Neubecker Katherine, Adams-Huet Beverley, Farukhi Irfan M, Delapena Rosinda C, Gruntmanis Ugis
Department of Medicine, University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA.
J Osteoporos. 2011;2011:924595. doi: 10.4061/2011/924595. Epub 2011 Jul 28.
Decrease of bone mineral density (BMD) and fracture risk is increased in men with prostate cancer receiving androgen deprivation therapy (ADT). We looked at possible predictors of decreased BMD and increased fracture risk in men with prostate cancer; most of whom were on ADT. In a retrospective study, we analyzed serum, BMD, and clinical risk factors used in the Fracture Risk Assessment (FRAX) tool and others in 78 men with prostate cancer with reported height loss. The subjects were divided in two groups: 22 men with and 56 without vertebral fractures. 17 of the 22 men with vertebral fractures on spine X-rays did not know they had a vertebral fracture. Of those 17 men, 9 had not previously qualified for treatment based on preradiograph FRAX score calculated with BMD, and 6 based on FRAX calculated without BMD. Performing spine films increased the predictive ability of FRAX for vertebral fracture. Vertebral fracture was better predicted by FRAX for other osteoporotic fractures than FRAX for hip fractures. The inclusion of BMD in FRAX calculations did not affect the predictive ability of FRAX. The PSA level showed a positive correlation with lumbar spine BMD and accounted for about 9% of spine BMD.
接受雄激素剥夺治疗（ADT）的前列腺癌男性患者骨矿物质密度（BMD）降低，骨折风险增加。我们研究了前列腺癌男性患者BMD降低和骨折风险增加的可能预测因素；其中大多数患者正在接受ADT治疗。在一项回顾性研究中，我们分析了78例有身高降低报告的前列腺癌男性患者血清、BMD以及骨折风险评估（FRAX）工具中使用的临床风险因素和其他因素。受试者被分为两组：22例有椎体骨折和56例无椎体骨折。在脊柱X光片上显示有椎体骨折的22例男性中，有17例不知道自己有椎体骨折。在这17例男性中，9例此前根据基于BMD计算的放射前FRAX评分不符合治疗标准，6例根据未使用BMD计算的FRAX评分不符合治疗标准。进行脊柱X光片检查提高了FRAX对椎体骨折的预测能力。对于其他骨质疏松性骨折，FRAX对椎体骨折的预测优于对髋部骨折的预测。在FRAX计算中纳入BMD并不影响FRAX的预测能力。前列腺特异性抗原（PSA）水平与腰椎BMD呈正相关，约占脊柱BMD的9%。
