Assessment of fracture risk among postmenopausal Sudanese women: Is the fracture risk assessment score beneficial?

Abstract

Objectives: Osteoporosis leads to fragile bones with a high risk of fracture. Moreover, a bone mineral density test has low sensitivity to predict fractures. Alternatively, the World Health Organization fracture risk assessment (FRAX) tool helps improve the prediction of fractures in women even before they develop osteoporosis. This study aimed to assess the risk of developing fractures in Sudanese women using the FRAX tool by studying clinical risk factors that lead to decreased bone strength. Methods: A cross-sectional community-based study was conducted in the River Nile State, Sudan (Jan 2020–June 2020). A questionnaire comprising demographic data and clinical risk factors of fragility fracture was used to determine whether these factors met the FRAX criteria. Results: Participants were 350 postmenopausal women between the ages of 51–60 (36%), with a body mass index (BMI) >25 in 61.4%. In addition, 11% were exposed to oral glucocorticoids, and premature menopause occurred among 20.3%. The risk of major osteoporotic fracture was highest (>20%) in approximately 7% of the women, and 16.3% of them had a high risk of hip fracture (>3%). The risk for fractures increases with age, and a lower BMI is significantly associated with minimal trauma fractures. This study observed significant relationships among systemic glucocorticoid use, insulin-dependent diabetes mellitus, premature menopause, and osteoporotic fractures. All significant associations had P < 0.05. Conclusion: This study observed that multiple risk factors significantly correlated with osteoporotic fractures. Therefore, the FRAX tool is useful in 10-year fracture risk predictions.