Table 3. Hazard ratio (HR) with 95% confidence interval (CI) per standard deviation (SD) increase in FRAX score for incident fracture according to self-reported ethnicity.
| Incident MOF from FRAX without BMD | Incident MOF from FRAX with BMD | Incident HIP from FRAX without BMD | Incident HIP from FRAX with BMD | |
|---|---|---|---|---|
| Model 1: Canadian FRAX, unadjusted | HR per SD | HR per SD | HR per SD | HR per SD |
| White women (referent) | 1 (REF) | 1 (REF) | 1 (REF) | 1 (REF) |
| Asian women | 0.51 (0.40-0.65) | 0.46 (0.35-0.59) | 0.22 (0.11-0.47) | 0.16 (0.08-0.34) |
| Black women | 0.49 (0.27-0.88) | 0.58 (0.32-1.00) | - | - |
| p-value for ethnicity | <0.001 | <0.001 | <0.001 | <0.001 |
|
| ||||
| Model 1 sensitivity: Canadian FRAX, adjusted for osteoporosis treatment, comorbidities, diabetes, residence, income | HR per SD | HR per SD | HR per SD | HR per SD |
| White women (referent) | 1 (REF) | 1 (REF) | 1 (REF) | 1 (REF) |
| Asian women | 0.49 (0.38-0.63) | 0.44 (0.34-0.57) | 0.21 (0.10-0.45) | 0.16 (0.07-0.33) |
| Black women | 0.45 (0.25-0.82) | 0.54 (0.30-0.97) | - | - |
| p-value for ethnicity | <0.001 | <0.001 | <0.001 | <0.001 |
|
| ||||
| Model 2: US ethnic calculators, unadjusted | HR per SD | HR per SD | HR per SD | HR per SD |
| White women (referent) | 1 (REF) | 1 (REF) | 1 (REF) | 1 (REF) |
| Asian women | 0.76 (0.59-0.97) | 0.73 (0.57-0.93) | 0.33 (0.16-0.7) | 0.24 (0.12-0.51) |
| Black women | 0.89 (0.49-1.60) | 1.20 (0.66-2.18) | - | - |
| p-value for ethnicity | 0.089 | 0.037 | 0.004 | <0.001 |
|
| ||||
| Model 3: Canadian FRAX, adjusted for Femur Neck Area | HR per SD | HR per SD | HR per SD | HR per SD |
| White women (referent) | 1 (REF) | 1 (REF) | 1 (REF) | 1 (REF) |
| Asian women | 0.55 (0.43-0.71) | 0.48 (0.38-0.62) | 0.25 (0.12-0.53) | 0.18 (0.08-0.37) |
| Black women | 0.51 (0.28-0.92) | 0.60 (0.33-1.09) | - | - |
| p-value for ethnicity | <0.001 | <0.001 | <0.001 | <0.001 |
|
| ||||
| Model 4: Canadian FRAX, adjusted for Total Hip Area | HR per SD | HR per SD | HR per SD | HR per SD |
| White women (referent) | 1 (REF) | 1 (REF) | 1 (REF) | 1 (REF) |
| Asian women | 0.59 (0.46-0.76) | 0.54 (0.42-0.7) | 0.29 (0.14-0.61) | 0.22 (0.11-0.47) |
| Black women | 0.52 (0.29-0.93) | 0.63 (0.35-1.13) | - | - |
| p-value for ethnicity | <0.001 | <0.001 | 0.001 | <0.001 |
|
| ||||
| Model 5: Canadian FRAX, adjusted for HAL | HR per SD | HR per SD | HR per SD | HR per SD |
| White women (referent) | 1 (REF) | 1 (REF) | 1 (REF) | 1 (REF) |
| Asian women | 0.52 (0.39-0.70) | 0.48 (0.36-0.64) | 0.35 (0.16-0.73) | 0.27 (0.13-0.57) |
| Black women | 0.55 (0.30-1.02) | 0.67 (0.36-1.25) | - | - |
| p-value for ethnicity | <0.001 | <0.001 | 0.005 | <0.001 |
|
| ||||
| Model 6: Canadian FRAX, adjusted for TBS | HR per SD | HR per SD | HR per SD | HR per SD |
| White women (referent) | 1 (REF) | 1 (REF) | 1 (REF) | 1 (REF) |
| Asian women | 0.47 (0.34-0.64) | 0.42 (0.31-0.58) | 0.35 (0.17-0.74) | 0.26 (0.12-0.54) |
| Black women | 0.51 (0.27-0.99) | 0.62 (0.32-1.18) | - | - |
| p-value for ethnicity | <0.001 | <0.001 | 0.006 | <0.001 |
|
| ||||
| Model 7: Canadian FRAX, adjusted for Lean mass and Fat mass Index | HR per SD | HR per SD | HR per SD | HR per SD |
| White women (referent) | 1 (REF) | 1 (REF) | 1 (REF) | 1 (REF) |
| Asian women | 0.47 (0.36-0.61) | 0.42 (0.32-0.55) | 0.25 (0.12-0.53) | 0.18 (0.09-0.39) |
| Black women | 0.47 (0.25-0.88) | 0.57 (0.31-1.07) | - | - |
| p-value for ethnicity | <0.001 | <0.001 | <0.001 | <0.001 |
Results from Cox regression models. Major osteoporotic fracture (MOF) and HIP fracture probability computed without and with femoral neck bone mineral density (BMD), FRAX tools. Black ethnicity not included in the hip fracture models as there were no observed events.