[Evaluation of the FRAX® Tool for Identifying Menopausal Women Under 65 Eligible for Bone Densitometry Screening]

Osteoporosis have been defined as the decrease in bone resistance that predisposes to fragility fractures. 50% of women over 50 years of age will suffer an osteoporotic fracture during their lifetime. Densitometry allows detecting mineral density and women with osteoporosis. The FRAX tool combines risk factors and permit calculating the high risk of major fracture than 10 years, the cutoff point in Chile being 3.2%.

To assess the ability of the FRAX tool to identify osteoporosis in menopausal women under 65 years of age.

Retrospective study of patients aged 50 to 64 years treated in the climacteric program at Clínica Santa María between 2019 and 2022.

A total of 264 women had bone densitometry (DXA) and FRAX assessment at baseline. The mean age was 57.4 years (SD ±4). A total of 53 patients had a calculated 10-year major osteoporotic fracture risk ≥3.2%. Bone densitometry with a T-score <-2.5 was found in 33 women. The sensitivity of FRAX to identify women with osteoporosis on DXA was 24.2%, detecting only 8 of the 33 women with T-score <-2.5.

Our results show that the FRAX alone fails to identify the majority of patients under 65 years of age at high risk of fracture who benefit of bone densitometry. More studies are needed to characterize menopausal women younger than 65 years with a T-score less than -2.5 in DO and a FRAX MOF risk less than 3.2%.