3253例围绝经及绝经后女性骨质疏松风险评估工具的应用  

The application of risk assessment tool for osteoporosis in 3253 perimenopausal and postmenopausal women

作　　者：郭勇 栗敏 张颖 贺丹丹 张智海 GUO Yong;LI Min;ZHANG Ying;HE Dandan;ZHANG Zhihai(Department of Hospital,Daxing Teaching Hospital,Capital Medical University,Beijing 102600,China;Department of Radiology,Integrated Traditional Chinese and Western Medicine Hospital of Daxing District,Beijing 100076,China;Department of Oncology,Daxing Teaching Hospital,Capital Medical University,Beijing 102600,China;Department of Bone Density,Integrated Traditional Chinese and Western Medicine Hospital of Daxing District,Beijing 100076,China;Department of Orthopedics,Guang’anmen Hospital,Chinese Academy of traditional Chinese Medicine,Beijing 100053,China)

机构地区：[1]首都医科大学大兴教学医院院部,北京102600 [2]北京市大兴区中西医结合医院放射科,北京100076 [3]首都医科大学大兴教学医院肿瘤科,北京102600 [4]北京市大兴区中西医结合医院骨密度室,北京100076 [5]中国中医科学院广安门医院骨科,北京100053

出　　处：《中国骨质疏松杂志》2023年第10期1420-1424,1436,共6页Chinese Journal of Osteoporosis

基　　金：国际课题“IOF对骨量减少人群骨折风险评估(FRAX)前瞻性研究”(IOFCJO-D001)。

摘　　要：目的比较分析FRAX(不含BMD模型)、BMD、BMI、OSTA指标对北京南郊地区围绝经期及绝经后女性骨质疏松风险的预测评估价值。方法选取2017年1月至2022年6月在大兴区中西医结合医院行骨密度检查的围绝经期及绝经后女性3253例,收集患者年龄、身高、体重、骨密度T值等数据,分析FRAX(不含BMD模型)、BMD、BMI和OSTA 4种指标在各年龄层和不同骨量之间的差异,绘制不同指标诊断骨量减少或骨质疏松的ROC曲线,比较各指标预测的准确性。结果随着年龄增加,BMD、OSTA减低,FRAX-MOF、FRAX-HF增加;②骨量越小,BMD、OSTA越低,FRAX-MOF、FRAX-HF越高;③FRAX-MOF、FRAX-HF诊断骨质疏松的AUC值分别为0.811和0.810,较OSTA(AUC=0.799)有更好的诊断效能(P<0.001);④;FRAX-MOF、FRAX-HF诊断骨量减少的AUC值分别为0.770和0.767,较OSTA(AUC=0.748)有更好的诊断效能(P<0.001),OSTA指数特异性较高(83.0%),临界值为0.10。结论无BMD的FRAX工具较OSTA诊断围绝经期及绝经后女性OP更优。但OSTA更为简单且具有较好的诊断效能,更适合用于社区或偏远地区,可以将OSTA 0.1作为早期干预的临界值。Objective To compare and analyze the value of FRAX(excluding BMD model),BMD,BMI and OSTA in predicting the risk of osteoporosis in peri-and postmenopausal women in the southern suburbs of Beijing.Methods 3253 peri-and postmenopausal women who underwent bone mineral density examination in Daxing District Hospital of Integrated traditional Chinese and Western Medicine from January 2017 to June 2022 were selected.The data of age,height,weight,and bone mineral density T value were collected,and the differences of FRAX(excluding BMD model),BMD,BMI and OSTA among different age groups and different bone mass were analyzed.The ROC curves of different indexes for the diagnosis of osteopenia or osteoporosis were drawn,and the prediction accuracy of each index was compared.Results With the increase of age,BMD and OSTA decreased,FRAX-MOF and FRAX-HF increased.②The smaller the bone mass,the lower the BMD and OSTA,the higher the FRAX-MOF and FRAX-HF.③The AUC values of FRAX-MOF and FRAX-HF in the diagnosis of osteoporosis were 0.811 and 0.810 respectively,which was better than that of OSTA(AUC=0.799)(P<0.001).④The AUC values of FRAX-MOF and FRAX-HF in the diagnosis of osteopenia were 0.770 and 0.767 respectively,which was better than that of OSTA(AUC=0.748)(P<0.001).The specificity of OSTA index was higher(83.0%)and the critical value was 0.10.Conclusion The FRAX tool without BMD is better than OSTA in the diagnosis of OP in peri-and postmenopausal women.However,OSTA is simpler and has better diagnostic efficacy,so it is more suitable for community or remote areas.OSTA 0.1 can be used as the threshold for early intervention.

关 键 词：骨质疏松 OSTA FRAX 骨密度 围绝经期 

分 类 号：R443[医药卫生—诊断学]