Assessing Osteoporosis Risk: A Comparative Study on Predicting Hip and Vertebral Fractures Among Diabetic and Cardiovascular Patients

Osteoporosis can lead to fractures of the hip and vertebrae, which can be a significant health concern for individuals who suffer from diabetes and cardiovascular disease. There is a lack of knowledge on fracture susceptibility, particularly for Middle Eastern groups, despite the fact that these groups share some risk factors in common. In addition to evaluating FRAX and other fracture prediction methods, the purpose of the study was to determine the condition-specific risk variables that are associated with hip and vertebral fractures in individuals who suffer from cardiovascular disease and diabetes. We analysed the DXA scans of 612 individuals aged 40 or older who entered a large hospital in Jordan between the years 2023 and 2024. Of these individuals, 302 were diagnosed with diabetes, and 310 were diagnosed with heart disease. We were able to obtain information regarding the individual's history, including their biomarkers, medications, and fracture history. An examination of the risk of fracture was carried out by the FRAX and Fracture algorithms. Despite the fact that their femoral neck T-scores were better (−1.8 vs. −2.1, p=0.03), results showed that individuals with diabetes mellitus (DM) had greater rates of spinal fractures (18.2% vs. 16.1%, p=0.48). Additionally, individuals with cardiovascular disease (CVD) had higher rates of hip fractures (9.7% vs. 5.6%, p=0.04). Risk Factors, of particular, having diabetes for more than ten years is associated with a twofold increase in the risk of spinal fractures (odds ratio = 2.3, 95% confidence interval = 1.4–3.8), using glucocorticoids is associated with a threefold increase in the risk of cardiovascular disease (odds ratio = 3.1, 95% confidence interval = 1.9–5.0). Fractures were shown to be underestimated by FRAX in individuals with diabetes (the observed/predicted ratio was found to be 1.9), but the accuracy of the model improved when diabetes-specific parameters were included (area under the curve: 0.71→0.78). Bisphosphonates were found to be less effective in reducing the risk of diabetes mellitus (38 percent versus 42 percent) than they were in reducing the risk of cardiovascular disease (p < 0.05). The patterns of fractures caused by diabetes and cardiovascular disease are distinct, which is why risk assessment is necessary. Modifications that are unique to diabetes are required in order to achieve an accurate forecast of FRAX.