Hachuła Marcin, Pietrzyk Barbara, Gruszka Wojciech, Cedrych Ida, Chudek Jerzy
Student Scientific Society, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland.
Pathophysiology Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland.
Prz Menopauzalny. 2020 Jul;19(2):72-79. doi: 10.5114/pm.2020.97844. Epub 2020 Jul 13.
High social cost and high risk of disability make postmenopausal osteoporosis one of major public health problem in the 21 century. The aim of this study was to assess frequency of undiagnosed and untreated osteoporosis in postmenopausal women in the Upper Silesia Region of Poland. Additionally, we compare estimation of the 10-year probability of major osteoporotic fractures (MOF) and hip fractures (HF) based on fracture risk assessment tool (FRAX) with and without bone mineral density (BMD).
The survey included 450 postmenopausal women (age 65 ±11 years). A detailed questionnaire included demographic and anthropometric data, comorbidity, history of previous low-energy fractures, family medical history, and treatment for osteoporosis. The FRAX calculator was used to estimate the risk of MOF and HF.
Osteoporosis was previously diagnosed in 23.7% women. Of those 70.2% were receiving vitamin D, 27% calcium preparations, 33% bisphosphonates, and 22% were untreated. Only 42.2% women with previous fractures had been diagnosed with osteoporosis and 42.8% received any treatment. 12.5% women with FRAX-BMD ≥ 10% had no risk factors of osteoporosis and < 10% risk of MOF and HF in FRAX without BMD.
Osteoporosis often remains undiagnosed and untreated in postmenopausal women. There is a great need to popularize FRAX without BMD calculator among physicians, especially GPs, as the risk calculation justify the implementation of antiosteoporotic therapy. Women with burden of risk factors of fractures and borderline FRAX without BMD values, should be referred to a densitometry examination, as having greater risk of fracture than shown by FRAX without BMD.
高社会成本和高致残风险使绝经后骨质疏松症成为21世纪主要的公共卫生问题之一。本研究的目的是评估波兰上西里西亚地区绝经后妇女中未诊断和未治疗的骨质疏松症的发生率。此外，我们比较了基于骨折风险评估工具（FRAX）在有和没有骨密度（BMD）情况下主要骨质疏松性骨折（MOF）和髋部骨折（HF）的10年概率估计。
该调查纳入了450名绝经后妇女（年龄65±11岁）。一份详细的问卷包括人口统计学和人体测量数据、合并症、既往低能量骨折史、家族病史以及骨质疏松症治疗情况。使用FRAX计算器来估计MOF和HF的风险。
先前有23.7%的女性被诊断出患有骨质疏松症。其中70.2%正在接受维生素D治疗，27%接受钙制剂治疗，33%接受双膦酸盐治疗，22%未接受治疗。仅有42.2%既往有骨折的女性被诊断出患有骨质疏松症，42.8%接受了任何治疗。12.5% FRAX-BMD≥10%的女性没有骨质疏松症的风险因素，且在无BMD的FRAX中MOF和HF风险<10%。
绝经后女性的骨质疏松症常常未被诊断和治疗。非常有必要在医生中，尤其是全科医生中推广无BMD的FRAX计算器，因为风险计算可为抗骨质疏松治疗的实施提供依据。有骨折风险因素负担且FRAX无BMD值处于临界值的女性，应转诊进行骨密度检查，因为其骨折风险高于无BMD的FRAX所显示的风险。
