Outcomes of Applying the NOF, NOGG and Taiwanese Guidelines to a Cohort of Chinese Early Postmenopausal Women

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 248-267-Osteoporosis II
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-248
Elaine Yun Ning Cheung*1, Annie Wai-Chee Kung2 and Kathryn CB Tan3
1United Christian Hospital, Hong Kong, Hong Kong, 2The Univeristy of Hong Kong, Hong Kong, 3Univ of Hong Kong, Hong Kong
Outcomes of Applying the NOF, NOGG and Taiwanese Guidelines to a Cohort of Chinese Early Postmenopausal Women

Elaine Cheung 1, A. W. Kung 2, Kathryn CB Tan2

1Department of Medicine & Geriatrics, United Christian Hospital, 2Department of Medicine, Queen Mary Hospital, Hong Kong, China SAR



We applied the NOF (National Osteoporosis Foundation, U.S.A.), NOGG (National Osteoporosis Guideline Group, U.K.) and Taiwanese guidelines to a cohort of young, Southern Chinese, postmenopausal women, and compared the treatment recommendations and fracture outcomes over 4.5 years.


Design: This study is part of the Hong Kong Osteoporosis Study in which postmenopausal women underwent regular assessment and followed up for fracture outcome.


Subjects: We studied 2266 treatment-naïve postmenopausal women with mean age of 62.1 years and mean follow-up of 4.5 years.

Measurement: The treatment recommendations based on different guidelines were compared. The women were followed up to determine the rate of fracture occurrence at the hip, clinical spine, humerus and distal radius.

Results: A total of 106 new major osteoporotic fractures were reported, of which 21 were hip fractures. Application of the NOF, NOGG and Taiwanese guidelines resulted in BMD screening of 40.7%, 17% and 31.8% of the cohort and treatment of 26.8%, 17.8% and 25.4% of the cohort, respectively. The NOF, NOGG and Taiwanese guidelines correctly identified 85.7%, 52.3% and 85.7% of the hip fractures and 58.5%, 35.8% and 59.4% of the major osteoporotic fractures, respectively.


Conclusion: Of the 3 guidelines, the application of the Taiwanese guidelines to guide BMD screening and treatment strategies for fracture prevention among Chinese postmenopausal women appears to be the most cost-effective. According to the Taiwanese guidelines, BMD screening is recommended for postmenopausal women aged older than 65 years and those younger with risk factors. The Taiwanese guidelines suggest treatment for postmenopausal women with osteoporotic fracture after 50 years of age. Apart from these subjects, other postmenopausal women would be treated if their FRAX with T-score reveals a 10-year major osteoporotic fracture risk 20% or a hip fracture risk 3%. The Taiwanese guidelines do not differentiate between those with osteoporosis or osteopenia, as in the NOF guidelines, and instead rely on the absolute 10-year fracture risk calculated by FRAX. Effort is still needed to improve the sensitivity of the Taiwanese guidelines, particularly for non-osteoporotic subjects, and specificity among the subjects aged 65 and older

Nothing to Disclose: EYNC, AWCK, KCT

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: The Osteoporosis and Endocrine Research Fund, The University of Hong Kong.
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