应用FRAX骨折风险预测工具模拟评估不同国家人群骨折风险的临床研究
Application of FRAX to simulate assessment of fracture risk in different countries
  
DOI:10.3969/j.issn.1006-7108.2019.01.012
中文关键词:  骨折风险评估工具  骨质疏松症  骨质疏松性骨折  10年内重要部位骨折概率  10年内髓部骨折概率  骨密度
英文关键词:fracture risk assessment Tool(FRAX)  osteoporosis  osteoporotic fracture  probability of a major osteoporotic fracture  probability of hip fracture  bone mineral density
基金项目:北京市科技计划课题《大兴区关于“北京市城镇居民骨质疏松症社区规范化管理标准”等相关技术的推广应用研究》(Z151100004015233)
作者单位
栗敏1 郭勇1* 张智海2 李宝2 1.北京市大兴区中西医结合医院北京100076 2.中国医科大学航空总医院脊柱外科北京100012 
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中文摘要:
      目的 应用FRAX工具模拟评估中国、日本、德国三国人群的10年内重要部位骨折概率(PMOF)及10年内髓部骨折概率(PHF),分析比较不同国家的骨折风险性差异,分析比较各国骨折风险与年龄、性别的变化关系。方法 收集2 976例受检者FRAX骨折风险评估危险因素11项及股骨颈骨密度BMD,应用FRAX骨折风险评估网站分别模拟评估中国、日本、德国三国模式下PMOF、PHF,采用两独立样本t检验及Mann-Whitney U检验分别对三国数据进行两两比较,并观察三国PMOF、PHF性别间差异及随年龄的变化趋势。结果 (1)三国不论男性、女性,均表现为PMOF在40~49岁中国最小、德国最大,50岁以上中国最小、日本最大,且差异有统计学意义。PHF在40~59岁日本最小、德国最大,60岁以上中国最小、德国最大,且差异有统计学意义。(2)三国不论男性、女性,PMOF、PHF均随年龄的增长而增长,仅中国在80岁以上年龄组两者概率有所下降。三国50岁以后女性10年内骨质疏松性骨折概率均大于男性,且女性PMOF、PHF概率增长的速度明显大于男性。结论 骨质疏松性骨折的发生概率存在地域差异,在同等条件下,欧洲国家发生骨质疏松性骨折的概率大于亚洲国家,发达国家骨折的概率大于发展中国家。骨质疏松性骨折的发生概率随年龄增长而增长,女性较男性更易发生骨质疏松性骨折。
英文摘要:
      Objective Using the FRAX tool to simulate the evaluation of 10 years probability of major osteoporotic fracture (PMOF) and 10 years probability of hip fracture(PHF ) for populations in China , Japan , and Germany , to analyze and compare fracture risk differences in different countries,and to analyze and compare the relationship between fracture risk and age and gender in each country. Methods 2 976 subjects were assessed for 11 risk factors for FRAX fracture risk assessment and bone mineral density(BMD).The FRAX fracture risk assessment website was used to simulate the evaluation of PMOF and PHF in China, Japan, and Germany. Two independent samples t test and Mann-Whitney U tests were used for pairwise comparison the data of the three countries,and to observe the gender differences and trends with age in PMOF and PHF in the three countries. Results (1)In both man and women in the three countries,PMOF was the lowest in China and the highest in Germany in those aged 40 to 49 years,PMOF was the lowest in China and the highest in Japan in those aged over 50 years,and the differences were statistically significant. PHF was the lowest in Japan and the highest in Germany in those aged 40 to 59 years,PHF was the lowest in China and the highest in Germany in those aged over 60 years, and the differences were statistically significant.(2)Regardless of men and women, in the three countries PMOF and PHF all increased with age, and only the probability in the 80+ age group in China had decreased. In all three countries,the 10 years probability of osteoporotic fractures in women aged over 50 years was higher than that of men, and the increase in the probability of PMOF and PHF with age in women was significantly faster than that of men. Conclusion There are regional differences in the probability of osteoporotic fracture. Under the same conditions,the probability of osteoporotic fracture in European countries is greater than that in Asian countries. The probability of fracture in developed countries is greater than that in developing countries. The incidence of osteoporotic fractures increases with age, women are more likely to have osteoporotic fractures than men.
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