“Fragility Score: a REMS‑based indicator for the prediction of incident fragility fractures at 5 years”

Paola Pisani1 Francesco Conversano1 Maurizio Muratore2 Giovanni Adami3 Maria Luisa Brandi4 Carla Cafarelli5 Ernesto Casciaro1 Marco Di Paola1 Roberto Franchini1 Davide Gatti3 Stefano Gonnelli5 Giuseppe Guglielmi6 Fiorella Anna Lombardi1 Alessandra Natale7 Valentina Testini6 Sergio Casciaro1

Aging Clinical and Experimental Research
Received: 25 November 2022 / Accepted: 20 January 2023

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Fragility Score: a REMSbased indicator for the prediction of incident fragility fractures at 5 years

Bone fragility is a silent condition that inevitably lead bones to break, causing the occurrence of fractures. Despite the wide use of bone mineral density (BMD) measurement as standard method, it is insufficient to reliably evaluate the severity of the skeletal fragility and to predict the fracture risk of individuals. Therefore, this study assessed the performance of the Fragility Score (FS) indicator, recently implemented on the Radiofrequency Echographic Multi Spectrometry (REMS) technology in the prediction of the fracture risk at 5 years. This parameter is able to evaluate the skeletal quality and fragility of bone microarchitecture. Lumbar and femoral investigations from approximately 2000 subjects, including both females and men, were analysed and the rate of fractures at various anatomical sites was assessed during a period of 5 years. The FS effectively identified patients at risk for incident fragility fractures. The FS parameter had the highest prediction ability for any considered fracture type in both genders, resulting always significantly higher than either T-scores measured by Dual-Energy X-ray Absorptiometry (DXA) and REMS. The FS indicator represents an optimal diagnostic tool to accurately detect an imminent fracture risk in the general population.

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