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| OSTA对2型糖尿病绝经妇女骨质疏松症筛查效果评价 |
| Evaluation of screening ability of OSTA for osteoporosis in postmenopausal women with type 2 diabetes |
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| DOI：10.3969/j.issn.1006.7108.2018.05.010 |
| 中文关键词: 骨质疏松 亚洲人骨质疏松自我筛查工具 2型糖尿病 绝经 分级诊疗 |
| 英文关键词:Osteoporosis Self-assessment tool for Asians (OSTA) Type 2 diabetes Post menopause Hierarchical medical system |
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| 中文摘要: |
| 目的 评估亚洲人骨质疏松自我筛查工具（osteoporosis self-assessment tool for Asians, OSTA）对2型糖尿病绝经妇女骨质疏松症（Osteoporosis，OP）的筛查效果，为分级诊疗中各级医疗机构，特别是基层医疗单位使用OSTA指数预测2型糖尿病绝经妇女骨质疏松症提供临床证据。方法 选取2015年1月至2016年6月在我院内分泌科住院的2型糖尿病绝经妇女151名，采用双能X线吸收法（DXA）测量腰椎（L1-4）和股骨颈骨密度，计算OSTA指数，判断OSTA指数预测2型糖尿病绝经妇女骨质疏松症的价值。结果 随年龄增长，受试者腰椎、股骨颈骨密度逐渐下降，OP检出率分别为28.5%、25.2%。OSTA各级风险中高风险指数在腰椎、股骨颈骨质疏松症检出率中最高，均为61%。OSTA中风险指数在腰椎和股骨颈OP检出率中较低，在骨量减少检出率中较高，分别是49.2%、50.8%。选取腰椎、股骨颈作为诊断的检测部位，OSTA指数预测OP的最佳截点分别是-2.9、-3.3时，对应的受试者工作特征曲线下面积最大(P=0.000)。结论 OSTA能较好的筛查出2型糖尿病绝经妇女骨质疏松症，可用于分级诊疗中基层医疗单位诊断骨质疏松症，建议OSTA最佳干预界值为-2.9。 |
| 英文摘要: |
| Objective To evaluate the screening effect of osteoporosis self-assessment tool for Asians (OSTA) for osteoporosis (OP) in postmenopausal women with type 2 diabetes, and to provide evidence for the use in hierarchical medical system. Methods A total of 151 postmenopausal women with type 2 diabetes who came to Department of Endocrinology in our hospital from Jan 2015 to Jun 2016 were selected. Bone mineral density (BMD) of the lumbar spine (L1-4) and femoral neck was measured with dual energy X-ray absorptiometry (DXA). OSTA index was calculated and assessed for the prediction of OP. Results BMD at L1-4 and the femoral neck decreased gradually with age, and the detectable rate of OP was 28.5% and 25.2%, respectively. The highest detectable rate of OP in high-risk group according to OSTA in L1-4 and the femoral neck was 61%. In medium-risk group according to OSTA in L1-4 and the femoral neck, the detectable rate of OP decreased. However, the detectable rate of osteopenia increased. They were 49.2% and 50.8%, respectively. Area under curves (AUC) of receiver operating curve for OSTA was the highest in L1-4 and the femoral neck when the best cutoff values were -2.9 and -3.3, respectively (P=0.000). Conclusion OSTA has certain predictive value in screening OP in postmenopausal women with type 2 diabetes, and it can be used in hierarchical medical system. The appropriate cutoff value of OSTA is -2.9. |
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