It is unclear as to whether western dwelling South Asian (SA) postmenopausal women have a different fracture risk to that of the native Caucasian (C) population. Moreover, the WHO Fracture Risk Assessment Tool (FRAX) has not been used previously to compare predicted risk of fractures in western dwelling South Asian women with same-age Caucasian women. This analysis used data from n=35 SA [mean (S.D.) age=59 (6) years] and n=136 C [mean (S.D.) age=61 (5) years] postmenopausal women in the D-FINES I study (UK, 20062007). FRAX score was calculated using femoral neck arial BMD (FN aBMD) and background demographic data, via the online tools at www.shef.ac.uk/FRAX/. The SA women were scored on both the India and UK tools as it was unclear which was likely to be the best epidemiological fit. There was no difference (P>0.05) between the two ethnic groups for FN aBMD (P=0.44). However, the 10 year fracture risk (%) was lower in the SA group (using the India tool) than the C group by 5060% (see table below). Similar results were obtained when using the UK tool in the SA group, with 2850% lower risk of fractures in SA than in C. The reduced FRAX score in the SA group has not been reported previously and may be due to a variety of lifestyle and medical factors, as well as possible differential reporting of family history of fracture. Further research is warranted with respect to future fracture risk in this ethnic group. These data will be helpful in the clinical setting.
|C (UK) n=136||SA (India) n=35||SA (UK) n=35|
|Group (Tool) n 10 year probability:||Median||IQR||Median||IQR||P*||Median||IQR|
|O. Fracture %||6.5||4.4||2.5||2.5||<0.001||4.7±||2.5|
|H. Fracture %||0.4||0.8||0.2||0.5||0.006||0.2±||0.6|
|FN aBMD (g/cm2)||0.76||0.11||0.77||0.1||0.44|||||
|*MannWhitney: C (UK) vs SA (India), O.=Osteoporotic, H.=Hip, ≠ANCOVA P value for BMI adjusted data. ±Statistically different from SA (India) and C (UK) using Wilcoxon test (P<0.005).|
The D-FINES I study was funded by the UK Food Standards Agency (Project N05064). All views expressed as those of the authors alone and do not constitute government advice.
14 May 2016 - 17 May 2016