Prediction of postmenopausal fracture risk with use of bone mineral measurements.

In a study of 1098 women (mean age, 63.3 years) nonspine fracture incidence and prevalence rates and spine fracture prevalence rates were compared by quintile of bone mineral content at the proximal radius, distal radius, os calcis, and lumbar spine. The risk of fracture associated with varying bone mineral content levels was explored with use of estimated odds ratios. Risk of fracture is significantly increased with diminishing quintiles of bone mineral content. Subjects in the lowest quintile of os calcis bone mineral content have a nonspine fracture risk 10 times greater than subjects in the highest bone mineral content quintile. The os calcis bone mineral content measurement is the best predictor of nonspine fracture risk and is also the best overall indicator of spine fracture risk. Therefore measurement of os calcis bone mineral content may be useful for routine risk evaluation of perimenopausal women. The ability to predict individual risk should allow for more rational preventive regimens.