FRAX软件评估北京地区中老年人骨折风险的预测价值

Clinical study on evaluating fracture risk of middle-aged and older people in Beijing using FRAX^(■)

目的评估不同部位骨密度(bone mineral density,BMD)值代入FRAX工具后对于北京地区中老年人骨折风险的预测价值。方法收集北京地区9 726例中老年人群的相关资料,应用FRAX~?中国模式分别代入髋部BMD及腰椎BMD时10年内主要部位骨质疏松性骨折及髋部骨折的概率,评估FRAX~?在中老年人骨折风险的预测价值。结果 (1)应用FRAX~?分别代入髋部BMD及腰椎BMD后计算10年内主要部位骨质疏松性骨折及髋部骨折概率并行配对样本秩和检验,差异均具有统计学意义(P<0.05)。(2)代入髋部BMD后,男性及女性人群随年龄增大,10年内主要部位骨质疏松性骨折及髋部骨折概率均增加。代入腰椎BMD后,女性人群随着年龄增大,10年内主要部位骨质疏松性骨折及髋部骨折概率均增加,但男性人群上述骨折概率并不伴随着年龄增大而增加。(3)总人群中合并既往骨折史的骨折风险高于无既往骨折史人群。结论髋部BMD及腰椎BMD代入FRAX后均能较好地预测未来10年骨折的风险概率;对于男性病例,应用FRAX时更推荐代入髋部BMD预测未来10年骨折的风险概率;FRAX~?对中老年人骨折风险预测具有重要价值。

Objective To evaluate the predictive value of bone mineral density of different sites in middle-aged and elderly people in Beijing using the FRAX tool.Methods The relevant data of 9 726 middle-aged and elderly people in Beijing and the risk factors contained in the FRAX tool were collected.The probability of 10 years major osteoporotic fracture and hip fracture were calculated using FRAX Chinese model with hip BMD and lumbar spine BMD respectively,and the predictive value of FRAX for fracture risk in middle-aged and elderly people was evaluated.Results(1)FRAX was used to calculate the probability of 10 years major osteoporotic fracture and hip fracture with lumbar spine BMD and hip BMD respectively,and the rank sum test of paired samples was performed(P<0.05).The difference was significant.(2)Estimated using hip BMD,the probability of major osteoporotic fracture and hip fracture increased with age in both males and females.Estimated using lumbar spine BMD,the probability of major osteoporotic fracture and hip fracture in the female population increased with age,but the fracture probability in the male population did not increase with the increase of age.(3)In the total population,the risk of fracture was higher in those with previous fracture history than those without previous fracture history.Conclusion Both BMD of hip and lumbar spine can predict the probability of fracture in the next 10 years.For male cases,it is more recommended to use hip BMD in FRAX to predict the risk of fracture in the next 10 years.FRAX has important value in predicting fracture risk in middle-aged and older people.