Siminoski Kerry, Leslie William D, Frame Heather, Hodsman Anthony, Josse Robert G, Khan Aliya, Lentle Brian C, Levesque Jacques, Lyons David J, Tarulli Giuseppe, Brown Jacques P
Department of Radiology and Diagnostic Imaging and Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Canada.
J Clin Densitom. 2007 Apr-Jun;10(2):120-3. doi: 10.1016/j.jocd.2007.01.001. Epub 2007 Feb 16.
In June 2005, new Canadian recommendations for bone mineral density (BMD) reporting in postmenopausal women and older men were published by Osteoporosis Canada (formerly the Osteoporosis Society of Canada) and the Canadian Association of Radiologists. The recommendations were developed by a multidisciplinary working group that included the Canadian Panel of the International Society for Clinical Densitometry and were reviewed and endorsed by multiple stakeholders. Previous Canadian osteoporosis guidelines advised intervention based on an individual's World Health Organization category (normal, osteopenia, or osteoporosis) as a marker of relative fracture risk. In the new approach, an individual's 10-yr absolute fracture risk, rather than BMD alone, is used for fracture risk categorization. Absolute fracture risk is determined using not only BMD results, but also age, sex, fragility fracture history, and glucocorticoid use. A procedure is presented for estimating absolute 10-yr fracture risk in untreated individuals, leading to assigning an individual to 1 of 3 absolute fracture risk categories: low risk (<10% 10-yr fracture risk), moderate risk (10-20%), and high risk (>20%). We propose that an individual's absolute fracture risk category should be the basis for deciding on treatment and frequency of BMD monitoring.
2005年6月，加拿大骨质疏松症协会（前身为加拿大骨质疏松症协会）和加拿大放射学会发布了关于绝经后女性和老年男性骨密度（BMD）报告的新建议。这些建议由一个多学科工作组制定，该工作组包括国际临床骨密度测量学会加拿大分会，并得到了多个利益相关者的审查和认可。加拿大先前的骨质疏松症指南建议根据个体的世界卫生组织分类（正常、骨量减少或骨质疏松症）进行干预，作为相对骨折风险的指标。在新方法中，个体的10年绝对骨折风险而非仅骨密度用于骨折风险分类。绝对骨折风险不仅根据骨密度结果确定，还根据年龄、性别、脆性骨折史和糖皮质激素使用情况确定。本文介绍了一种在未接受治疗的个体中估计10年绝对骨折风险的方法，从而将个体分为3个绝对骨折风险类别之一：低风险（10年骨折风险<10%）、中度风险（10%-20%）和高风险（>20%）。我们建议个体的绝对骨折风险类别应作为决定治疗和骨密度监测频率的依据。
