Fig. 2.

Criteria for initiation of pharmacological treatment for osteoporosis in Japan (adapted from Orimo et al. [39]). Abbreviations: aBMD: bone mineral density, YAM: young adult mean for women; FRAX: fracture risk assessment tool FRAX® (www.shef.ac.uk/FRAX). ¹ proximal femur (hip) fracture and/or vertebral fracture caused by a slight external force after menopause in women and after age 50 in men. ² distal forearm, proximal humerus, pelvis, lower leg, and/or rib fracture caused by a slight external force after menopause in women and after age 50 in men. ³ revision of additional T-scores is under consideration for some measurement sites. An aBMD less than 70% of YAM is equivalent to DXA T-score of − 2.5. ⁴ applied in persons < 75 years. Additionally, a lower cut-off value does not include all young persons in and around their 50s for whom pharmacological treatment is recommended based on the present diagnostic criteria. ⁵ critera should be applied only to persons who answer “No” to FRAX® risk factors of “glucocorticoid,” “rheumatoid arthritis,” or “secondary osteoporosis”