绝经后女性不同部位骨密度及FRAX预测值与BMI的相关性分析  

Correlation analysis between the bone mineral density of different positions,FRAX predicted value and BMI in postmenopausal women

作　　者：吴婉 郦忆文 梁冰 王旸 曹玉茹 王涛 WU Wan;LI Yiwen;LIANG Bing;WANG Yang;CAO Yuru;WANG Tao(Department of General Practice,The First Affiliated Hospital of Bengbu Medical University,Bengbu Anhui 233004,China;Department of Rheumatology and Immunology,The First Affiliated Hospital of Bengbu Medical University,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医科大学第一附属医院全科医学科,安徽蚌埠233004 [2]蚌埠医科大学第一附属医院风湿免疫科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2024年第2期182-186,共5页Journal of Bengbu Medical College

基　　金：安徽省高校人文社会科学研究项目(SK2019A0179)。

摘　　要：目的:探讨绝经后女性不同部位骨密度(BMD)及骨折风险评估工具(FRAX)计算出的骨折风险与体质量指数(BMI)的相关性。方法:选取2020年9月至2021年8月于蚌埠医科大学第一附属医院就诊并进行BMD检查的绝经后女性313例,收集研究对象的人口统计学资料及BMD相关信息,并应用FRAX工具计算未来10年发生主要骨质疏松性骨折(脊椎、前臂、髋骨或肩部骨折)的概率(PMOF)和髋部骨折的概率(PHF),分析FRAX预测值与BMD和BMI的相关性,以及联合股骨颈T值的FRAX预测值和不联合股骨颈T值的FRAX预测值是否有差异。结果:腰椎、股骨颈、全髋的BMD随着BMI的增加而增加(P<0.01);FRAX预测值在联合股骨颈T值的情况下,随着BMI的增加,骨折风险逐渐下降(P<0.01);未联合股骨颈T值的FRAX预测值在BMI<28 kg/m^(2)时,随着BMI的增加,骨折风险逐渐下降(P<0.05),当BMI≥28 kg/m^(2)时,骨折风险开始出现上升趋势(P<0.05);在骨量减少人群中,难以筛选出骨折高危人群,FRAX严重低估了发生主要骨质疏松性骨折的风险。结论:体质量过低的人群BMD通常较低,使用FRAX评估其发生骨折的风险相对较高。Objective:To investigate the correlation between bone mineral density(BMD)of different positions,fracture risk calculated by fracture risk assessment tool(FRAX)and body mass index(BMI)in postmenopausal women.Methods:The demographic information and BMD-related information of 313 postmenopausal women detected by BMD examination in the First Affiliated Hospital of Bengbu Medical University from September 2020 to August 2021 were investigated.The probability of major osteoporotic fractures(including spine,forearm,hip or shoulder)and probability of hip fracture(PHF)over the next 10 years were calculated using the FRAX tool.The correlation of predicted values of FRAX and BMD with BMI were analyzed,and it was analyzed whether there was a difference between the FRAX predicted values of the combined and uncombined femoral neck T value.Results:The BMD of lumbar spine,femoral neck and total hip increased with the increase of BMI(P<0.01).In combination with the femoral neck T value,the risk of fracture decreased with the increase of BMI(P<0.01).At the BMI<28 kg/m^(2) of the predicted value of FRAX without the T value of the femoral neck,the fracture risk decreased gradually with the increase of BMI(P<0.05),and the fracture risk began to increase at BMI≥28 kg/m^(2).Among people with reduced bone mass,it was difficult to screen out those at high risk of fracture,and the FRAX significantly underestimated the risk of major osteoporotic fractures.Conclusions:The BMD in people with low body mass is generally low,and the risk of fracture calculated by FRAX is relatively high.

关 键 词：骨质疏松性骨折 绝经 女性 体质量指数 骨折风险评估工具 骨密度 

分 类 号：R683[医药卫生—骨科学]