From the Guidelines
Patients who demonstrate known risk factors for osteoporosis according to the WHO Fracture Risk Assessment Tool (FRAX) include those with advanced age, low body mass index, previous fragility fractures, parental history of hip fracture, current smoking, excessive alcohol consumption, rheumatoid arthritis, and long-term use of oral glucocorticoids. The following patients are demonstrating known risk factors for osteoporosis:
- b. Female patient who is a 1 pack per day smoker: Smoking is a known risk factor for osteoporosis, as it can decrease bone density and increase the risk of fractures 1.
- c. Female patient who had a total hysterectomy at age 34: Early menopause, which can be caused by a hysterectomy, is a risk factor for osteoporosis, as it can lead to a decrease in estrogen levels, which are important for maintaining bone density 1.
- d. Male patient with type 1 diabetes: Certain medical conditions, such as type 1 diabetes, can increase the risk of osteoporosis, as they can affect bone health and increase the risk of fractures 1.
- e. Male patient whose parent experienced a hip fracture at age 70: A parental history of hip fracture is a known risk factor for osteoporosis, as it can indicate a genetic predisposition to the condition 1. It is essential to note that the FRAX tool evaluates these factors to calculate a patient's 10-year probability of experiencing a major osteoporotic fracture or hip fracture, which can help clinicians identify patients who would benefit from bone mineral density testing and potentially preventive treatment with medications such as bisphosphonates, denosumab, or teriparatide 1. Some of the key risk factors for osteoporosis include:
- Advanced age (particularly over 65)
- Low body mass index (under 19 kg/m²)
- Previous fragility fractures
- Parental history of hip fracture
- Current smoking
- Excessive alcohol consumption (three or more units daily)
- Rheumatoid arthritis
- Long-term use of oral glucocorticoids
- Early menopause
- Prolonged immobility
- Malabsorption disorders
- Primary hyperparathyroidism
- Certain medications such as aromatase inhibitors, androgen deprivation therapy, and some anticonvulsants 1.
From the Research
Patients Demonstrating Known Risk Factors for Osteoporosis
The following patients demonstrate known risk factors for osteoporosis according to the World Health Organization (WHO) Fracture Risk Assessment Tool:
- b. Female patient who is a 1 pack per day smoker: Smoking is a known risk factor for osteoporosis, as it can interfere with the body's ability to absorb calcium and vitamin D, leading to weaker bones 2.
- c. Female patient who had a total hysterectomy at age 34: Early menopause, such as that caused by a hysterectomy, can increase the risk of osteoporosis due to the loss of estrogen, which helps to maintain bone density 2.
- d. Male patient with type 1 diabetes: Certain medical conditions, including type 1 diabetes, can increase the risk of osteoporosis due to their impact on bone health and density 2.
- e. Male patient whose parent experienced a hip fracture at age 70: A family history of osteoporosis or fractures can increase an individual's risk of developing osteoporosis, as it may indicate a genetic predisposition to weaker bones 3, 4.
Additional Considerations
While the WHO Fracture Risk Assessment Tool takes into account various clinical risk factors, including age, sex, and bone mineral density, it is essential to consider other factors that may contribute to an individual's risk of osteoporosis, such as lifestyle and dietary habits 5, 2.
Limitations of the FRAX Tool
The FRAX tool has limitations and should not be used in all situations, as it may not accurately predict fracture risk for certain individuals, such as those with secondary osteoporosis or those taking certain medications 3, 6.