of hip fracture and a major osteoporotic fracture using the FRAX algorithm, vitamin D status, bone mineral density (BMD), and biochemical markers of bone turnover in men over 50 years of age with type 2 diabetes mellitus (T2DM). We estimated FRAX-predicted 10-year fracture probability, levels of 25-hydroxyvitamin D (25-OH-D), markers of bone turnover, and bone mineral density at the L1-L4 (lumbar spine (LS)) and femur neck (FN) in 68 men with T2DM and compared these with an age-matched group (n = 68). The mean (range) age of the T2DM group was 61.4 (51-78) years. The prevalence of hypovitaminosis D (25-OH-D <75 nmol/L) was 59 %. The mean (range) FRAX hip fracture and FRAX major osteoporotic fracture was 0.7 (0-2.8) and 3.2 (0-8.5) %, respectively. BMD at the FN (0.974 vs. 0.915 g/cm(2), p = 0.008) and LS (1.221 vs. 1.068 g/cm(2), p < 0.001) was significantly higher in the T2DM cohort as compared to the healthy age-matched males. 25-OH-vitamin D (67.7 vs.79.8 nmol/L, p < 0.001), crosslaps (0.19 vs. 0.24 μg/L, p = 0.004), and osteocalcin (13.3 vs. 15.7 μg/L, p = 0.004) were significantly lower in the T2DM group. There was no difference in FRAX-related fracture probability between the two groups. Acknowledging the limitations of our study size, we suggest that the increased BMD in T2DM and the noninclusion of T2DM as a secondary risk factor in the FRAX algorithm may be probable explanations for the discordance between literature-observed and FRAX-related fracture probabilities.

Incidence of Hip Fracture in Barranquilla, Colombia, and the Development of a Colombian FRAX Model

A FRAX model for Colombia was released June 30, 2010. This article describes the data used to develop the Colombian FRAX model and illustrates its features compared to other countries. Hip fracture cases aged 50 years or more who were referred to all hospitals serving the city of Barranquilla were identified prospectively over a 3-year period (2004-2006). Age- and sex-stratified hip fracture incidence rates were computed using the 2005 census. Present and future numbers of hip fracture cases in Colombia were calculated from the age- and sex-specific incidence and the national population demography. Mortality rates for 1999 were extracted from nationwide databases and used to estimate hip fracture probabilities. For other major fractures (clinical vertebral, forearm, and humerus), incidence rates were imputed, using Swedish ratios for hip to other major osteoporotic fracture, and used to construct the FRAX model. Incidence of hip fracture increased with age, more markedly in women than in men. Over all ages, the female to male ratio was 1.7. By extrapolation, there were estimated to be 7,902 new hip fracture cases (2,673 men, 5,229 women) in Colombia in 2010, which was predicted to increase to 22,720 cases (7,568 men, 15,152 women) in 2035. The 10-year probability of hip or major fracture was increased in patients with a clinical risk factor, lower BMI, female gender, a higher age, and a decreased BMD T score. The remaining lifetime probability of hip fracture at the age of 50 years was 2.5 and 4.7 % in men and women, respectively, which were lower than rates in a Mexican population (3.8 and 8.5 %, respectively) and comparable with estimates for Venezuela (2.4 and 7.5 %, respectively). The FRAX tool is the first country-specific fracture-prediction model available in Colombia. It is based on the original FRAX methodology, which has been externally validated in several independent cohorts. Despite some limitations, the strengths make the Colombian FRAX tool a good candidate for implementation into clinical practice.

