Latest research may help doctors identify which postmenopausal women are at an increased risk for a future fracture. Researchers say the most important predictor of bone fracture in postmenopausal women without a previous fracture is bone mineral density. Bone mineral density is measured by a T-score. As the T-score decreases, the risk for fracture increases. The question has been what level of a T-score indicates an increased risk.
In one study, researchers looked at different levels of T-scores and fracture incidence within one year of bone mineral density testing. According to the World Health Organization, a T-score of -2.5 or lower indicates osteoporosis. The study showed that of 2,259 women who had fractures, only 6.4 percent of the women had a T-score of -2.5 or less. If treatment is only given to women with a T-score of -2.5 or less, many women who had fractures will miss the opportunity for treatment. Researchers say in order to reduce osteoporotic fractures doctors cannot just rely on T-scores.
The second study focused on identifying women with osteopenia at potential risk for fracture within one year of bone mineral testing. Osteopenia is indicated by a T-score of -2.5 to -1.0. The study looked at data on 57,421 women. Researchers looked at 32 risk factors for a fracture and it was found that the most important predictors of fracture included: women who had a previous fracture; a T-score at a peripheral site, such as the forearm, of -1.8 or less; self-rated poor health status and poor mobility. The classification system developed by the researchers correctly identified 74 percent of women who suffered from a future fracture.
Researchers say they hope that the above guidelines will be useful for physicians in evaluating the risk of fracture in postmenopausal women.