INSERM Research Unit 831, Hopital E Herriot, Université de Lyon, Lyon, France.
J Bone Miner Res. 2010 Oct;25(10):2101-7. doi: 10.1002/jbmr.106.
The FRAX tool estimates an individual's fracture probability over 10 years from clinical risk factors with or without bone mineral density (BMD) measurement. The aim of our study was to compare the predicted fracture probabilities and the observed incidence of fracture in French women during a 10-year follow-up. The probabilities of fracture at four major sites (hip, clinical spine, shoulder, or wrist) and at the hip were calculated with the FRAX tool in 867 women aged 40 years and over from the Os des Femmes de Lyon (OFELY) cohort.The incidence of fracture was observed over 10 years. Thus 82 women sustained 95 incident major osteoporotic (OP) fractures including 17 fractures at the hip. In women aged at least 65 years (n = 229), the 10-year predicted probabilities of fracture with BMD were 13% for major OP fractures and 5% for hip fractures, contrasting with 3.6% and 0.5% in women younger than 65 years (p < .0001). The predicted probabilities of both major OP and hip fractures were significantly higher in women with osteoporosis (n = 77, 18% and 10%) and osteopenia (n = 390, 6% and 2%) compared with women with normal BMD (n = 208, 3% and <1%; p < .0001. The predicted probabilities of fracture were two and five times higher in women who sustained an incident major OP fracture and a hip fracture compared with women who did not (p < .0001). Nevertheless, among women aged at least 65 years with low BMD values (T-score < or = -1; n = 199), the 10-year predicted probability of major OP fracture with BMD was 48% lower than the observed incidence of fractures (p < .01). A 10-year probability of major OP fracture higher than 12% identified more women with incident fractures than did BMD in the osteoporotic range (p < .05). In French women from the OFELY cohort, the observed incidence of fragility fractures over 10 years increased with age following a pattern similar to the predicted probabilities given by the FRAX tool. However, in women aged at least 65 years with low BMD, the observed incidence of fractures was substantially higher than the predicted probability.
FRAX 工具基于临床危险因素和（或）骨密度（BMD）测量结果，估计个体在 10 年内发生骨折的概率。本研究旨在比较 FRAX 工具预测的骨折概率和法国女性在 10 年随访期间发生的骨折实际发生率。我们在里昂女性骨研究（Os des Femmes de Lyon，OFELY）队列中纳入了 867 名年龄在 40 岁及以上的女性，使用 FRAX 工具计算了这些女性 4 个主要部位（髋部、临床脊柱、肩部或腕部）和髋部的骨折概率。通过 10 年的随访观察到骨折的实际发生率。因此，82 名女性发生了 95 例主要骨质疏松性（OP）骨折，其中 17 例为髋部骨折。在年龄至少 65 岁的女性（n=229）中，有 BMD 的 10 年预测主要 OP 骨折概率为 13%，髋部骨折概率为 5%，而年龄小于 65 岁的女性则分别为 3.6%和 0.5%（p<0.0001）。与 BMD 正常的女性（n=208，3%和<1%；p<0.0001）相比，患有骨质疏松症（n=77，18%和 10%）和骨量减少（n=390，6%和 2%）的女性，其主要 OP 和髋部骨折的预测概率显著更高。与未发生主要 OP 骨折和髋部骨折的女性相比，发生了主要 OP 骨折和髋部骨折的女性骨折预测概率高 2 倍和 5 倍（p<0.0001）。然而，在年龄至少 65 岁且 BMD 值较低（T 评分≤-1；n=199）的女性中，BMD 预测的 10 年主要 OP 骨折概率比观察到的骨折发生率低 48%（p<0.01）。与骨密度在骨质疏松范围内（p<0.05）相比，FRAX 工具预测的 10 年主要 OP 骨折概率大于 12%，可以识别出更多发生骨折的女性。在 OFELY 队列的法国女性中，10 年内脆性骨折的实际发生率随年龄增长而增加，这与 FRAX 工具预测的概率模式相似。然而，在年龄至少 65 岁且 BMD 较低的女性中，观察到的骨折发生率显著高于预测概率。
