¿Debería la herramienta FRAX tener en cuenta otras variables para evaluar la fractura osteoporótica por fragilidad?

Abstract

Introduction and objective: the objective of this study was to assess the significance of variables not included in the FRAX tool regarding the incidence of osteoporotic fractures. Materials and methods: a total of 316 women older than 50 years were followed for 8 years. The variables collected (age, BMI, previous fracture, parental history of hip fracture, smoking habit, use of glucocorticoids, femoral neck BMD) and those not collected by the FRAX tool (age at menarche, menopause, fertile years, nulliparity) were studied. Results: age and parental history of hip fracture were associated with hip fractures, but so were age at menopause and fertile years. Age [odds ratio (OR), 1.09; 95 % confidence interval (CI), 1.01-1.17] and age at menopause [OR, 0.90; 95 %CI, 0.82-0.99] were associated with hip fractures after the multivariate analysis adjusted for age and BMI. BMI, femoral neck BMD and nulliparity were associated with the occurrence of Colles fractures. According to the multivariate analysis, only nulliparity was associated with Colles fractures [OR, 4.59; 95 %CI, 1.59-13.26)]. Major osteoporotic fractures were signifi-cantly associated with parental history of hip fracture, nulliparity, and fertile years. According to the multivariate analysis, the parental history of hip fracture [OR, 3.26; 95 %CI, 1.23-8.61], nulliparity [OR, 3.07; 95 %CI, 1.48-6.37], and fertile years [OR, 0.92; 95 %CI, 0.87-0.98] were associated with the occurrence of major osteoporotic fractures. Conclusions: among the FRAX variables, age and parental history of hip fracture were associated with the incidence of major osteoporotic and hip fractures. However, the significance of other gynecological variables was similar, which is indic-ative that they should certainlay be taken into consideration during patient history assessment.