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转诊至意大利骨质疏松症中心的绝经后女性骨折风险评估:墨西拿的单日经验

Fracture risk assessment in postmenopausal women referred to an Italian center for osteoporosis: a single day experience in Messina.

作者信息

Catalano Antonino, Morabito Nancy, Basile Giorgio, Fusco Sergio, Castagna Graziella, Reitano Francesca, Albanese Raffaella Ciano, Lasco Antonino

机构信息

Unit of Geriatrics, Department of Internal Medicine, University Hospital of Messina, Messina, Italy.

出版信息

Clin Cases Miner Bone Metab. 2013 Sep;10(3):191-4.

Abstract

Osteoporosis is a major cause of fragility fractures and these are responsible of large social burden; nevertheless, osteoporosis often remains an underdiagnosed disease. FRAX is a new and simple validate fracture risk assessment tool helping physicians to select patients at high risk of future fragility fractures. To promote early diagnosis of osteoporosis, we evaluated fracture risk by FRAX and performed phalangeal quantitative ultrasound (QUS) measurements in a population of postmenopausal women referring to our center during the World Osteoporosis Day on 20th October 2011. Eighty post-menopausal women (age 60.8±8.6) were screened and the risk of major osteoporotic and hip fractures over ten years was calculated by considering multiple clinical risk factors (CRFs). The median risk of major osteoporotic fracture (%) was 4.9 (3.5-8.6) in women younger than 55 years, 7.3 (5.4-11) in women aged between 55 and 65 years and 17.5 (11-27) in women older than 65 years; the median risk of hip fracture (%) was 0.6 (0.3-1.3), 1.5 (0.9-2.5) and 7.2 (3.1-14) respectively. QUS measurements, were lower in the older women and when multiple CRFs coexisted, and were found to correlate with fracture risk, especially with hip fracture risk (p<0.05). Within one month from the screening, 75% (44/59) of the women over 55 years came back and received a diagnosis of osteoporosis/osteopenia by dual x-ray absorptiometry (DXA); a positive association between DXA and QUS measurements was observed (p<0.0001). Adequate treatment of these subjects could reduce fracture rates, improve the quality of life, and reduce the social costs of osteoporosis.

摘要

骨质疏松症是脆性骨折的主要原因,而脆性骨折会带来巨大的社会负担;然而,骨质疏松症往往仍未得到充分诊断。FRAX是一种新型且简便的经验证的骨折风险评估工具,可帮助医生筛选出未来发生脆性骨折风险较高的患者。为促进骨质疏松症的早期诊断,我们于2011年10月20日世界骨质疏松日期间,对前来我们中心就诊的绝经后女性群体,采用FRAX评估骨折风险并进行了指骨定量超声(QUS)测量。筛选了80名绝经后女性(年龄60.8±8.6岁),通过考虑多种临床风险因素(CRF)计算了她们未来十年发生主要骨质疏松性骨折和髋部骨折的风险。年龄小于55岁的女性,主要骨质疏松性骨折的中位风险(%)为4.9(3.5 - 8.6);年龄在55至65岁之间的女性为7.3(5.4 - 11);年龄大于65岁的女性为17.5(11 - 27);髋部骨折的中位风险(%)分别为0.6(0.3 - 1.3)、1.5(0.9 - 2.5)和7.2(3.1 - 14)。老年女性以及存在多种CRF并存时的QUS测量值较低,且发现其与骨折风险相关,尤其是与髋部骨折风险相关(p<0.05)。在筛查后的一个月内,55岁以上女性中有75%(44/59)回来接受了双能X线吸收法(DXA)诊断为骨质疏松症/骨量减少;观察到DXA与QUS测量值之间存在正相关(p<0.0001)。对这些受试者进行适当治疗可降低骨折发生率、改善生活质量并降低骨质疏松症的社会成本。

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