Tilburg University CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg, The Netherlands.
Maturitas. 2011 Sep;70(1):74-9. doi: 10.1016/j.maturitas.2011.06.006. Epub 2011 Jul 8.
The identification of vertebral fractures (VFs) is important for decisions on fracture prevention. Vertebral fracture assessment (VFA) was shown to be a patient-friendly and valid method for detecting undiagnosed VFs in (Dutch) women. However, this has only been investigated in women seeking care at secondary or tertiary institutions.
To investigate the prevalence of previously undiagnosed VFs in women in Dutch primary care using VFA.
A total of 566 Dutch women aged 50 years and older (mean age, 69 years; SD=8.4) with clinical risk factors (CRFs) for fractures volunteered for dual-energy X-ray absorptiometry (DXA) measurement and VFA. VFs were defined semi-quantitatively using Genant's method.
One CRF was present in each of 130 women, 274 had two, and 162 women had more than two CRFs. In 120 (21%) of the women, previously unknown osteoporosis (T-score ≤ -2.5SD) was diagnosed, and in 174 (31%), a previously undiagnosed moderate or severe VF was found. No osteoporosis was found in 130 (75%) of the women with a VF. Based on the outcome of DXA, 21% of the women were eligible for treatment, while the combination of DXA and VFA resulted in a total of 250 (44%) women requiring treatment.
The percentage of previously unknown VFs diagnosed by VFA in women aged 50 years and older with one or more CRFs for fractures in primary care is high. When only using BMD measurements, only half the women eligible for treatment would actually receive this. We recommend performing VFA in all women aged 50 years and older who are referred for DXA based on Dutch case finding criteria.
识别椎体骨折（VF）对于预防骨折的决策很重要。椎体骨折评估（VFA）已被证明是一种患者友好且有效的方法，可用于检测（荷兰）女性中未诊断的 VF。然而，这仅在寻求二级或三级医疗机构护理的女性中进行了研究。
使用 VFA 调查荷兰初级保健中女性中先前未诊断的 VF 的患病率。
共有 566 名年龄在 50 岁及以上（平均年龄，69 岁；SD=8.4）且具有骨折临床危险因素（CRF）的荷兰女性自愿接受双能 X 射线吸收法（DXA）测量和 VFA。VF 使用 Genant 方法进行半定量定义。
130 名女性中的每一位都存在一个 CRF，274 名女性存在两个 CRF，162 名女性存在两个以上 CRF。在 120 名（21%）女性中，诊断出先前未知的骨质疏松症（T 评分≤-2.5SD），174 名（31%）女性发现先前未诊断的中度或重度 VF。在 130 名（75%）有 VF 的女性中未发现骨质疏松症。根据 DXA 的结果，21%的女性符合治疗条件，而 DXA 和 VFA 的联合结果导致总共 250 名（44%）女性需要治疗。
在初级保健中患有一个或多个骨折 CRF 的年龄在 50 岁及以上的女性中，通过 VFA 诊断出的先前未知 VF 的比例很高。仅使用 BMD 测量时，实际上只有一半符合治疗条件的女性会接受治疗。我们建议对所有根据荷兰病例发现标准转介至 DXA 的 50 岁及以上女性进行 VFA。
