通过测量骨密度来筛查出一例未被诊断出的骨质疏松症病例，需要筛查多少名加拿大老年人？一项来自加拿大骨质疏松症研究（CaMos）的基于人群的研究。
What is the number of older Canadians needed to screen by measurement of bone density to detect an undiagnosed case of osteoporosis? a population-based study from CaMos.
作者信息
Sawka Anna M, Papaioannou Alexandra, Josse Robert G, Murray Timothy M, Ioannidis George, Hanley David A, Prior Jerilynn C, Thabane Lehana, Papadimitropoulos E A, Gafni Amiram, Pickard Laura, Anastassiades Tassos, Kirkland Susan, Adachi Jonathan D
机构信息
Department of Medicine, Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada.
出版信息
J Clin Densitom. 2006 Oct-Dec;9(4):413-8. doi: 10.1016/j.jocd.2006.07.004. Epub 2006 Sep 1.
Routine bone mineral densitometry (BMD) screening has been recommended for women aged >or=65 yr (Osteoporosis Canada [OC], International Society for Clinical Densitometry [ISCD], Canadian and United States Task Forces on Preventative Healthcare, and National Osteoporosis Foundation) and for men >or=65 yr (OC) or >or=70 yr (ISCD). We estimated the number of older Canadians needed to screen (NNS) by BMD to detect an undiagnosed case of osteoporosis, using prospective, multicenter, population-based data from the Canadian Multicentre Osteoporosis Study (CaMos). We included participants aged >or=65 yr with baseline dual-energy X-ray absorptiometry (DXA) BMDs at the femoral neck and lumbar spine (L1-L4). Osteoporosis was defined by a T-score <or=2.5 at either site. Patients were questioned about a prior diagnosis of osteoporosis. We studied 2699 women and 1032 men aged >or=65 yr. The percentage prevalence and 95% confidence intervals were determined. In individuals aged >or=65 yr, the prevalence of osteoporosis was 25.6% in women (95% confidence interval, 24.0%, 27.3%) and 8.9% in men (7.3%, 10.8%). In 652 men aged >or=70 yr, the prevalence of osteoporosis was 11.3% (9.1%, 14.0%). Of the participants with BMD-defined osteoporosis, 76.6% of woman aged >or=65 yr (73.2%, 79.6%; 516 of 674 women), 93.4% of men aged >or=65 yr (86.4%, 96.9%; 85 of 91), and 93.2% of men >or=70 yr (84.9%, 97.0%; 68 of 73) were not aware of it. Thus, the minimum NNS by BMD testing to detect one previously undiagnosed case of osteoporosis in Canada is: 6 women aged >or=65 yr, 13 men aged >or=65 yr, and 10 men aged >or=70 yr.
对于年龄≥65岁的女性（加拿大骨质疏松协会[OC]、国际临床骨密度测量学会[ISCD]、加拿大和美国预防保健特别工作组以及美国国家骨质疏松基金会）以及年龄≥65岁的男性（OC）或≥70岁的男性（ISCD），推荐进行常规骨密度（BMD）筛查。我们利用加拿大多中心骨质疏松研究（CaMos）的前瞻性、多中心、基于人群的数据，估算了通过骨密度检测来发现1例未确诊骨质疏松病例所需筛查的加拿大老年人数量（NNS）。我们纳入了年龄≥65岁、基线时股骨颈和腰椎（L1 - L4）有双能X线吸收法（DXA）骨密度检测结果的参与者。骨质疏松的定义为任一部位的T值≤ - 2.5。询问患者既往是否有骨质疏松诊断。我们研究了2699名年龄≥65岁的女性和1032名年龄≥65岁的男性。确定了患病率百分比及95%置信区间。在年龄≥65岁的个体中，女性骨质疏松患病率为25.6%（95%置信区间，24.0%，27.3%），男性为8.9%（7.3%，10.8%）。在652名年龄≥70岁的男性中，骨质疏松患病率为11.3%（9.1%，14.0%）。在骨密度定义为骨质疏松的参与者中，年龄≥65岁的女性中有76.6%（73.2%，79.6%；674名女性中的516名）、年龄≥65岁的男性中有93.4%（86.4%，96.9%；91名男性中的85名）以及年龄≥70岁的男性中有93.2%（84.9%，97.0%；73名男性中的68名）未意识到自己患病。因此，在加拿大通过骨密度检测发现1例既往未确诊的骨质疏松病例所需筛查的最小NNS为：年龄≥65岁的女性6名、年龄≥65岁的男性13名以及年龄≥70岁的男性10名。
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