Nakada Takafumi, Teranishi Masaaki, Ueda Yukio, Sone Michihiko
Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan; Department of Otorhinolaryngology, Gifu Prefectural Tajimi Hospital, 5-161 Maehata-cho, Tajimi, Gifu 507-8522, Japan.
Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-ku, Nagoya 466-8550, Japan.
Auris Nasus Larynx. 2018 Dec;45(6):1173-1177. doi: 10.1016/j.anl.2018.05.002. Epub 2018 May 18.
Patients with benign paroxysmal positional vertigo (BPPV) can have vitamin D deficiency, which is a cause of abnormal bone turnover. Several studies have established a relationship between osteoporosis and BPPV. The World Health Organization Fracture Risk Assessment Tool, widely known as FRAX (http://www.shef.ac.uk/FRAX), is a computer-based algorithm for assessing fracture risk. No direct comparison has been made between the FRAX scores of patients with BPPV and controls. The purpose of this study was to determine whether women with BPPV are at high risk of fracture as assessed using FRAX.
The study involved 40 postmenopausal women diagnosed with BPPV between July 2015 and April 2016, and 40 postmenopausal women as controls. The 10-year major osteoporotic and hip fracture risks were calculated using FRAX and were compared between BPPV patients and controls using Welch's t test and a general linear model.
The 10-year major osteoporotic fracture risk was 20.4%±12.1% for BPPV patients (aged 72.4±8.6years) and 14.3%±6.5% for controls (aged 71.2±6.3years). The 10-year hip fracture risk was 9.0%±9.8% for BPPV patients and 5.0%±3.9% for controls. The BPPV group had significantly higher 10-year major risks of osteoporotic fracture (p=0.0069) and hip fracture (p=0.0202) compared with controls. Similarly, after adjustment for age, the BPPV group had significantly higher 10-year risks of major osteoporotic fracture (p=0.0007) and hip fracture (p=0.0092) compared with controls.
Fracture risk calculated using FRAX was significantly higher in the BPPV group than in controls. Women with BPPV may need early intervention to prevent future fractures.
良性阵发性位置性眩晕（BPPV）患者可能存在维生素D缺乏，这是骨转换异常的一个原因。多项研究已证实骨质疏松症与BPPV之间存在关联。世界卫生组织骨折风险评估工具，广为人知的FRAX（http://www.shef.ac.uk/FRAX），是一种基于计算机的评估骨折风险的算法。尚未对BPPV患者与对照组的FRAX评分进行直接比较。本研究的目的是确定使用FRAX评估时，BPPV女性是否存在高骨折风险。
本研究纳入了2015年7月至2016年4月期间诊断为BPPV的40名绝经后女性，以及40名绝经后女性作为对照。使用FRAX计算10年主要骨质疏松性骨折和髋部骨折风险，并使用Welch t检验和一般线性模型在BPPV患者与对照组之间进行比较。
BPPV患者（年龄72.4±8.6岁）的10年主要骨质疏松性骨折风险为20.4%±12.1%，对照组（年龄71.2±6.3岁）为14.3%±6.5%。BPPV患者的10年髋部骨折风险为9.0%±9.8%，对照组为5.0%±3.9%。与对照组相比，BPPV组的10年主要骨质疏松性骨折风险（p=0.0069）和髋部骨折风险（p=0.0202）显著更高。同样，在调整年龄后，与对照组相比，BPPV组的10年主要骨质疏松性骨折风险（p=0.0007）和髋部骨折风险（p=0.0092）显著更高。
使用FRAX计算的骨折风险在BPPV组显著高于对照组。BPPV女性可能需要早期干预以预防未来骨折。
