Clinics (Sao Paulo). 2017 May; 72(5): 289-293.

Copyright © 2017 CLINICS

The Effect of FRAX on the Prediction of Osteoporotic Fractures in Urban Middle-aged and Elderly Healthy Chinese Adults

Jun Wang I , Xuejun Wang II , Zhen Fang II , Nanjia Lu III , Liyuan Han III *

Director’s Office, Minglou Street Community Health Service Center, Jiangdong District, Ningbo, China

Director’s Office, Dongliu Street Community Health Service Center, Jiangdong District, Ningbo, China

Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China

*Corresponding author. E-mail:

received October 8, 2016; revised February 9, 2017; accepted February 24, 2017.



We aimed to analyze the applicability of a fracture risk assessment tool for the prediction of osteoporotic fractures in middle-aged and elderly healthy Chinese adults.


A standard questionnaire was administered, and bone mineral density was measured in residents visiting the Dongliu Street Community Health Service Center. Paired t-tests were used to compare the FRAX-based probabilities of fractures estimated with and without consideration of bone mineral density. Risk stratification and partial correlation analyses were applied to analyze the associations between FRAX-based probabilities and body mass index or bone mineral density at different sites.


A total of 444 subjects were included in this study. Of these subjects, 175 (39.59%) were diagnosed as osteoporotic, and 208 (47.06%) were diagnosed as osteopenic. The Kappa value for the detection of osteoporosis at the L1-L4 lumbar spine and femoral neck was 0.314. The FRAX-based 10-year major osteoporotic fracture probability and hip osteoporotic fracture probability estimated without considering bone mineral density were 4.93% and 1.64%, respectively; when estimated while considering bone mineral density, these probabilities were 4.97% and 1.54%, respectively. A significant positive association was observed between the FRAX-based fracture probabilities estimated with and without consideration of bone mineral density, while significant negative associations between body mass index and the estimated FRAX-based fracture probabilities after adjustment for age and the estimated FRAX-based fracture probabilities and femoral neck bone mineral density were identified. These results remained the same after controlling for lumbar spine bone mineral density.


The Chinese FRAX model could predict osteoporotic fracture risk regardless of whether bone mineral density was considered and was especially appropriate for predicting osteoporotic fractures of the femoral neck.

Keywords: FRAX, Osteoporotic Fracture, Bone Mineral Density

Articles from Clinics are provided here courtesy of
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

2nd © Copyright 2007 - Revista Clinics - All rights reserved