类风湿关节炎校正FRAX在老年2型糖尿病中的干预阈值  

RA corrected for the intervention threshold for FRAX in elderly type 2 diabetes

作　　者：李秀秀 麻新灵 黎依技 付龙龙 苏美基 韦燕芬 杨明瑞 LI Xiuxiu;MA Xinling;LI Yiji;FU Longlong;SU Meiji;WEI Yanfen;YANG Mingrui(Graduate School,Youjiang Medical University For Nationalities,Baise 533000;Department of Endocrinology,Baise People's Hospital,Baise 533000,China)

机构地区：[1]右江民族医学院研究生学院,广西百色533000 [2]百色市人民医院内分泌科,广西百色533000

出　　处：《中国骨质疏松杂志》2024年第6期842-846,共5页Chinese Journal of Osteoporosis

基　　金：广西科技计划项目(2021AC19182);右江民族医学院高层次人才项目(yy2020bsky048)。

摘　　要：目的通过使用类风湿关节炎(rheumatoid arthritis,RA)校正FRAX在2型糖尿病(type 2 diabetes mellitus,T2DM)患者中的干预阈值,验证其预测价值。方法选取2023年1~5月在某三甲医院就诊并住院的T2DM患者324例,分为OP组和非OP组,收集其一般临床资料和骨密度,将FRAX中的RA选项替换为T2DM进行评分。比较组间一般临床资料及校正后的FRAX评分差异。RA校正后FRAX的预测能力可通过Logistic回归模型及ROC曲线进行分析,通过灵敏度和特异度确定其干预阈值。选择2023年6~7月就诊的T2DM患者93例验证其临床应用价值。结果OP组女性比例、年龄较高、糖尿病病程较长、有既往骨折史、使用糖皮质激素及校正MOFP、校正HFP均高于非OP组;体重、BMI均低于非OP组(P<0.05)。验证组骨折患者女性比例、年龄、糖尿病病程、BMI、校正MOFP、校正HFP人数高于未骨折患者(P均<0.05)。结论校正FRAX-MOFP≥6%或校正FRAX-HFP≥3%作为干预阈值有较好的准确性,RA校正FRAX可提高对桂西地区T2DM患者骨折风险评估概率。Objective To verify the predictive value of FRAX by using rheumatoid arthritis(RA)in patients with T2DM.Methods 324 T2DM patients hospitalized in a Grade A hospital from January to May 2023 were selected and divided into OP and non-OP groups,their general clinical data and bone density were collected,and RA option in FRAX was replaced with T2DM for scoring.The differences in general clinical data and corrected FRAX scores were compared between the two groups.The predictive ability of FRAX after RA correction can be analyzed by logistic regression model and ROC curve,and its intervention threshold can be determined by sensitivity and specificity.Ninety-three T2DM patients who hospitalized during June to July 2023 were used to verify their clinical application value.Results The proportion of women,OP group,higher age,longer diabetes duration,previous fracture history,glucocorticoid use and adjusted MOFP and adjusted HFP were higher than the non-OP group;weight and BMI were lower than the non-OP group(P<0.05).In the validation group,the proportion of women,age,duration of diabetes,BMI,adjusted MOFP,and number of adjusted HFP were higher than those without fracture,with P<0.05.Conclusion The correction for FRAX-MOFP 6%or correction for FRAX-HFP 3%had good accuracy as the intervention threshold,and RA correction for FRAX could improve the probability of fracture risk assessment for T2DM patients in western Guangxi.

关 键 词：FRAX 2型糖尿病 骨质疏松 骨折风险 类风湿关节炎 

分 类 号：R684.3[医药卫生—骨科学] R587.1[医药卫生—外科学]