| Objective To apply the fracture risk assessment tool (FRAX) to assess the risk of osteoporotic fracture in the middle-aged and elderly population in Nanchang City, to compare the difference in fracture risk between men and women, and to analyze the correlation between fracture risk and bone mineral density (BMD), and bone metabolism biochemical markers. Methods The survey was conducted in Xihu District and Qingshanhu District in Nanchang in June 2018. Participants received questionnaires (including age and disease history, etc.), physical examination (measurement of height and weight, etc.), and bone densitometry and laboratory tests (including blood glucose and bone metabolism biochemical markers, etc.). The probability of major osteoporotic fracture (PMOF) and probability of hip fracture (PHF) in the next 10 years were calculated using the FRAX. The collected data were statistically analyzed using SPSS software. Results A total of 1051 Nanchang residents aged 40-90 years were surveyed, including 250 men and 801 women, with an average age of 59±8 years. The prevalence of osteoporosis was 33.4%, with a prevalence of 21.6% in men and 36.9% in women. The PHF, lumbar BMD, femoral neck BMD, and 25-hydroxyvitamin D (25OHD) levels in men were higher than those in women. PMOF, blood phosphorus (P), osteocalcin (OC), and β-carboxy-terminal cross-linked telopeptide of type 1 collagen (β-CTX) levels were lower than those in women. Spearman correlation and stepwise linear regression analysis showed that among all participants, PMOF was negatively correlated with lumbar BMD, femoral neck BMD, and blood Ca levels, and was positively correlated with β-CTX levels. PHF was negatively correlated with lumbar BMD, femoral neck BMD, blood calcium (Ca), P, and OC levels, and was positively correlated with 25OHD and β-CTX levels. In male participants, PMOF was negatively correlated with lumbar BMD and femoral neck BMD. PHF was negatively correlated with femoral neck BMD. Among female participants, both PMOF and PHF were negatively correlated with lumbar BMD, femoral neck BMD, and blood Ca levels, and were positively correlated with β-CTX levels (all P values<0.05). Conclusion The FRAX values are not only related to BMD, but also related to a number of bone metabolism biochemical markers. The correlation between the FRAX values and bone resorption marker β-CTX is more precise than the bone formation marker OC. Therefore, the combination of FRAX with BMD and bone metabolism biochemical markers may better predict the risk of osteoporotic fractures. |