FRAX评分评估初诊2型糖尿病患者骨质疏松骨折发生概率的价值  

Value of FRAX score for evaluating fracture risk induced by osteoporosis in new-diagnostic type 2 diabetes patients

作　　者：俞海燕[1] 王尧[2] 唐伟[1] 

机构地区：[1]东南大学医学院附属江阴医院,江苏无锡214400 [2]东南大学附属中大医院,江苏南京210009

出　　处：《现代中西医结合杂志》2015年第25期2750-2752,2761,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江苏省科技支撑计划(社会发展)项目(BE2011605)

摘　　要：目的 探讨FRAX评分评估初诊2型糖尿病患者10年骨质疏松骨折发生概率的价值。方法 选取207例初发糖尿病患者作为糖尿病组,健康体检者504例作为对照组,收集2组相关临床指标,同时采用双能X射线骨密度仪检查腰椎L1—4、左侧股骨颈及Ward＇s三角的骨密度,并按照总体、男性、女性分别通过FRAX公式计算2组10年髋部骨折发生概率和10年主要骨质疏松性骨折发生概率,比较2组不同年龄段骨量情况及10年骨折发生概率。结果 糖尿病组中总体、男性以及女性既往骨折发病率均明显高于对照组（P均〈0.05）,糖尿病组股骨颈及L1的骨密度值均高于对照组（P均〈0.05）;糖尿病组10年主要骨质疏松性骨折发生概率和10年髋部骨折发生概率均低于对照组（P均〈0.05）。随着年龄段的增长,2组骨量减少的发生率及10年骨折发生概率均呈逐渐上升趋势（P均〈0.05）,而2组相同年龄段骨量减少发生率比较差异均无统计学意义（P均〉0.05）;糖尿病组〉50-60岁、〉60-70岁、〉70岁人群10年髋部骨折发生概率和10年主要骨质疏松性骨折发生概率均明显低于对照组（P均〈0.05）。结论 随着年龄段的增长,2型糖尿病患者10年骨折发生概率逐渐增高。在2型糖尿病患者中,应当建立更加精准的FRAX评分工具来预测糖尿病患者骨折风险。Objective It is to explore the value of FRAX score for evaluating fracture risk induced by osteoporosis in new-diagnostic type 2 diabetes patients in ten years .Methods These 207 subjects with new-diagnosed diabetes were selected as DM group and 504 healthy subjects as normal -control （ NC group） were enrolled and were collected and their clinical infor-mation were collected .The bone mineral density of lumbar vertebra L 1-4, left femoral neck and Ward＇s triangle was meas-ured by dual -energy X-ray absorptiometry examination.The 10-year probability of hip fracture（PHF） and a major osteopo-rotic fracture（PMOF） was calculated by FRAX algorithm according to totality , male and female.The bone mineral density of different age group and 10-year probability of fracture between the two groups were compared .Results In the total , male and female subjects the frequency of previous fracture in DM group was higher than that in NC group （P〈0.05）.The T value at femur neck and lumbar spine L1 in DM group were higher than NC group（P〈0.05）.The 10-year probability of PHF and a major PMOF in DM group was lower than that in NC group （P〈0.05）.With age increasing, occurrence rate of bone mineral density decreasing and 10-year probability of fracture increased gradually （P〈0.05） in both groups, but there was no sig-nificant difference in occurrence rate of bone mineral density decreasing among the groups with same age in both groups （ P〉0.05）.In DM group, the 10-year probability of PHF and a major PMOF of the ones whose age 〉50-60, 〉60-70, 〉70 years were obviously lower than that of NC group （P〈0.05）.Conclusion The 10-year probability osteoporotic fracture had an increased trend with the increasing age .In type 2 diabetes,we should set up more precise algorithm model to predict frac-ture risk of diabetes .

关 键 词：骨质疏松 FRAX 2型糖尿病 

分 类 号：R587.2[医药卫生—内分泌]