Nakamura Toshitaka
Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Japan.
Clin Calcium. 2009 Dec;19(12):1723-8.
WHO fracture risk assessment tool (FRAX) been included in two representative guidelines, one issued from European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the other from National Osteoporosis Foundation in U.S. (NOF). Both guidelines commonly set the new track for the use of FRAX with BMD in addition to the conventional algorithm based on BMD and clinical risk factors. However, two guidelines differ in determining intervention threshold values of FRAX. ESCEO guideline proposed age-dependent values of, such as approximately 15%, 20%, and 30% of 10-year fracture probability for major osteoporotic fractures at the respective ages of 60, 70, and 80 years for postmenopausal women. On the other hand, NOF guideline indicated the fixed value 20% for osteoporotic fracture or 3% for hip fracture at the ages of 50 or more. These two different approaches may provide clues when including FRAX in the guideline for clinicians in Japan.
世界卫生组织骨折风险评估工具（FRAX）已被纳入两项具有代表性的指南中，一项由欧洲骨质疏松症和骨关节炎临床与经济学会（ESCEO）发布，另一项由美国国家骨质疏松症基金会（NOF）发布。这两项指南通常都为FRAX与骨密度（BMD）的联合使用设定了新路径，除了基于骨密度和临床风险因素的传统算法。然而，两项指南在确定FRAX的干预阈值方面存在差异。ESCEO指南提出了与年龄相关的值，例如对于绝经后女性，在60岁、70岁和80岁时，主要骨质疏松性骨折的十年骨折概率分别约为15%、20%和30%。另一方面，NOF指南指出，在50岁及以上人群中，骨质疏松性骨折的固定值为20%，髋部骨折为3%。当在日本的临床医生指南中纳入FRAX时，这两种不同的方法可能会提供线索。
