Study Compares Fracture Risks Between Osteoporosis, Osteopenia

Osteoporosis and osteopenia both lead to an increased risk of bone fractures in patients, which can lead to disability and cause a significant burden. A recent study compared the fracture risk between these 2 conditions, finding that patients suffering from osteopenia had a significantly higher fracture risk because of their weight compared to those with osteoporosis, whereas patients with osteoporosis had a higher fracture risk because of previous fractures compared to those with osteopenia.

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The researchers conducted a cross-sectional study with 82 patients—46 with osteoporosis and 36 with osteopenia. The fracture risk of each patient was evaluated using the Fracture Assessment Risk (FRAX) index that considered clinical fracture risks or combination of clinical fracture risks and bone density. The researchers collected their patient data through a face-to-face questionnaire with the patients.

“By using FRAX index, it is possible to establish 10-year fracture risk, depending on the age, and life expectancy of clinical fracture risk,” explained the authors. “The introduction of FRAX index has assisted with the identification of patients of low, intermediate, and high fracture risks. For patients with intermediate fracture risk, some additional prevention measures are advised, such as measuring of femur density and reassessment of the risk.”

The results demonstrated statistically significant differences in representation of specific fracture risks between those with osteoporosis and osteopenia, involving weight and previous fractures. Specifically, patients with osteopenia had a significantly higher fracture risk compared to those with osteoporosis, because of their weight. However, patients suffering from osteoporosis had higher fracture risk in comparison to patients with osteopenia, because of previous fractures.

Using the FRAX calculator, the researchers categorized patients into 3 risk levels based on the National Osteoporosis Guideline Group (NOGG) guidelines. The majority of patients (58.7%) had a low risk of major osteoporotic fractures (MOFs), less than one-third of patients had an intermediate risk, and 10.87% had a high risk. For hip fracture, the majority of patients with osteoporosis (56.52%) had low fracture risk, 39.96% had high risk, and 6.52% had intermediate risk.

As for osteopenia, 91.67% of patients had a low risk level for hip fracture, while 5.56% of patients with osteopenia had a high-risk level of hip fracture. Additionally, only 1 patient had an intermediate risk level of hip fracture, according to the results.

“These findings are consistent with those from a previous research, which has shown that reduced BMI significantly affects the occurrence of osteoporotic fractures, and from another study, which suggested that patients with existing fracture due to osteoporosis have five times the risk of fracture compared to those with no history of fracture,” noted the authors.

The researchers suggested these results may be useful in the resign of future interventional strategies to prevent or reduce the risk of fracture. They emphasize that for who suffer from an increased fracture risk, individual therapeutic programs should be adopted.

Reference

Tomasevic-Todorovic S, Vazic A, Issaka A, Hanna F. Comparative assessment of fracture risk among osteoporosis and osteopenia patients: a cross-sectional study. [published online May 30, 2018]. Open Access Rheumatol. doi: 10.2147/OARRR.S151307.