Polska Fundacja Osteoporozy, Białystok, Poland.
Endokrynol Pol. 2011;62(4):290-8.
The 2007 WHO guidelines for the treatment of osteoporosis require that we know the population risk of an osteoporotic fracture for each country to classify patients requiring treatment.
Studies have been carried out among a random cohort of 1,608 women over the age of 40 to assess a ten-year absolute risk of main osteoporotic fractures (AR-10 m.o.fx.) and hip fractures (AR-10 h.fx.) by using FRAX®BMI and FRAX®BMD based on the epidemiology of fractures in England.
Both methods gave similar results in assessing the probability of fracture, showing the increase of AR-10 m.o.fx. in subsequent life decades to rise from 5% in the fifth decade to 25% in the ninth, mean result 11%, and AR-10 h.fx. to rise over the same period from 0.5% to 13%, mean result 3%. The number of fractures increases up to the seventh and eighth decades, and decreases according to the number of patients in the age group. The commonest fracture risks reported, other than old age and low BMI, were a prior fracture, a family history of hip fracture and smoking.
Comparative analysis of examined parameters of FRAX between people with and without fractures showed considerable differences only in age and AR-10 m.o.fx. This doubled in people with previous fractures (ca. 18% vs. 9%) and AR-10 h.fx. (ca. 5% vs. 2.5%). The "middle" area between the average population risks (AR-10 m.o.fx. 11% and AR-10 h.fx. 3%) and the risks in patients with fractures (AR-10 m.o.fx. 18% and AR-10 h.fx. 9%) could work as an indicator: below those values the risk is low and no treatment is required; above those values, the risk is high, and intervention is necessary; the middle area implies a BMD examination and reassessment of the fracture risk.
2007 年世卫组织骨质疏松症治疗指南要求我们了解每个国家骨质疏松性骨折的人群风险，以便对需要治疗的患者进行分类。
对 1608 名年龄在 40 岁以上的随机队列进行了研究，以评估基于英格兰骨折流行病学的 FRAX®BMI 和 FRAX®BMD 的 10 年主要骨质疏松性骨折（AR-10 m.o.fx.）和髋部骨折（AR-10 h.fx.）的 10 年绝对风险。
两种方法在评估骨折概率方面给出了相似的结果，表明在随后的生命十年中，AR-10 m.o.fx.的增加幅度从第五个十年的 5%上升到第九个十年的 25%，平均为 11%，AR-10 h.fx.在同一时期从 0.5%上升到 13%，平均为 3%。骨折数量在第七和第八个十年增加，然后根据年龄组的患者数量减少。除了年龄和低 BMI 之外，报告的最常见骨折风险因素还有既往骨折、髋部骨折家族史和吸烟。
对 FRAX 检查参数的比较分析表明，只有年龄和 AR-10 m.o.fx.在有和无骨折的人群之间存在相当大的差异。在有既往骨折的人群中，这一数字翻了一番（约 18%比 9%），在 AR-10 h.fx.中翻了一番（约 5%比 2.5%）。在平均人群风险（AR-10 m.o.fx.为 11%，AR-10 h.fx.为 3%）和骨折患者风险（AR-10 m.o.fx.为 18%，AR-10 h.fx.为 9%）之间的“中间”区域可以作为一个指标：低于这些值，风险较低，不需要治疗；高于这些值，风险较高，需要干预；中间区域意味着需要进行 BMD 检查和重新评估骨折风险。
