Bastos-Silva Yasmin, Aguiar Luiza Borges, Pinto-Neto Aarão M, Baccaro Luiz Francisco, Costa-Paiva Lúcia
Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Barão Geraldo, 13083-881, Campinas, SP, Brazil.
Arch Osteoporos. 2016;11:16. doi: 10.1007/s11657-015-0255-y. Epub 2016 Apr 11.
The risks of fracture were calculated in 402 postmenopausal Brazilian women by FRAX with or without the inclusion of bone densitometry values. The correlation between the risk of major osteoporosis fracture or hip fracture calculated by FRAX with or without BMD was similar in this population, 0.76 and 0.64, respectively.
The objective of this study is to evaluate the degree of agreement between the 10-year fracture risk in postmenopausal Brazilian women, calculated using the WHO Fracture Risk Assessment Tool (FRAX)-Brazil, with and without the inclusion of bone mineral density (BMD) values.
A cross-sectional study was conducted with 402 postmenopausal women (≥40 years) who had undergone bone densitometry prior to initiating any pharmacological treatment for osteopenia or osteoporosis. The risks of a major osteoporosis fracture or hip fracture were calculated according to FRAX-Brazil either using clinical risk factors alone or with the inclusion of BMD value. The tests used were intraclass correlation coefficient, Mann-Whitney test, and univariate linear regression analysis.
When the patients were classified according to the cutoff point defined as determining a high risk of a major osteoporosis fracture (≥20 %), 0.75 % were defined as high risk when BMD values were included and 1 % when they were not. With respect to the hip, 5.22 % were defined as having a high risk of fracture (≥3 %) when BMD values were included and 11.44 % when they were not. Intraclass correlation coefficient between the FRAX-Brazil assessed risk with and without the inclusion of BMD values was 0.76 (95 % CI 0.716-0.799) for a major osteoporosis fracture and 0.64 (95 %CI 0.583-0.698) for a hip fracture.
The correlation found for the FRAX-Brazil score obtained with and without the inclusion of BMD values was good for the risk of a major osteoporosis fracture and moderate for the risk of a hip fracture. The fracture risk calculated was similar in this population irrespective of whether or not BMD values were included in the algorithm.
在402名巴西绝经后女性中，使用FRAX计算了有无骨密度测量值时的骨折风险。在该人群中，FRAX计算的有或无骨密度测量值时的主要骨质疏松性骨折或髋部骨折风险之间的相关性相似，分别为0.76和0.64。
本研究的目的是评估使用世界卫生组织骨折风险评估工具（FRAX）-巴西版计算的巴西绝经后女性10年骨折风险，有无纳入骨密度（BMD）值时的一致性程度。
对402名绝经后女性（≥40岁）进行了一项横断面研究，这些女性在开始任何治疗骨质减少或骨质疏松的药物治疗之前接受了骨密度测量。根据FRAX-巴西版，仅使用临床风险因素或纳入BMD值来计算主要骨质疏松性骨折或髋部骨折的风险。使用的检验方法为组内相关系数、曼-惠特尼检验和单变量线性回归分析。
当根据定义为确定主要骨质疏松性骨折高风险（≥20%）的截断点对患者进行分类时，纳入BMD值时有0.75%被定义为高风险，未纳入时为1%。对于髋部，纳入BMD值时有5.22%被定义为骨折高风险（≥3%），未纳入时为11.44%。FRAX-巴西版评估的有或无BMD值时的风险之间的组内相关系数，对于主要骨质疏松性骨折为0.76（95%CI 0.716-0.799），对于髋部骨折为0.64（95%CI 0.583-0.698）。
FRAX-巴西版评分在纳入和未纳入BMD值时所发现的相关性，对于主要骨质疏松性骨折风险而言良好，对于髋部骨折风险而言中等。在该人群中，无论算法中是否纳入BMD值，计算出的骨折风险相似。
