2012 年波兰女性骨质疏松性骨折 10 年概率评估：FRAX 和 Nguyen 等的列线图方法-方法一致性及其临床实用性。

Ten-year probability of osteoporotic fracture in 2012 Polish women assessed by FRAX and nomogram by Nguyen et al.-Conformity between methods and their clinical utility.

机构信息

Metabolic Bone Diseases Unit, Dept. and Clinic of Internal Diseases, Diabetology and Nephrology, Medical University of Silesia, Katowice, Poland.

出版信息

Bone. 2010 Jun;46(6):1661-7. doi: 10.1016/j.bone.2010.02.012. Epub 2010 Feb 13.

DOI:10.1016/j.bone.2010.02.012

PMID:20156606

Abstract

PURPOSE

The aim of the cross-sectional study was to establish the degree of conformity between 10-year probability of osteoporotic fracture, assessed by FRAX, and using the nomograms, as proposed by Nguyen at al.

METHODS

Postmenopausal Polish women (2012) were examined in their mean age of 68.5+/-7.9 years (age range 55-90 years). Fracture probability by FRAX was based on age, BMI, prior fracture, hip fracture in parents, steroid use, rheumatoid arthritis, alcohol use, secondary osteoporosis and T-score for femoral neck BMD. Fracture probability by Nguyen's nomograms was based on age, the number of prior fractures, the number of falls and T-score for femoral neck BMD.

RESULTS

The mean conformity rate was 79.1% for any fracture risk (for threshold 20%) and 79.5% for hip fracture (threshold 3%). Any and hip fracture risks were significantly higher for both methods in women with fracture history in comparison to those without fracture and increased with ageing. The influence of prior fracture and ageing was more evident in Nguyen's nomograms. ROC analyses of any fracture risk in FRAX and Nguyen's methods demonstrated the area under curve (AUC) at 0.833 and 0.879, respectively. Similar analyses for hip fracture demonstrated AUCs for FRAX and Nguyen's technique at 0.726 and 0.850, respectively. The AUCs for Nguyen's nomograms were significantly larger than the AUCs for FRAX (p<0.0001).

CONCLUSION

The mean conformity for any fracture risk is 79.1% and 79.5% for hip fracture. Nguyen's nomograms seem to be more efficient in fracture risk assessment, especially for hip fractures, due to a higher accuracy of the method. The information on the number of falls during the last year and multiple fractures ought to be incorporated into the method of fracture risk prediction.

MINI-ABSTRACT: The degree of conformity was assessed in a group of 2012 women between 10-year FRAX prognosis of fracture and Nguyen et al.'s nomograms. The mean conformity for any fracture risk is 79.1% and 79.5% for hip fracture. Nguyen's nomograms seem to be more efficient in fracture risk assessment due to higher accuracy.

摘要

目的

本横断面研究的目的是确定 10 年骨质疏松性骨折概率（通过 FRAX 评估）与 Nguyen 等人提出的列线图之间的一致性程度。

方法

2012 年，对波兰绝经后女性进行检查，平均年龄为 68.5+/-7.9 岁（年龄范围 55-90 岁）。FRAX 骨折概率基于年龄、BMI、既往骨折、父母髋部骨折史、类固醇使用、类风湿关节炎、饮酒、继发性骨质疏松症和股骨颈 BMD 的 T 评分。基于年龄、既往骨折次数、跌倒次数和股骨颈 BMD 的 T 评分，使用 Nguyen 列线图计算骨折概率。

结果

对于任何骨折风险（阈值 20%）和髋部骨折风险（阈值 3%），平均一致性率分别为 79.1%和 79.5%。与无骨折史的女性相比，有骨折史的女性两种方法的任何和髋部骨折风险均显著更高，且随年龄增长而增加。在 Nguyen 列线图中，既往骨折和年龄的影响更为明显。FRAX 和 Nguyen 方法的任何骨折风险的 ROC 分析显示曲线下面积（AUC）分别为 0.833 和 0.879。对于髋部骨折，FRAX 和 Nguyen 技术的 AUC 分别为 0.726 和 0.850。与 FRAX 相比，Nguyen 列线图的 AUC 显著更大（p<0.0001）。