摘要
目的探讨骨折风险评估工具（FRAx）对中老年2型糖尿病患者骨折风险的预测价值。方法对153例行骨密度检查的50岁以上2型糖尿病患者进行回顾性分析，根据FRAX指定的危险因子，记录研究对象的年龄、性别、身高、体质量、体质指数、既往脆性骨折史、父母髋部骨折史、当前吸烟史、过量饮酒史、长期使用类固醇激素史、风湿性关节炎、其他继发性骨质疏松症病史，及以股骨颈T值为代表的骨密度值（BMD）；分别计算加人BMD的FRAX评分（FRAX／BMD）和不加入BMD的FRAX评分（FRAX／-）。根据髋部脆性骨折风险≥3％或其他主要部位脆性骨折风险≥20％的治疗切点，分为治疗建议相同组和治疗建议不同组，应用独立￡检验或卡方检验比较两组之间的危险因子。结果86．9％（133／153）患者不论是否加入BMD应用FRAX计算出的骨折风险相当，均能给出一致的治疗建议。年龄、性别和股骨颈T值在两组之间比较，差异有统计学意义（均P〈0．001），其他危险因子两组差异无统计学意义。结论对于中老年2型糖尿病患者，FRAX／-对骨折风险的预测价值与FRAX／BMD基本相当，提示不进行骨密度检查也可预测骨折风险；年龄较小、骨密度值较大及男性对象的FRAX／-对骨折风险有更高的预测价值。
Objective To evaluate the predictive value of fracture risk assessment tool （FRAX） for determining fracture probabilities in middle-aged and elderly patients with type 2 diabetes. Methods Retrospective analysis was carried out on 153 type 2 diabetic patients aged over 50 years undergoing dual energy X-ray absorptiometry measurements. Fracture risk factors including age, gender, height, weight, body mass index, history of previous fragility fractures, parental history of hip fracture, history of smoking, excessive drinking, long-term use of steroid hormone, history of rheumatoid arthritis, the history of secondary osteoporosis diseases, and femoral neck T-score of bone mineral density （BMD） were recorded. FRAX scores with BMD （FRAX/BMD） and without BMD （FRAX/-） were calculated. Therapeutic interventions were recommended if the 10-year risk of fractures was more than 3% for hip osteoporotic fractures and more than 20% for other major fractures. Subjects were separated into the identical treatment recommendation group and the different treatment recommendation. Fracture risk factors were compared between groups. Results 133 （6.9 % ） patients had identical fracture risk predictions in the FRAX calculation, regardless of whether BMD join in or not. Age, gender and femoral neck T scores had significant differences between the two groups （all P〈0. 001）, while other risk factors had no statistical differences between the two groups （all P〉0.05）. Conclusions In most middle aged and elderly patients with type 2 diabetes, the FRAX/-- provides the same prediction as FRAX/BMD value for predicting fracture risk, which shows that fracture risks can be predicted without bone density examination. The FRAX/- has higher predictive values on fracture for people who are younger, male, and has higher BMD .
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2015年第2期168-170,共3页
Chinese Journal of Geriatrics
关键词
骨折
危险性评估
骨密度
糖尿病
2型
Fractures, bone
Risk assessment
Bone density
Diabetes mellitus, type 2
