Performance of FRAX in Predicting Fractures in US Postmenopausal Women with Varied Race and Genetic Profiles
Document Type
Article
Publication Date
1-20-2020
Publication Title
Journal of Clinical Medicine
Volume
9
Issue
1
First page number:
1
Last page number:
15
Abstract
BACKGROUND: Whether the Fracture Risk Assessment Tool (FRAX) performed differently in estimating the 10-year fracture probability in women of different genetic profiling and race remained unclear. METHODS: The genomic data in the Women's Health Initiative (WHI) study was analyzed (n = 23,981). The genetic risk score (GRS) was calculated from 14 fracture-associated single nucleotide polymorphisms (SNPs) for each participant. FRAX without bone mineral density (BMD) was used to estimate fracture probability. RESULTS: FRAX significantly overestimated the risk of major osteoporotic fracture (MOF) in the WHI study. The most significant overestimation was observed in women with low GRS (predicted/observed ratio (POR): 1.61, 95% CI: 1.45-1.79) specifically Asian women (POR: 3.5, 95% CI 2.48-4.81) and in African American women (POR: 2.59, 95% CI: 2.33-2.87). Compared to the low GRS group, the 10-year probability of MOF adjusted for the FRAX score was 21% and 30% higher in the median GRS group and high GRS group, respectively. Asian, African American, and Hispanic women respectively had a 78%, 76%, and 56% lower hazard than Caucasian women after the FRAX score was adjusted. The results were similar for hip fractures. CONCLUSIONS: Our study suggested the FRAX performance varies significantly by both genetic profile and race in postmenopausal women.
Keywords
Genetic Risk Score (GRS); Bone Mineral Density (BMD); Single Nucleotide Polymorphism (SNP); Fracture Risk Assessment Tool (FRAX)
Disciplines
Medicine and Health Sciences
Language
English
Repository Citation
Wu, Q.,
Xiao, X.,
Xu, Y.
(2020).
Performance of FRAX in Predicting Fractures in US Postmenopausal Women with Varied Race and Genetic Profiles.
Journal of Clinical Medicine, 9(1),
1-15.
http://dx.doi.org/10.3390/jcm9010285