老年男性未来十年PMOF和PHF的治疗阈值分析

The analysis of treatment thresholds of PMOF and PHF in elderly men in the next ten years

目的探讨老年男性未来十年主要骨质疏松性骨折风险(PMOF)和髋部骨折风险(PHF)的治疗阈值.方法收集2019年1月1日至12月31日在浙江省人民医院体检的老年男性557例,通过问卷调查和骨密度测定,应用骨折风险预测工具(FRAX)分别计算不包含股骨颈骨密度的PMOF(non-BMD)、PHF(non-BMD),和包含股骨颈骨密度的PMOF(BMD)、PHF(BMD),并进行统计分析.结果老年男性PMOF(non-BMD)为(4.15±1.51)%,PMOF(BMD)为(2.96±1.50)%,差异有统计学意义(P<0.05),PHF(non-BMD)为(2.47±1.24)%,PHF(BMD)为(1.44±1.08)%,差异有统计学意义(P<0.05).557例老年男性,骨量正常213例(38.24%)、低骨量220例(39.50%)、骨质疏松组124例(22.26%),三组的PMOF(non-BMD)、PHF(non-BMD)、PMOF(BMD)、PHF(BMD)均逐渐增高,组间差异均有统计学意义(P<0.05),PMOF(non-BMD)或PMOF(BMD)>20%者0例.结论美国指南推荐标准(PMOF≥20%、PHF≥3%)不适用于中国老年男性,PMOF(non-BMD)、PHF(non-BMD)、PMOF(BMD)、PHF(BMD)的治疗阈值可参考5%、3%、4%和2%.

Objective To find the treatment thresholds for the major osteoporotic fracture risk (PMOF) and hip fracture risk (PHF) of Chinese elderly men in the next ten years. Methods A ollction of 557 elderly men who received physical examinations in Zhejiang Provincial Pcople’s Hospital from January 1 to December 31,2019. Through questionnaire survey and bone density measurement, the fracture risk sssment tool (FRAX) was used to caleulate PMOF (non- BMD),PHF (non- BMD) without femoral neck bone density. PMOF (BMD),PHF(BMD) including femoral neck bone densiry, and statistical analysis. Results Elderly men' s PMOF (non- BMD) was (4.15±1.51) %,PMOF (BMD) was (2.96±1.50) %,the diference was stistically significant (P<0.05),and PHF (non- BMD) was (2.47±1.24) %,PHF (BMD) was(1.44±1.08) %,the difference was satistically significant (P<0.05) . Among 557 elderly men. 213 cases (38.24%) were normal bone mass, 220 cases (39.50%) were low bone mass, and 124 cases (22.26%) were osteoporosis.PMOF (non-BMD),PHF (non-BMD),PMOF (BMD),and PHF (BMD) in the three groups increased gradually, and the diferences between the groups were stitically significant (P<0.05) .PMOF (non-BMD) or PMOF (BMD) >20% in 0 cases. Conclusions The US guidelines recommended standards (PMOF≥20%,PHF≥3%) are not applicable to Chinese elderly men. The treatment thresholds of PMOF (non-BMD),PHF (non-BMD),PMOF (BMD),and PHF (BMD) can be referred to 5%,3%,4% and 2%.