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Note: The diagnostic category is based on the T-score at the femoral neck, using the 1995 NHANES III reference data for non-Hispanic white women.

Adapted from Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B. Ten year probabilities of osteoporotic fracture according to BMD and diagnostic thresholds. Osteoporos Int 2001;12:989-995 with permission of the publisher. © Springer-Verlag

Note: The diagnostic category is based on the T-score at the femoral neck, using the 1995 NHANES III reference data for non-Hispanic white women.

Adapted from Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B. Ten year probabilities of osteoporotic fracture according to BMD and diagnostic thresholds. Osteoporos Int 2001;12:989-995 with permission of the publisher. © Springer-Verlag mortality from Sweden are robust, fracture rates are high and mortality is low compared to other parts of the world.

Another approach to 10-year fracture risk, which also suggests levels for intervention, has been proposed using guidelines developed by the NIH (16) for the detection and treatment of high cholesterol in the prevention of heart disease (17). These guidelines defined high risk for heart disease as a 10-year risk greater than 20%. Moderate risk was a 10-year risk from 10 to 20% and low risk, a 10-year risk of less than 10%.

Fig. 10-3. Ten-year global fracture risk stratified by risk probabilities of 10 and 20% based on age and femoral neck T-score. Reproduced courtesy of Dr. Ken Faulkner, GE Medical Systems, Madison, WI.

Fig. 10-3. Ten-year global fracture risk stratified by risk probabilities of 10 and 20% based on age and femoral neck T-score. Reproduced courtesy of Dr. Ken Faulkner, GE Medical Systems, Madison, WI.

In an analogous fashion, the 10-year risk for all fractures (global fracture risk) for any given age and BMD that corresponds to 10 and 20% can be calculated and presented in graphic form as shown in Fig. 10-3. Interestingly, at age 65, a 20% 10-year risk for all fractures occurs at a T-score of -2.5. A T-score of -1 at age 65 results in a 10% 10-year fracture risk.

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