Ultrasonic measurement of BMD,FRAX^® and OSTA in the prediction of fracture risk in maintenance hemodialysis

Objective To evaluate and compare the validity of quantitative ultrasound bone measurements (QUS) to measure the bone mineral density (BMD), FRAX and OSTA for predicting fracture risk in maintenance hemodialysis (MHD) patients.Methods 113 patients from the Blood Purification Center of Nanchong Central Hospital from January 2013 to January 2015 were fitted in this study. The demographic information, clinical risk factors of osteoporosis, and the data of BMD from one third of distal radius about the MHD patients were collected. The probability of fracture risk in MHD patients was calculated by FRAX and OSTA. ROC curves were drawn. The validity of BMD, FRAX and OSTA for predicting fracture risk in MHD patients was compared.Results 113 patients were fitted in predicting fracture risk. There were 63 females and 50 males with age ranging 13-83 years (mean 56.6±16.0 years). The fracture group had 14 (12.39%) patients, and the control group had 99 (87.61%) patients. The average BMD in the fracture group and control group was -3.69±2.32 and -2.09±1.91 respectively (P<0.05). The FRAX^® index showed significant difference between the two groups (z=-4.837, P<0.01). The average score in the fracture group and control group was -3.69±2.76 and 0.46±3.60 respectively (P<0.05). AUC areas of ROC curves of BMD, FRAX^® and OSTA were 0.688 (95% CI 0.534-0.842); 0.900 (95% CI 0.816-0.984); 0.868 (95% CI 0.793-0.942), respectively. The cutoff values of BMD, FRAX^® and OSTA were -2.45, 3.25 and -2.93 respectively.Conclusions All of BMD, FRAX^® and OSTA may discriminate fracture risk among MHD patients and FRAX^® had the higher validity.