Association of the FRACTURE Index With Bone Mineral Density and Fracture Risk Stratification in Postmenopausal Women:...

Introduction Osteoporosis is a major public health concern among postmenopausal women due to accelerated bone loss and increased susceptibility to fragility fractures. Although bone mineral density (BMD) assessment using dual-energy X-ray absorptiometry (DEXA) is the standard diagnostic tool, fracture risk is influenced by multiple clinical factors beyond BMD alone. The FRACTURE Index is a validated clinical risk assessment tool that integrates several key predictors to estimate future fracture risk. Objective To evaluate the association between the FRACTURE Index and bone mineral density and to assess its role in fracture risk stratification among postmenopausal women. Methods This hospital-based cross-sectional study included 102 postmenopausal women aged ≥45 years who underwent DEXA scanning. Bone mineral density was classified according to World Health Organization criteria. Future fracture risk was assessed using the FRACTURE Index. Descriptive statistics were used for data summarization, while associations were analyzed using chi-square tests and Pearson correlation coefficients. Results Among the participants, 31 women (30.4%) were osteoporotic, 47 (46.1%) were osteopenic, and 24 (23.5%) had normal BMD. A FRACTURE Index score ≥6, indicating high future fracture risk, was observed in 42 women (41.2%). Higher FRACTURE Index scores were significantly associated with lower lumbar spine T-scores (r = -0.759, p < 0.001), increasing age (r = 0.63, p < 0.001), prior fracture history (χ² = 38.07, p < 0.001), and maternal history of fracture (χ² = 25.83, p < 0.001). Conclusion The FRACTURE Index effectively identifies postmenopausal women at high risk of future osteoporotic fractures and demonstrates a strong association with bone mineral density. Its integration into routine clinical screening may enhance early risk stratification and preventive strategies, particularly in resource-limited settings.