PREDICTION OF FRACTURES IN PERIMENOPAUSAL WOMEN - A COMPARISON OF DUAL-ENERGY X-RAY ABSORPTIOMETRY AND BROAD-BAND ULTRASOUND ATTENUATION

Objective-To consider whether bone mineral density (BMD) measurements can predict traumatic fractures occurring in perimenopausal women. Met hods-One thousand perimenopausal women called up for screening underwe nt both dual energy x ray absorptiometry (DXA) of the spine and hip, a nd broadband ultrasound attenuation (BUA) of the heel. Two years later , they were sent a questionnaire to discover those who had since had a fracture, and compare them with those who had not. Results-About 2% o f the women had sustained a fracture in the two years since attendance for screening. Fractures in this age group can be predicted weakly, b ut significantly, by bone mass measurements using DXA and BUA (odds ra tios from 1.4 to 2.1). The lumbar spine appeared to be one of the best predictive sites (odds ratio for 1 SD reduction in BMD 2.1 (95% confi dence interval 1.2 to 3.8)), but no significant differences were found between the areas under the curve in receiver operator characteristic (ROC) analysis. Conclusion-In this preliminary study it appeared that bone mass measurements are predictive of perimenopausal traumatic fra ctures in addition to postmenopausal fractures related to osteoporosis . DXA of the lumbar spine did not perform significantly better than BU A. The number of fractures occurring was low, however, and further lon g term follow up is required to confirm the finding.