Incidence of Hip Fracture in Romania and the Development of a Romanian FRAX Model

A FRAX(®) model for Romania calibrated to the total Romanian population was released June 1, 2011. This article describes the data used to develop the Romanian FRAX model and illustrates its features compared to models for other countries. Age- and sex-stratified hip fracture incidence rates and mortality rates for 2010 were extracted from nationwide databases from the age of 40 years. For other major fractures, Romanian incidence rates were imputed, using Swedish ratios for hip to other major osteoporotic fracture (humerus, forearm, and clinically symptomatic vertebral fractures). Fracture incidence rates increased with increasing age: for hip fracture, incidence rates were higher among younger men than women but with a female preponderance from the age of 65 years. The 10-year probability of hip or major fracture was increased in patients with a clinical risk factor (CRF), lower BMI, female gender, higher age, and decreased BMD T score. Of the CRFs, a parental hip fracture accounted for the greatest increase in 10-year fracture probability. The Romanian FRAX tool is the first country-specific fracture prediction model. It is based on the original FRAX methodology, which has been externally validated in several independent cohorts. Despite some limitations, the strengths make the Romanian FRAX tool a good candidate for implementation into clinical practice.

ABSOLUTE FRACTURE RISK ASSESSMENT IN OUTPATIENTS WITH DISTAL RADIUS OSTEOPOROSIS

Objectives: to assess the absolute fracture risk in outpatients with osteoporosis (OP) at distant radius. Methods: individual absolute fracture risk was assessed using FRAX tool without hip neck bone mineral density (BMD) input in 3082 subsequent subjects (2911 females and 171 males) aged from 40 to 95 (median age 60), calculated by Finnish population data. Distant radius BMD was estimated in all patients by DTX200. Results: 774 (25.1 %) patients had had history of low traumatic fractures. BMD≤- .5 SD was detected in 1659 cases, fracture history in 558 (33.6%) of them (OR = 2.21; 95 % CI 1.93-2.55). Median 10-year probability of a major osteoporotic fracture was 4.90 % (25- 75 %; 1.10 - 55.0) and 10-year probability of a hip fracture was 0.8 % (0 - 46), absolute risk 10 % and higher was detected in 434 (64,3 %) patients. Calculated 10-year probability of a major osteoporotic fracture &gt; 10 % was associated with previous low traumatic fractures: OR = 4,55; 95 % CI 4,06- 5,10, test sensitivity being 56.1 % with specificity 89.6 % . The same association was found for 10-year probability of hip fracture &gt;3 %: OR = 3.57 (3.19 - 4.00), test sensitivity being 51,6 % with specificity 86,7 %. Conclusion: FRAX tool for individual absolute fracture risk assessment should be introduced into general practice for clinical decision making in prophylaxis of OP associated fractures.

The Predictive Accuracy of PRE-BMD FRAX Scoring in Identifying the Need for Treating Osteoporosis in Patients with Coeliac Disease

Purpose: Patients with coeliac disease are at increased risk of osteoporosis. Current guidance recommend the use of Dual-Emission X-ray absorptiometry (DEXA) scans at diagnosis of coeliac disease in order to assess for osteoporosis and guide the need for preventative therapy. The WHO fracture risk assessment web tool can be used with or without bone mineral density (BMD) to calculate a FRAX scores (10-year probability of major osteoporotic fracture and hip fracture). Patients are assigned, based on their pre-BMD FRAX outcome into low, intermediate (requiring BMD measurement) and high (requiring preventative therapy) risk groups in accordance with guidelines from the National Osteoporosis Guidelines Group (NOGG). Our study aimed to assess the accuracy of Pre-BMD FRAX scores in predicting need for preventative therapy in a coeliac cohort. Methods: We conducted a retrospective review of 70 biopsy proven coeliac disease patients who had undergone an index DEXA scan whilst attending follow up at our hospital between 2007 and 2011.Clinical data including demographics, DEXA scans was obtained from case note and electronic patient record review. Information regarding previous history of fractures and history of hip fracture in patient parents was obtained by direct interview. Pre and post-BMD FRAX assessment scores were calculated retrospectively. All coeliac patients were considered to have secondary osteoporosis as a risk factor for FRAX calculation. Pre-BMD FRAX risk status was compared with Post-BMD FRAX outcome to identify patients requiring and not requiring therapy. The study was approved by our Institutional Review Board. Results: Seventy biopsy proven coeliac patients (female 51) with a median age of 54 were analysed. Pre-BMD FRAX risk status (low and intermediate/high risk) had a sensitivity of 82 % (95 % CI 73-91) in correctly identifying 9 out of 11 patients as needing treatment. Specificity was 76% (95 % CI 66-86) identifying 44 out of 58 patients as not needing treatment. The positive predictive value (PPV) was 39% (95 % CI 28-50) with 9 out of 23 patients correctly identified as needing treatment but the negative predictive value was high 96% (95% CI 91-100) as 44 patients out 46 were correctly identified as not needing treatment. Specificity and PPV results were influenced by the intermediate risk Pre-BMD FRAX sub-group of which 12 (75%) required lifestyle advice and 4 (25%) required preventative therapy following post-BMD FRAX assessment. Conclusion: In patients with coeliac disease, pre-BMD FRAX risk status is sensitive as well as specific in predicting need for osteoporosis treatment and can help guide clinical decisions potentially avoiding DEXA scanning if appropriate.

