Department of Family Medicine and the Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555, USA.
J Am Board Fam Med. 2010 Mar-Apr;23(2):186-94. doi: 10.3122/jabfm.2010.02.090027.
Vertebral fracture, one of the most frequent osteoporotic fractures in both sexes, is a powerful indicator of future osteoporotic fractures. Vertebral fractures are associated with increased mortality and decreased quality of life. Osteoporosis is a major predictor of low-trauma fracture. The Male Osteoporosis Risk Estimation Score (MORES), a clinical prediction tool that uses age, weight, and a history of chronic obstructive pulmonary disorder, was developed and validated previously to identify men at risk for hip osteoporosis who might benefit from bone densitometry. This study evaluated the effectiveness of the MORES to identify men at risk of lumbar osteoporosis.
US population data from the National Health and Nutrition Examination Survey (NHANES, 1999-2004) were used to test the validity of the MORES to identify men at risk of lumbar osteoporosis.
The MORES value was compared with vertebral done densitometry (DXA) scores for men 50 years of age and older. The sensitivity was 0.582 (95% CI, 0.460-0.694) and specificity was 0.652 (95% CI, 0.627-0.676). Comparing universal DXA screening in 50-year-old men, the number needed to screen (NNS) to prevent one case of vertebral fracture would be reduced from 9418 to 3641 by prescreening with the MORES. In 70-year-old men, the MORES reduced the NNS from 4987 with universal screening to 3583.
This analysis validated the MORES as a clinical tool to identify men at risk for lumbar osteoporosis. Compared with universal screening, the MORES was able to reduce the NNS to prevent one additional vertebral fracture across all age groups except in men 85 to 89 years of age. The magnitude of the NNS to prevent one additional vertebral fracture does not support using the MORES to screen solely for osteoporosis of the lumbar spine.
椎体骨折是两性中最常见的骨质疏松性骨折之一，是未来发生骨质疏松性骨折的有力指标。椎体骨折与死亡率增加和生活质量下降有关。骨质疏松症是低创伤性骨折的主要预测因素。男性骨质疏松风险估计评分（MORES）是一种临床预测工具，使用年龄、体重和慢性阻塞性肺疾病病史，以前开发并验证过，用于识别有髋部骨质疏松风险的男性，这些男性可能受益于骨密度测量。本研究评估了 MORES 识别有腰椎骨质疏松风险男性的有效性。
使用来自国家健康和营养检查调查（NHANES，1999-2004 年）的美国人群数据来测试 MORES 识别有腰椎骨质疏松风险男性的有效性。
将 MORES 值与 50 岁及以上男性的椎体骨密度（DXA）评分进行比较。敏感性为 0.582（95%CI，0.460-0.694），特异性为 0.652（95%CI，0.627-0.676）。比较 50 岁男性的普遍 DXA 筛查，通过 MORES 进行预筛查可将预防一例椎体骨折所需的筛查人数（NNS）从 9418 减少到 3641。在 70 岁男性中，MORES 将 NNS 从 4987 降至 3583，与普遍筛查相比。
本分析验证了 MORES 作为一种识别有腰椎骨质疏松风险男性的临床工具。与普遍筛查相比，MORES 能够降低 NNS，以预防除 85-89 岁男性以外的所有年龄段的额外椎体骨折。预防额外一例椎体骨折的 NNS 数量不支持单独使用 MORES 筛查腰椎骨质疏松症。
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