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| BMD、OSTA与FRAX®预测绝经后女性骨质疏松性 骨折风险的比较研究 |
| Comparative study of BMD，OSTA，and FRAX in the prediction of osteoporotic fracture risk in postmenopausal women |
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| DOI： |
| 中文关键词: 绝经后女性 骨质疏松性骨折 骨密度 OSTA，FRAX |
| 英文关键词:Postmenopausal women Osteoporotic fracture BMD OSTA FARX |
| 基金项目: |
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| 中文摘要: |
| 目的比较腿D、OSTA与FRAX? (不含BMD模型）预测绝经后女性骨质疏松性骨折风险的准确性，为选择适合我国 绝经后女性骨质疏松性骨折风险工具提供研究依据。方法2011年1月至2011年12月，以首都医科大学附属北京友谊医院 就诊并接受DXA骨密度检査的绝经后女性为研究对象，连续纳人1497例，建立队列。基于基线数据，以就诊时发生骨质疏松性骨折与否为参考标准，绘制ROC曲线，比较BMD、OSTA及FRAX?评分预测骨质疏松骨折发生风险的准确性。结果发生骨折组（n = 343)患者的BMD，OSTA评分与FRAX?评分均低于未发生骨折组（n = 1154)，且差异均有统计学意义。BMD、OSTA及FRAX?评分（不使用骨密度的主要部位FRAX?评分）预测骨折风险的ROC曲线下面积分别为0.654(95%CI:621.-0.687)，0. 629(95% CI：0. 595 -0. 663)和 0. 907(95% CI：0. 888 - 0. 926)，最佳诊断截点值分别为-1.25，-1.90 和3.65%。结论不使用骨密度的主要部位FRAX?评分可用于我国绝经后女性的骨质疏松性骨折风险评估，但诊断截点值 为3. 65%，远低于WHO推荐的20%，其原因需要进一步研究。 |
| 英文摘要: |
| Objective To compare the accuracy of BMD，OSTA， and FRAX ( non-BMD model) on the prediction of osteoporotic fracture risk，and to provide a suitable tool of osteoporotic fractures for Chinese postmenopausal women. Methods This cohort study assessed 1497 postmenopausal women who took BMD test in Beijing Friendship Hospital from January 2011 to December 2011. Based on the baseline data and the occurrence of actual fractures，ROC curves were drawn. The accuracy of BMD， OSTA，and FRAX (non-BMD model) in the prediction of osteoporotic fracture risk was compared. Result Values of BMD， OSTA，and FRAX in fracture group (n =343) were lower than those in non-fracture group (n = 1154)，and the difference was statistically significant. AUC areas of ROC curves of BMD，OSTA，and FRAX were 0. 654 (95% CI: 0. 621 - 0. 687)，0. 629 (95%CI： 0. 595 -0. 663)，and 0. 907 (95%CI: 0. 888 -0. 926)，respectively. The best cutoff values were -1.25， -1. 90，and 3.65%，respectively. Conclusion FRAX without BMD values can be used for the prediction of osteoporotic fracture risk in Chinese postmenopausal women. However， the diagnosis cutoff value is 3.65%， which is far less than 20% of the WHO recommendation. Therefore， further study should be conducted to explore the reason. |
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