应用FRAX评估中老年男性人群骨折风险的多中心研究

A multicenter study on the assessment of fracture risk in middle-aged and elderly men with FRAX

目的探讨分别按照不同地区及人群、不同骨密度测量方法计算骨折风险评估工具(FRAX~)的多中心研究在评价男性中老年人骨折风险的预测价值。方法分别搜集中国医科大学航空总医院(本文简称HK)、北京密云区中医医院(本文简称MY)、山东省医学科学院颈肩腰腿痛医院(本文简称SD)行双能X线骨密度检查的中老年人男性病例共7095例,输入相关资料,应用FRAX~中国模式计算各研究对象10年内主要部位骨质疏松性骨折及髋部骨折的概率,应用统计学对比分析根据上述研究资料得到的FRAX值。结果三个中心研究对象10年内主要部位骨质疏松性骨折概率及髋部骨折概率分别行两两Mann-Whitney U检验,P<0.05,差异均有统计学意义,分别对三个中心男性人群进行年龄分组,并进行两两对比,其中MY-SD对比组中50～59岁组及80～89组,P>0.05,差异无统计学意义,其余MY-HK,HK-SD对比组P<0.05,差异具有统计学意义。结论前臂骨密度及髋部骨密度代入FRAX后均能较好的预测未来10年男性人群骨折的风险概率;即使是不同地区人群及应用不同检测设备得到的前臂骨密度值代入FRAX后仍能较好的预测未来10年男性人群的骨折风险概率,且差异在某些年龄组无显著性,FRAX~工具对男性中老年人骨折风险预测极具价值。

Objective To explore the predictive value of a multicenter study for the assessment tool of fracture risk by calculation of different regions and population and different bone mineral density measurement method in middle-aged and elderly males. Methods Data of 7095 middle and elder age males from Aviation General Hospital of China Medical University(referred as HK), Miyun District Traditional Chinese Medicine Hospital of Beijing(referred as MY), and Shandong Provincial Academy of Medical Sciences Neck, Shoulder, Low Back, and Leg Pain Hospital(referred as SD), respectively, were collected. Bone mineral density(BMD) was determined using dual energy X-ray. According to the relevant data, the probability of osteoporotic fracture and hip fracture in 10 years were calculated with FRAX Chinese model. The FRAX values obtained from the above study were compared. Results The probability of osteoporotic fracture and hip fracture in 10 years among the three centers were significantly different in Mann-Whitney U test(P< 0.05). The male population of the three centers were divided into age groups and compared with each other. There was no significant difference(P> 0.05) between 50-59 years old group and 80-89 years old group in MY-SD control group, while there was significant difference in other MY-HK and HK-SD control groups(P<0.05). ConclusionBMD of the forearm and the hip may predict the risk of fracture in male population in the next 10 years. Even if the BMD of the forearm is obtained from different regions and using different detection equipment, it may predict the probability of fracture risk of male population in the next 10 years with FRAX model. FRAX tool is valuable for predicting fracture risk in middle-aged and elderly males.