FRAX对绝经后骨质疏松症患者颈动脉粥样硬化的诊断价值

The diagnostic value of FRAX for carotid atherosclerosis in postmenopausal osteoporosis patients

目的探讨FRAX对绝经后骨质疏松症患者颈动脉粥样硬化的诊断价值。方法选取201例在2019年2月至2023年7月于连云港市第一人民医院住院治疗的绝经后骨质疏松症患者,对受试者进行信息采集、血液检验、颈动脉超声和双能X线骨密度检查,将患者分为颈动脉粥样硬化组(n=125)和非颈动脉粥样硬化组(n=76),采用FRAX计算未来十年内主要部位骨折风险(PMOF)和髋部骨折风险(PHF)。结果颈动脉粥样硬化组的年龄和收缩压较非颈动脉粥样硬化组更高(P<0.05)。两组之间的血脂和骨代谢等指标差异无统计学意义(P>0.05)。颈动脉粥样硬化组髋部和股骨颈骨密度较非颈动脉粥样硬化组显著降低(P<0.05),PMOF和PHF显著升高(P<0.05)。回归分析显示髋部和股骨颈骨密度与颈动脉粥样硬化呈负相关(P<0.05),PMOF和PHF与颈动脉粥样硬化呈正相关(P<0.05)。调整混杂因素后,上述差异仍有统计学意义(P<0.05)。ROC曲线分析发现PHF对颈动脉粥样硬化的诊断价值最高,曲线下面积为0.775,PMOF诊断颈动脉粥样硬化的曲线下面积为0.773。结论在绝经后骨质疏松症患者中,髋部和股骨颈骨密度与颈动脉粥样硬化呈负相关,PMOF和PHF与颈动脉粥样硬化呈正相关,FRAX对颈动脉粥样硬化具有良好的诊断价值。

Objective To explore the diagnostic value of the fracture risk assessment tools(FRAX)for carotid atherosclerosis in postmenopausal osteoporosis patients.Methods A total of 201 postmenopausal osteoporosis patients admitted to the first People's Hospital of Lianyungang from February 2019 to July 2023 were enrolled.Personal information collection,blood tests,carotid artery ultrasound examination,and dual⁃energy X⁃ray bone mineral density(BMD)examination were conducted on all subjects.All the participants were classified into two groups,the carotid atherosclerosis group(n=125)and the non⁃carotid atherosclerosis group(n=76).The ten⁃year probability of major osteoporotic fracture(PMOF),as well as the ten⁃year probability of hip fracture(PHF),was calculated with FRAX.Results Age and systolic blood pressure in the carotid atherosclerosis group were higher than those in the non⁃carotid atherosclerosis group(P<0.05).There were no significant differences in blood lipid and bone metabolism markers between the two groups(P>0.05).Participants in the carotid atherosclerosis group had lower BMD of the hip and femoral neck compared with those in the non⁃carotid atherosclerosis group(P<0.05).PMOF and PHF were higher in the carotid atherosclerosis group(P<0.05).Regression analysis showed that BMD of the hip and femoral neck was negatively correlated with carotid atherosclerosis(P<0.05).PMOF and PHF were positively correlated with carotid atherosclerosis(P<0.05).The above differences were still statistically significant after adjusting for confounding factors(P<0.05).Receiver operating curve(ROC)analysis showed that PHF had the highest diagnostic value for carotid atherosclerosis,and the area under the curve was 0.775,while the area under the curve of PMOF was 0.773.Conclusion In postmenopausal osteoporosis patients,BMD of the hip and femoral neck is negatively correlated with carotid atherosclerosis,while PMOF and PHF are positively correlated with carotid atherosclerosis.FRAX exhibits good diagnostic value for carotid atherosclerosis.