骨折风险评估工具对膝骨关节炎患者骨质疏松症治疗决策的临床影响：骨折风险评估工具与世界卫生组织标准的多中心比较研究
Clinical Impact of the Fracture Risk Assessment Tool on the Treatment Decision for Osteoporosis in Patients with Knee Osteoarthritis: A Multicenter Comparative Study of the Fracture Risk Assessment Tool and World Health Organization Criteria.
作者信息
Kim Bo Young, Kim Hyoun-Ah, Jung Ju-Yang, Choi Sang Tae, Kim Ji-Min, Kim Sang Hyon, Kwon Seong-Ryul, Suh Chang-Hee, Kim Sung-Soo
机构信息
Division of Rheumatology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Korea.
Department of Rheumatology, Ajou University School of Medicine, Suwon 16449, Korea.
出版信息
J Clin Med. 2019 Jun 26;8(7):918. doi: 10.3390/jcm8070918.
BACKGROUND
To compare the frequency of high-risk osteoporotic fracture in patients with knee OA (OA) using the fracture risk assessment tool (FRAX) and the bone mineral density (BMD).
METHODS
We retrospectively assessed 282 Korean patients with knee OA who visited five medical centers and 1165 healthy controls (HCs) aged ≥50 years without knee OA. After matching for age, sex, and body mass index, 478 subjects (239 patients with knee OA and 239 HCs) were included.
RESULTS
Based on the BMD, the frequency of osteoporosis was 40.2% in patients with knee OA and 36.4% in HCs. The predicted mean FRAX major osteoporotic fracture probabilities calculated with or without femur neck BMD differed significantly between the knee OA and HCs (6.9 ± 3.8% versus 6.1 ± 2.8%, = 0.000 and 8 ± 3.6% versus 6.8 ± 2.3%, < 0.001, respectively). The mean FRAX hip fracture probabilities calculated with or without femur neck BMD differed significantly in the knee OA and HCs (2.1 ± 2.4% versus 1.7 ± 1.8%, = 0.006 and 3 ± 2.3% versus 2.4 ± 1.6%, < 0.001, respectively).
CONCLUSION
Our study suggests that FRAX may have a clinical impact on treatment decisions to reduce osteoporotic facture in patients with knee OA.
背景
使用骨折风险评估工具（FRAX）和骨密度（BMD）比较膝骨关节炎（OA）患者中高风险骨质疏松性骨折的发生率。
方法
我们回顾性评估了282名就诊于五个医疗中心的韩国膝OA患者以及1165名年龄≥50岁且无膝OA的健康对照者（HCs）。在对年龄、性别和体重指数进行匹配后，纳入了478名受试者（239名膝OA患者和239名HCs）。
结果
基于骨密度，膝OA患者中骨质疏松的发生率为40.2%，HCs中为36.4%。在膝OA患者和HCs之间，无论是否使用股骨颈骨密度计算得出的FRAX主要骨质疏松性骨折预测平均概率均存在显著差异（分别为6.9±3.8%对6.1±2.8%，P = 0.000；8±3.6%对6.8±2.3%，P < 0.001）。在膝OA患者和HCs之间，无论是否使用股骨颈骨密度计算得出的FRAX髋部骨折预测平均概率也存在显著差异（分别为2.1±2.4%对1.7±1.8%，P = 0.006；3±2.3%对2.4±1.6%，P < 0.001）。
结论
我们的研究表明，FRAX可能会对降低膝OA患者骨质疏松性骨折的治疗决策产生临床影响。
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