The Accuracy of Pre Bone Mineral Density FRAX Scores in Predicting Need for Treatment in Patients with Inflammatory Bowel Disease at Risk of Osteoporosis

Purpose: Patients with Inflammatory Bowel disease (IBD) are at increased risk of Osteoporosis. Dual-Emission X-ray absorptiometry (DEXA) scans are frequently used to assess for osteoporosis and guide the need for preventative therapy. The WHO fracture risk assessment web tool can be used with or without bone mineral density (BMD) to calculate a FRAX score (10-year probability of major osteoporotic fracture and hip fracture). Patients are assigned, based on their pre-BMD FRAX outcome into low, intermediate (requiring BMD measurement) and high (requiring preventative therapy) risk groups in accordance with guidelines from the National Osteoporosis Guidelines Group (NOGG). Our study aimed to assess the accuracy of Pre-BMD FRAX scores in predicting need for preventative therapy in an IBD cohort. Methods: We conducted a retrospective review of 95 patients who had undergone an index DEXA scan whilst attending IBD clinics at our hospital between 2007 and 2011. Clinical data including demographics, disease characteristics and therapy were obtained from case note and electronic patient record review. Pre and post-BMD FRAX assessment scores were calculated retrospectively. All IBD patients were considered to have secondary osteoporosis as a risk factor for FRAX calculation. Fifteen patients were excluded as they had previously received bisphosphonates. Pre-BMD FRAX risk status was compared with Post-BMD FRAX outcome to identify patients requiring and not requiring therapy. Results: Eighty patients (female 56) with a median age of 53.8 and mean disease duration of 14.1 years were analysed. Fifty-two (65%) patients had Crohn's disease, 27 (34%) patients ulcerative colitis and 1 patient had IBD-type unclassified (IBDU). Pre-BMD FRAX risk status (low and intermediate/high risk) had a sensitivity of 100% (95% CI 87.9-100), in correctly identifying 28 out of 28 patients as needing treatment. Specificity was low at 31% (95% CI 19.9-44.3) identifying only 16 out of 52 patients as not needing treatment. The positive predictive value was low (44%; 95% CI 32.3-55.9) with 28 out of 64 patients correctly identified as needing treatment but the negative predictive value was high (100%; 95% CI 80.6-100) as all 16 patients were correctly identified as not needing treatment. Specificity and PPV results were influenced by the intermediate risk Pre-BMD FRAX sub-group of which 33 (73%) required lifestyle advice and 12 (27%) required preventative therapy following post-BMD FRAX assessment. Conclusion: In IBD patients, pre-BMD FRAX risk status is sensitive at predicting need for osteoporosis treatment and can help guide clinical decision making potentially avoiding DEXA scanning in IBD sub-groups.

