Importance of bone mineral density measurements in evaluating fragility bone fracture risk in Asian Indian men

Summary We evaluated the effect of BMD on fracture risk prediction using FRAXR among Asian Indian men when used in conjunction with clinical risk factors. A majority of our subjects were either osteopenic or osteoporotic, and their fracture risk increased when FRAXR was used in conjunction with femur neck T-scores. Introduction Asian Indian men living in the United States may represent a population that is at high and underappreciated risk for fragility bone fractures. Purpose To evaluate the effect of BMD on fracture risk prediction using FRAXR among Asian Indian men when used in conjunction with clinical risk factors. Methods Forty four Asian Indian men (mean age 64.9 (پ}8.4) years) who had lived in the United States for an average of 33.6 (پ}10.6) years underwent BMD measurement at the proximal femur. Subjects were subjected to a general physical exam and history of fracture, hip fracture in a parent, current smoking and alcohol use, and diagnosis of inflammatory arthritis was obtained. Data from each subject were entered into the FRAXR algorithm and 10-year fracture probabilities were calculated using clinical risk factors (CRFs) alone and in combination with femur neck T-scores. Results Thirteen subjects (29.5%) had femur neck T-scores..1.0, 28 (63.6%) T-scores between .1.0 and .2.5, and three (6.8%) T-scores<.2.5. The 10-year probability of a major osteoporotic fracture based on a combination of clinical risk factors and femur neck T-scores was significantly higher than the fracture probability based on clinical risk factors alone (t(43)=2.58, p=0.01). Conclusions Among Asian Indian men, the 10-year probability of a major osteoporotic fracture increases when femur neck T-scores are added to clinical risk factors in the FRAXR algorithm, and this population have a high fracture probability even in the absence of clinical risk factors.