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Bone Abstracts (2013) 1 PP368 | DOI: 10.1530/boneabs.1.PP368

ECTS2013 Poster Presentations Osteoporosis: pathophysiology and epidemiology (49 abstracts)

Portuguese and spanish FRAX® tool versions: a comparative analysis from EpiReumaPt

Nelia Gouveia 1 , Helena Canhao 1, , Tania Rego 1 , Susana Sousa 1 & Jaime Branco 1,


1Sociedade Portuguesa de Reumatologia; Equipa de Investigação do EpiReumaPt, Lisbon, Portugal; 2Instituto de Medicina Molecular da, Faculdade de Medicina da, Universidade de Lisboa; Serviço de Reumatologia, Centro Hospitalar de Lisboa Norte, Hospital de Santa Maria, EPE, Lisbon, Portugal; 3CEDOC, Faculdade de Ciências Médicas da, Universidade Nova de Lisboa, Serviço de Reumatologia, Centro Hospitalar de Lisboa Ocidental, EPE/Hospital Egas Moniz, Lisbon, Portugal.


EpiReumaPt is a cross-sectional, epidemiologic study to estimate the prevalence of rheumatic diseases in Portugal. Selected cases randomized from the 10 000 Portuguese subjects recruited are eventually observed by a rheumatologist. Portuguese and Spanish FRAX® tool were applied. The major osteoporotic (MOFR) and hip (HFR) fracture risk were calculated without DXA results.

The FRAX tool has been developed by WHO to evaluate 10 years fracture risk. It was validated for many countries, including Spain and Portugal.

A comparative analysis of risk fracture evaluation by Portuguese and Spanish FRAX tool was made on 1444 subjects observed by a rheumatologist. Mean age was 57.98 years old (S.D. 15.34), 67.3% were women and 95% were Caucasians.

In the total sample the difference between the mean MOFR assessed by the Portuguese algorithm (4.74 (S.D. 5.9)) and the Spanish (4.4 (S.D. 5.25)) was statistically significant (P=0.000). The same was observed to mean HFR difference between Portuguese algorithm (1.8 (S.D. 3.96)) and the Spanish one (1.6 (S.D. 3.7)) (P=0.000).

The results from Portuguese and Spanish FRAX® tool were statistically significant in women for MOFR and for both sexes for HFR (Table 1).

Table 1
Major Osteoporotic riskHip Fracture risk
Portuguese toolSpanish toolP valuePortuguese toolSpanish toolP value
Female5.565.090.00002.091.840.0000
(n=972)S.D. 6.77S.D. 5.96S.D. 4.54S.D. 4.21
Male3.072.990.2521.171.060.0063
(n=472)S.D. 3.01S.D. 2.9S.D. 2.23S.D. 2.25
The difference between Portuguese and Spanish FRAX® data was also statistically significant for subjects with ≥ 40 years old (MOFR: Portuguese =5.34 (S.D. 6.19), Spanish =4.77 (S.D. 5.58), P=0.0000); (HFR: Portuguese =2.06 (S.D. 4.21), Spanish =1.83 (S.D. 3.94), P=0.0000).

Conclusions: Significant statistically differences were observed in 10 year major and hip fracture risk when the Portuguese or the Spanish FRAX algorithms were applied. Yet the clinical impact of these differences is unknown, it suggests that the FRAX tool should be validated and selected for the specific population.

Volume 1

European Calcified Tissue Society Congress 2013

Lisbon, Portugal
18 May 2013 - 22 May 2013

European Calcified Tissue Society 

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