FRAX在绝经后骨质疏松症中骨折风险评估的Meta分析

Meta-analysis of FRAX in fracture risk assessment in postmenopausal osteoporosis

目的系统评价未使用骨密度检测时,通过FRAX工具评估绝经后骨质疏松症(PMOP)中骨折发生概率的应用准确性。方法系统检索CNKI、CBM、VIP、WanFang、PubMed、Embase、Cochrane图书馆,开展方法学质量评估,同时借助软件Stata16.0和Metadisc实施Meta分析。所纳入文献合计12篇,涉及研究为14个。结果 Meta分析结果表明,FRAX敏感度为84.68%,特异性为63.18%。合并SROC曲线绘制,最终得到诊断的准确率为85%,P<0.05,准确率接近骨密度检测方法。其中,髋部骨折概率对于骨密度评估方法的敏感度为81.9%,特异性为65.02%。使用FRAX评估时,诊断的准确率为83%,P<0.05;主要部位骨折概率对于骨密度评估方法的敏感度为73.5%;特异性为72.71%,使用FRAX评估时得到诊断的准确率为81%,P<0.05。结论 FRAX工具是一种可靠的应用于绝经后骨质疏松症中的骨折评估方法。

Objective To systematically evaluate the application of FRAX(without BMD) to evaluate the fracture in postmenopausal osteoporosis(PMOP). Methods The libraries of CNKI, CBM, VIP, WanFang, PubMed, Embase, and Cochrane were searched systematically, and the methodological quality of the included studies was evaluated, and the Stata 16.0 and Metadisc software were used for meta-analysis. A total of 12 articles and 14 studies were included. Results Meta-analysis showed that the sensitivity of FRAX was 84.68%;the specificity was 63.18%. Combined with SROC curve drawing, the final diagnosis accuracy rate was 85%, P<0.05. and the accuracy was close to that of bone density detection. Among them, the sensitivity of the hip bone to the bone density assessment method is 81.9%;the specificity is 65.02%. When used FRAX evaluation, the final diagnosis accuracy rate was 83%, P<0.05. The sensitivity of the fracture probability of the main site to the bone mineral density assessment method was 73.5%;the specificity is 72.71%. When FRAX was used for evaluation, the accuracy of the diagnosis is 81%, P<0.05. Conclusion FRAX is a reliable fracture assessment method used in women with postmenopausal osteoporosis.