FRAX预测老年男性2型糖尿病患者骨折风险的临床应用

Clinical application of FRAX in aged men with type 2 diabetes mellitus

目的 评估FRAX软件预测老年男性2型糖尿病患者骨折发生风险的临床应用价值,并且对2型糖尿病患者骨折风险的危险因素进行相关性分析.方法 纳入在郑州大学第一附属医院就诊的2型糖尿病男性患者103例,门诊健康体检患者82例.记录所有研究对象的基本资料和一般临床指标,采用问卷调查的形式进行临床危险因子的评估.应用FRAX软件在有、无BMD存在的条件下评估老年男性2型糖尿病患者与非糖尿病患者的10年内主要部位骨折风险和髋部骨折风险并进行比较.应用多重线性回归分析来探讨10年内主要部位骨折风险和髋部骨折风险与2型糖尿病组各临床指标间的相互关系.结果 2型糖尿病组与对照组相比,体质量[（75.80±9.74）kg vs（69.61±9.97） kg],体质量指数（BMI）[（26.0 6±2.85） kg/m2 vs（23.98±2.99） kg/m2],2型糖尿病组明显高于对照组（P＜0.01）.在有、无BMD存在的条件下计算出的10年内主要部位骨折风险、髋部骨折风险差异未见统计学意义（P＞0.05）.2型糖尿病组患者与对照组相比,10年内主要部位骨折风险和髋部骨折风险在有、无BMD存在的条件下差异均未见统计学意义（P＞0.05）.年龄（P＜0.01）、BMI（P＜0.01）和糖尿病病程（P=0.012）是10年内髋部骨折风险和主要部位骨折风险的主要决定因素.结论 FRAX软件可能低估了老年男性2型糖尿病患者的骨折发生风险,BMI指数过低、病程较长的老年男性2型糖尿病患者应注意骨质疏松骨折的预防.

Objective To assess the clinical application of FRAX in aged men with type 2 diabetes mellitus and investigate the associations between FRAX scores and diabetes related clinical indexes.Methods The basic informations,general clinical data and the results of clinical risk factors questionnaire of 103 T2DM and 82 control subjects from the first affiliated hospital of Zhengzhou university were collected.The FRAX scores of major osteoporotic fracture and hip fracture with and without BMD were calculated by Fracture risk assessment tool Chinese model.The differences between the two groups were observed.Using multiple linear regression analysis to determine the association between FRAX scores and diabetes related clinical indexes.Results Average weight[（75.80 ± 9.74）kg vs（69.61 ± 9.97）kg] and mean BMI [（26.06 ± 2.85） kg/m2 vs （23.98 ± 2.99） kg/m2] were significantly higher in the T2DM group than those in the control group（P 〈0.01）.The FRAX scores calculated with and without BMD had no significant difference（P 〉0.05）.The FRAX scores with and without BMD had no significant difference between T2DM and control subjects（P 〉 0.05）.Among other factors,age（P 〈 0.01）,BMI （P 〈 0.01） and diabetes duration（P =0.012） were main determinants of major osteoporotic fracture and hip fracture.Conclusions The Chinese model of fracture risk assessment tool may underestimate the scores of major osteoporotic fracture and hip fracture,the old men with T2DM patients who have low BMI and long disease duration should pay more attention to the prevention of osteoporotic fracture.