Table 2.

Discrimination (Area under the ROC curve: AUC) and reclassification for fracture in three MrOS cohort from base model of FRAX (10 year probability of fracture, calculated with knowing BMD)

	Sweden (N = 2516)				US (N = 1469)*				Hong Kong (N = 1476)
		Reclassification				Reclassification				Reclassification
	AUC	Category-free (4-decimal) NRI (95% CI)			AUC	Category-free (4-decimal) NRI (95% CI)			AUC	Category-free (4-decimal) NRI (95% CI)
		Combined	Event	Non-event		Combined	Event	Non-event		Combined	Event	Non-event
Hip Fracture	N=173				N=47				N=45
Base model	0.72				0.78				0.74
Bio T	0.71	0.05 (−0.10,0.21)	0.08	−0.02	0.79	−0.07 (−0.36,0.22)	−0.05	−0.02	0.72	0.33 (0.04,0.62)	0.20	0.13
Low BioT (<163.5 ng/dl)	0.72	0.03 (−0.12,0.18)	−0.66	0.69	0.75	0.18 (−0.09,0.45)	−0.44	0.62	0.75	0.10 (−0.08,0.29)	−0.78	0.88
Bio E2	0.71	0.11 (−0.04,0.26)	0.11	0.00	0.78	−0.03 (−0.34,0.27)	−0.02	−0.01	0.73	0.34 (0.05,0.62)	0.27	0.07
Low BioE2 (<11.4 pg/ml)	0.70	0.26 (0.10,0.41)	−0.10	0.36	0.75	0.19 (−0.11,0.49)	−0.07	0.26	0.73	0.20 (−0.07,0.47)	−0.42	0.62
Total T	0.72	−0.07 (−0.22,0.08)	0.02	−0.09	0.78	−0.07 (−0.35,0.20)	−0.17	0.10	0.74	0.12 (−0.16,0.40)	0.18	−0.06
Low TotalT (≤300 ng/dl)	0.72	0.02 (−0.14,0.17)	0.68	−0.66	0.76	0.09 (−0.13,0.31)	0.66	−0.57	0.75	0.07 (−0.11,0.26)	−0.78	0.85
Total E2	0.71	0.08 (−0.07,0.24)	0.14	−0.06	0.78	−0.05 (−0.32,0.23)	−0.13	0.08	0.73	0.08 (−0.21,0.37)	0.13	−0.06
Low TotalE2 (≤16 pg/ml)	0.71	0.12 (−0.03,0.28)	−0.40	0.52	0.77	0.12 (−0.15,0.40)	−0.32	0.44	0.74	0.28 (0.02,0.55)	−0.47	0.75
SHBG	0.71	0.12 (−0.04,0.27)	−0.14	0.26	0.75	0.02 (−0.27,0.30)	−0.19	0.21	0.73	0.03 (−0.26,0.32)	−0.20	0.23
High SHBG (>59.1nM)	0.70	0.14 (−0.01,0.29)	−0.42	0.56	0.75	0.14 (−0.13,0.41)	−0.36	0.50	0.73	0.30 (0.01,0.60)	−0.16	0.46
Major Osteoporotic Fracture	N=416				N=106				N=95
Base model	0.65				0.65				0.69
Bio T	0.66	0.09 (−0.02,0.19)	0.12	−0.03	0.65	0.14 (−0.06,0.34)	0.13	0.01	0.69	0.23 (0.03,0.44)	0.14	0.09
Low BioT (<163.5 ng/dl)	0.66	0.09 (−0.02,0.19)	−0.62	0.71	0.65	0.19 (0.01,0.37)	−0.44	0.63	0.70	0.14 (−0.01,0.28)	−0.75	0.89
Bio E2	0.66	0.10 (−0.01,0.20)	0.10	0.00	0.65	0.10 (−0.10,0.31)	0.10	0.00	0.69	0.20 (−0.01,0.41)	0.16	0.04
Low BioE2 (<11.4 pg/ml)	0.65	0.21 (0.11,0.32)	−0.16	0.37	0.65	0.25 (0.05,0.45)	−0.02	0.27	0.68	0.20 (−0.01,0.41)	0.16	0.04
Total T	0.65	−0.01 (−0.12,0.09)	0.07	−0.09	0.65	0.04 (−0.16,0.23)	−0.11	0.15	0.68	0.21 (0.01,0.41)	0.26	−0.05
Low TotalT (≤300 ng/dl)	0.66	0.02 (−0.09,0.12)	−0.64	0.66	0.65	0.05 (−0.10,0.21)	0.62	−0.57	0.69	0.06 (−0.06,0.19)	−0.79	0.85
Total E2	0.65	0.05 (−0.06,0.15)	0.11	−0.07	0.66	0.03 (−0.17,0.22)	−0.07	0.09	0.69	0.11 (−0.10,0.31)	0.14	−0.03
Low TotalE2 (≤16 pg/ml)	0.65	0.09 (−0.01,0.20)	−0.44	0.53	0.66	0.07 (−0.12,0.25)	−0.38	0.44	0.69	0.22 (0.05,0.39)	−0.54	0.76
SHBG	0.66	0.17 (0.06,0.27)	−0.11	0.27	0.67	0.21 (0.01,0.41)	−0.06	0.26	0.69	0.01 (−0.19,0.21)	−0.17	0.18
High SHBG (>59.1nM)	0.65	0.18 (0.07,0.28)	−0.40	0.58	0.66	0.25 (0.06,0.44)	−0.26	0.51	0.69	0.18 (−0.02,0.37)	−0.28	0.46

Bold AUC or combined NRI indicates significant improvement in prediction, p < 0.05(two-sided);

Base model only contains FRAX with BMD;

^*Missing measured albumin resulted in missing values for 86 bioavailable testosterone and estradiol values in US data. For bioavailable T and E₂ measures: number of hip fracture = 43, AUC of base model = 0.79; number of major osteoporotic fractures = 100, AUC of base model = 0.65