FRAX~评估北京地区老年男性人群骨质疏松性骨折风险的应用价值研究  

Study on fracture predictive value of FRAX~ for senile men in Beijing

作　　者：赵真[1] 卢玉[1] 苗也[1] 王翠英[1] 

机构地区：[1]首都医科大学附属北京友谊医院医疗保健中心,北京100050

出　　处：《临床和实验医学杂志》2016年第19期1891-1895,共5页Journal of Clinical and Experimental Medicine

基　　金：首都医科大学基础-临床科研合作基金(15JL-L01);北京市保健委员会的保健科研课题(京13-05号);北京市友谊医院院启动课题(Y1402)

摘　　要：目的 评价骨折风险评估工具FRAX对北京地区老年男性骨质疏松性骨折的预测价值,讨论25-羟维生素D[25（OH）D]水平对于FRAX预测结果的影响。方法 以348例无骨折史的北京地区老年男性为研究对象,收集其家族史、临床资料、检测血清25（OH）D水平并采用双能X线骨密度仪测定腰椎及髋部骨密度,应用FRAX中国模式计算个体10年骨折发生概率。将研究对象按照不同年龄组及25（OH）D水平分层,分析不同组别10年髋部骨折概率和10年主要骨质疏松性骨折概率,比较25（OH）D对FRAX预测结果的影响。结果 受试者中4人达到骨质疏松性骨折高危患者诊断标准。10年髋部骨折概率为0.96±0.31（0-4.2）,随年龄增长骨折风险概率同步增高,各年龄组间比较差异有统计学意义（P〈0.05）。10年主要骨质疏松性骨折概率为3.57±0.98（1.3-7.6）,各年龄组间比较差异均无统计学意义（P〉0.05）。不同25（OH）D水平组间比较结果提示,随维生素D水平下降10年髋部骨折概率有增加趋势（P〈0.05）。维生素D严重缺乏组10年主要骨质疏松性骨折概率明显高于充足组且差异有统计学意义（P〈0.05）。结论 FRAX预测结果低估了北京地区老年男性骨质疏松性骨折发生概率,临床工作中结合维生素D营养状态等多因素综合判断有利于提高预测价值。Objective To evaluate the applicability of FRAX （ Fracture Risk Assessment tool） for fracture prediction in senile men in Beijing, and to discuss the effect of 25 hydroxyvitamin D on FRAX . Methods A total of 348 senile men were involved and their personal data including age, height, weight, the brittle fracture history of parents, oral steroid administration history, drinking history and smoking history were collected. The serum concentrations of 25 hydroxyvitamin D were measured, and bone mineral denisity at lumbar spines 1 - 4 （LI - 4） , left femo-ral neck and total hip were measured by dual - energy X - ray absorptiometry. The individual 10 - year hip and major osteoporotic fracture probability had been calculated by FRAX？ Chinese model. Participants were divided into 4 groups by age and 4 groups according to serum levels of 25 hydroxyvitamin D. The results of FRAX in different groups were comparaed, and the effect of vitamin D status on FRAX？ had been studied. Results Only 4 participants achieved the diagnostic criteria of high risk of osteoporotic fracture. The 10 - year probability of hip fracture was 0.96 ±0.31 （0 -4.2） and it wasincreasedwiththeincrease of age, andthe difference was statistically significant among groups of all age （ P 〈0.05）. The 10 - year probability of major osteoporotic fracture was 3.57 ±0. 98 （1.3 -7.6）, and the difference was not statistically significant among all age groups （ P 〈0.05）. The 10 - year probability of hip fracture was increased with the decrease of levels of vitamin D, and the difference was statistically significant among all groups （ P 〈 0 .0 5 ） . The 10 - year probability of major osteoporotic fracture in vitamin D deficient group was higher than that of the probability of sufficient group （ P 〈0. 05）. Conclusion FRAX Chinese model may underestimate 10 - year osteoporotic fracture probability in semile men in Beijing. Many factors such as the nutritional status of vitamin D may raise the p

关 键 词：老年男性 骨折风险评估工具 低骨量 25 - 羟维生素 D 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]