[Development and application of fracture risk assessments].

Definition of osteoporosis by BMD T-score has been accepted globally. However, the age-dependent changes in BMD values differ on the different sites for measurements and the sensitivity of BMD to predict the risk of osteoporotic fracture, assessed by the risk gradient value, is as small as 1.7. Reportedly, WHO Fracture Risk Assessment (FRAX®) tool to compute 10-year probabilities of osteoporotic fracture, is sensitive enough to select the high fracture risk subjects with the risk gradient value of 2.57 - 2.77 in Japanese men and women. The combination of the three major risk factors such as age, BMD and prevalent fractures, when both morphometric spine and clinical non-spine fracture are included, represents the value of 2.49 - 2.71. Radiographic assessment of prevalent vertebral fracture, along with FRAX®evaluation, seems to be important in assessing the fracture risk in Japanese subjects.