The relationship between body composition and fracture risk using the FRAX model in central south Chinese postmenopausal women

To assess the relationship between body composition and fracture risk as determined by the FRAX(®) model in postmenopausal women in central south China. A cross-sectional study was conducted in 779 women. Bone mineral density (BMD) of the left femur and total body composition were measured by dual X-ray absorptiometry. All clinical information was available for incorporation into the FRAX model to assess the 10-year fracture probability. In the FRAX model, when BMD values were included, the 10-year probability of major osteoporotic fractures and hip fractures was 3·4% and 1·0%, respectively, which was significantly higher than the probability rates of 2·7% and 0·8%, respectively, for the same events when BMD values were not included (P<0·01). Both fat mass and lean mass were negatively correlated with the predicted 10-year probability of fracture (P<0·01), and femoral neck BMD was the most significant determinant of the predicted 10-year fracture probability. Compared with fat mass, lean mass had more impact on the 10-year probability of both major and hip osteoporotic fractures. In postmenopausal women in central south China, both fat mass and lean mass were negatively correlated with the predicted 10-year fracture probability. The effect of lean mass and fat mass on fracture risk may be mediated through their impact on BMD. Compared with fat mass, lean mass had more of an impact on the risk of both major osteoporotic and hip fractures, showing that physical activity is an important component in the prevention of osteoporotic fracture.

Increased Fracture Risk Assessed by Fracture Risk Assessment Tool in Greek Patients with Crohn’s Disease

The World Health Organization has recently developed the fracture risk assessment tool (FRAX) based on clinical risk factors and bone mineral density (BMD) for evaluation of the 10-year probability of a hip or a major osteoporotic fracture. The aim of this study was to evaluate the use of the FRAX tool in Greek patients with inflammatory bowel disease (IBD). FRAX scores were applied to 134 IBD patients [68 Crohn's disease (CD); 66 ulcerative colitis (UC)] who underwent dual-energy X-ray absorptiometry scans at the femoral neck and lumbar spine during the period 2007-2012. Calculation of the FRAX scores, with or without BMD, was made through a web-based probability model used to compute individual fracture probabilities according to specific clinical risk factors. The median 10-year probability of a major osteoporotic fracture for IBD patients based on clinical data was 7.1%, and including the BMD was 6.2%. A significant overestimation with the first method was found (P = 0.01). Both scores with and without BMD were significantly higher in CD patients compared with UC patients (P = 0.02 and P = 0.005, respectively). The median 10-year probability of hip fracture based on clinical data was 0.8%, and including the BMD was 0.9%. The score with use of BMD was significantly higher in CD compared with UC patients (P = 0.04). CD patients have significantly higher FRAX scores and possibly fracture risk compared with UC patients. The clinical FRAX score alone seems to overestimate the risk of osteoporotic fracture in Greek IBD patients.

PWE-239 The accuracy of pre bone mineral density frax scores in predicting need for treatment in patients with inflammatory bowel disease at risk of osteoporosis

IntroductionPatients with Inflammatory Bowel disease (IBD) are at increased risk of Osteoporosis. Dual-Emission x-ray absorptiometry (DEXA) scans are frequently used to assess for osteoporosis and guide the need for preventative...

Protective effect of myo-inositol hexaphosphate (phytate) on bone mass loss in postmenopausal women

The objective of this paper was to evaluate the relationship between urinary concentrations of InsP6, bone mass loss and risk fracture in postmenopausal women. A total of 157 postmenopausal women were included in the study: 70 had low (≤0.76 μM), 42 intermediate (0.76-1.42 μM) and 45 high (≥1.42 μM) urinary phytate concentrations. Densitometry values for neck were measured at enrollment and after 12 months (lumbar spine and femoral neck), and 10-year risk fracture was calculated using the tool FRAX(®). Individuals with low InsP6 levels had significantly greater bone mass loss in the lumbar spine (3.08 ± 0.65 % vs. 0.43 ± 0.55 %) than did those with high phytate levels. Moreover, a significantly greater percentage of women with low than with high InsP6 levels showed more than 2 % of bone mass loss in the lumbar spine (55.6 vs. 20.7 %). The 10-year fracture probability was also significantly higher in the low-phytate group compared to the high-phytate group, both in hip (0.37 ± 0.06 % vs 0.18 ± 0.04 %) and major osteoporotic fracture (2.45 ± 0.24 % vs 1.83 ± 0.11 %). It can be concluded that high urinary phytate concentrations are correlated with reduced bone mass loss in lumbar spine over 12 months and with reduced 10-year probability of hip and major osteoporotic fracture, indicating that increased phytate consumption can prevent development of osteoporosis.