Risk Factors for Osteoporosis and 10-year Absolute Fracture Risk in a National Representative Sample of Bulgarian women Aged 50 Years and Older

Author: A-M. Borissova, R. Rashkov, M. Boyanov, A. Shinkov, P. Popivanov, N. Temelkova, J. Vlahov, M. Gavrailova

Abstract:

The Bulgarian Osteoporosis Epidemiology Study was implemented by the National Program against Osteoporosis in Bulgaria 2005- 2010. This original work is a part of the aforementioned study and its objective was to determine the prevalence of the major risk factors for osteoporosis and the 10-year absolute fracture risk in a national representative sample of Bulgarian women aged 50 and older. The National Statistical Institute selected a national represen- tative epidemiological sample, a questionnaire was implemented searching for major risk factors for osteoporosis and allowing fracture risk calculation according to FRAX. Ten National Osteoporosis centers throughout the country participated. BMD was measured at the proximal femur (femoral neck). The statistical analysis was performed on SPSS 13,0 for Windows. One thousand three hundred thirty one women were included (mean age 63,8±8,3 yrs), grouped into decades. The mean 10-year absolute fracture risk for major fractures was 13,4±9,2%, and for hip fractures 2,8±5,2%. The mean risk for hip fractures rose above the critical threshold at the age of 65 and that for major fractures – later at the age of 70-75. The prevalence of some major risk factors for osteoporosis was as follows: height loss > 3 cm – 33,1% of all women, family history of hip fractures – 4,1%, previous clinical hip fractures – 1,9 %, previous vertebral fractures – 2,3%, all fractures – 23,3%, smoking – 11,9%. The factors associated with significantly increased fracture risk were height loss, smoking and previous fractures. In conclusion, our study is the largest one in Bulgaria and allows assumptions about the prevalence of osteoporotic fractures among women aged 50 and older in our country – about 30436 women with hip fractures, about 36844 with vertebral fractures (clinically confirmed).