Efficiency of bone density testing by dual-biphotonic X-rays absorptiometry for diagnosis of osteoporosis according to French guideline recommendations: the PRESAGE study.

Objectives And Methods: Bone mineral density is a major risk factor of fracture. Its measurement is reimbursed by French national health insurance according to clinical criteria. In this multicentre cross-sectional observational study, we estimated the proportion of postmenopausal women with osteoporosis among those referred for a bone mineral density measurement. Risk factors for osteoporosis and therapeutic recommendations were described.

Results: Six hundred and forty-six postmenopausal women were evaluated. Osteoporosis was diagnosed in 57.6%, osteopenia in 38.7% and a normal bone mineral density in 3.7%. The main risk factors for fracture were personal history of fracture (40%), family fracture (23%), smoking (15%) and glucocorticoids use (15%). Anti-osteoporosis drug was recommended for 93% of women with osteoporosis and for 45% of women with osteopenia. A logistic regression analysis showed that a T-score=-2.5 was the most important factor related to the treatment decision-making. Cluster analysis identified five types of women with different combinations of fracture risk factors. The percentage of postmenopausal women -96.3% - referred for bone mineral density and for whom a treatment could be recommended had osteoporosis or osteopenia.

Conclusion: In spite of recommendations, the physician therapeutic decision-making was mainly based on the bone mineral density result.