Multivariate analysis of risk factors for major osteoporotic fracture risk assessed with radiofrequency echographic multi spectrometry (REMS)
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FRAX, MOF, risk factors, REMS

How to Cite

Vladeva, S., & Nikolov, N. (2022). Multivariate analysis of risk factors for major osteoporotic fracture risk assessed with radiofrequency echographic multi spectrometry (REMS). Rheumatology (Bulgaria), 30(1), 3-15.


Aim. The 10-year probability of a FRAX for a major osteoporotic fracture (MOF) above 20% is considered a high fracture risk based on health and economic estimates. The aim of the current study was to identify the multivariate significant risk factors for FRAX MOF ≥20%, calculated by BMD of the femoral neck based on a assessment with the innovative radiofrequency echographic multispectrometry (REMS) ultrasound technique for axial skeletal scans.

Object of the study. For 304 women aged 40-90 years examined by REMS, age, height, weight, body mass index (BMI), menopause and the following risk factors for calculating FRAX were assessed - previous fractures, family history of hip fractures, smoking , alcohol consumption ≥3 units daily, use of corticosteroids (CS), diagnosed rheumatoid arthritis (RA) and secondary osteoporosis.

Methodology. According to the value of FRAX MOF women were divided into two groups - with FRAX MOF <20% and with FRAX MOF ≥20%. A binary logistic regression analysis was performed to assess the multivariate significant risk factors for FRAX MOF ≥20%.

Results and conclusions. Significant risk factors in the multivariate analysis for FRAX MOF ≥20% were previous fracture, use of CS, diagnosis of RA and BMDUS of the left femoral neck. The previous fracture increased the risk of FRAX MOF ≥20% by a factor of 38.77. Women who use CS showed about a 13.5-fold higher risk of FRAX MOF ≥20% than those who do not use CS. The diagnosis of rheumatoid arthritis increases the risk of FRAX MOF ≥20% by 6.92. Any 1% increase in left femoral BMD reduced the risk of FRAX MOF ≥20% by 0.29%. This specific model, designed to predict FRAX MOF ≥20% with REMS, may be useful for deciding on therapy in women with high risk factors for FRAX MOF ≥ 20%.
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