# Association of the FRACTURE Index With Bone Mineral Density and Fracture Risk Stratification in Postmenopausal Women: A Cross-Sectional Study

## TL;DR

This study shows that the FRACTURE Index is a useful tool for identifying postmenopausal women at high risk of fractures and is strongly linked to bone density levels.

## Contribution

The study demonstrates the FRACTURE Index's effectiveness in fracture risk stratification and its association with BMD in postmenopausal women.

## Key findings

- 41.2% of participants had a FRACTURE Index score ≥6, indicating high fracture risk.
- Higher FRACTURE Index scores were strongly correlated with lower lumbar spine T-scores and older age.
- Prior fracture history and maternal fracture history were significantly associated with higher FRACTURE Index scores.

## Abstract

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.