FRAX在中国绝经后女性人群骨折风险预测中的适用性评价  

Applicability assessment of FRAX for Chinese postmenopausal women

作　　者：邓介超[1] 唐海[1] 朱富强[1] 陈浩[1] 贾璞[1] 包利[1] 华琳[2] 哈鹏程 

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050 [2]首都医科大学生物工程学院数学教研室,北京100069 [3]西斯比亚(北京)医药技术研究有限责任公司,北京102206

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2012年第4期247-254,共8页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：北京市卫生系统高层次卫生技术人才培养资助(215工程;2009-3-06)

摘　　要：目的评价世界卫生组织发布的骨折风险预测工具(FRAX)对中国绝经后女性人群的适用性,探索有、无股骨颈骨密度(BMD)对FRAX预测结果的影响。方法对2314名绝经后中国女性进行回顾性队列分析。采集所有入选者FRAX预测工具中所包含的各危险因素资料,将包括股骨颈BMDT值等数据输入FRAX,计算10年骨折风险。从所有危险因素数据中得出针对中国绝经后女性骨折风险预测的回归方程,将该方程得出的骨折风险值与FRAX预测值相比较。对有无BMD情况下的FRAX预测值进行比较。结果除吸烟和饮酒外,FRAX预测风险与各危险因素间均具有统计学意义,既往骨折史是最重要的危险因素。骨质疏松引起的主要骨折概率(临床性椎体、髋部、肱骨和前臂骨折)和髋部骨折的概率均随着股骨颈BMD的下降而升高。根据中国绝经后女性骨折风险预测回归方程计算的髋部骨折风险概率与FRAX预测结果一致,有无BMD情况下的FRAX预测结果差异无统计学意义。结论 FRAX可用于中国绝经后女性人群骨折风险预测,无BMD情况下的FRAX预测结果同样可靠。Objective This study aims to evaluate the applicability of World Health Organization fracture risk assessment tool （FRAX） in Chinese postmenopausal women, and to assess the reliability of FRAX calculated without BMD. Methods This study was a retrospective cohort analysis of 2 314 postmenopausal Chinese women. All risk factors were collected from subjects requested in the FRAX assessment. Then FRAX was applied, retrospectively, with femoral neck T-score, to estimate 10-year probability of fracture of subjects. Moreover, the statistical correlation analysis pertaining to the application of FRAX and BMD when predicting fracture risk of Chinese postmenopausal women was also performed. The correlation between the fracture risk assessed by FRAX and the risk calculated by logistic regression algorithm was statistically evaluated in this Chinese population. Finally, the correlation among BMD, FRAX calculated with and without BMD was compared. Results There were significant differences between the FRAX results of each group divided by risk factors, except for drinking and smoking groups. Previous history fracture was the most influential factor. In the correlation analysis, both of the probability of major osteoporotic and hip fracture increased with the decline of BMD T-score. In addition, the assessment result of hip fracture generated by Logistic regression equation was consistent with the result by FRAX. For both major osteoporotic and hip fracture, FRAX measured without BMD was negatively correlated with BMD, and positively correlated with FRAX measured with BMD. Conclusion FRAX had practicability and eftectiveness in the assessment of fracture risk for Chinese postmenopausal women. FRAX measured without BMD was consistent with FRAX measured with BMD.

关 键 词：FRAX 骨折风险预测 中国绝经后女性 骨密度 

分 类 号：R681[医药卫生—骨科学]