Department of Family Medicine, Medical University, Poznań, Poland.
Endokrynol Pol. 2011 Jan-Feb;62(1):30-6.
Epidemiological prognoses regarding the global spread of post-menopausal osteoporosis can prove somewhat nebulous. But it is clear that low-energy fractures and their consequences will become an increasingly serious health problem. Therefore it is crucial to implement prognostic procedures which could more effectively predict the incidence of osteoporosis and its complications.
The study involved 378 female patients aged 40-86 years for whom clinical risk factors of osteoporotic fracture were analysed. Densitometry (DPX) was performed at femoral neck. The 10-year risk of fracture was assessed according to the British model of FRAX calculator.
The study group was divided into two, depending on the history of low-energy fractures. Previous osteoporotic fractures were confirmed in 128 patients. In this group, the mean bone mineral density (BMD) values (0.717 g/cm(2)) were lower than in the group without fracture history (0.735 g/cm(2)). In 33.3% of patients aged 50-59 years and 17% of women aged 60-79 who required medical treatment for their clinical status (previous fracture), the FRAX value did not meet the criterion of pharmacotherapy administration. Considering BMD in the calculation of FRAX produced an even higher underestimation of the fracture risk. Of women aged 40-49, 25% were qualified for pharmacotherapy of osteoporosis. In that particular age category, BMD did not affect the FRAX value. BMD measurement had a higher discriminatory value among patients aged 50-79, increasing the number of patients requiring therapy by more than 50%.
关于绝经后骨质疏松症在全球传播的流行病学预测可能有些模糊。但很明显，低能量骨折及其后果将成为一个日益严重的健康问题。因此，实施能够更有效地预测骨质疏松症及其并发症发生率的预测程序至关重要。
这项研究涉及 378 名年龄在 40-86 岁的女性患者，分析了骨质疏松性骨折的临床危险因素。对股骨颈进行了密度测定（DPX）。根据英国 FRAX 计算器模型评估了 10 年骨折风险。
研究组根据低能量骨折的病史分为两组。128 例患者有骨质疏松性骨折病史。在该组中，平均骨密度（BMD）值（0.717 g/cm²）低于无骨折史组（0.735 g/cm²）。在年龄为 50-59 岁的 33.3%和年龄为 60-79 岁且因临床状况（既往骨折）需要治疗的 17%的女性中，FRAX 值不符合药物治疗标准。在计算 FRAX 时考虑 BMD 会导致骨折风险的估计值进一步低估。在年龄为 40-49 岁的女性中，有 25%有资格接受骨质疏松症药物治疗。在该特定年龄组中，BMD 对 FRAX 值没有影响。BMD 测量在 50-79 岁的患者中具有更高的区分价值，使需要治疗的患者人数增加了 50%以上。
