Division of Radiology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Norwegian University of Science and Technology, NTNU, Department of Public Health and Nursing, Norway.
Maturitas. 2021 Feb;144:60-67. doi: 10.1016/j.maturitas.2020.10.019. Epub 2020 Nov 6.
To evaluate the predictive ability of digital X-ray radiogrammetry (DXR) for fracture in women attending general mammography screening.
In a nested case-control study, women aged between 40 and 75 years, who attended the regional mammography screening program, had their bone mass assessed with DXR and provided information regarding clinical risk factors for osteoporosis. Follow-up was done through cross-referencing with National Patient Registers. Associations between DXR, clinical risk factors and fracture risk were examined. Receiver operating characteristics curves for DXR T-score and different fracture types were plotted, and their respective AUC calculated.
Fractures (hip, major osteoporotic and any clinical facture). Fracture diagnoses were retrieved from National Patient Registers.
14,841 women had their bone mass examined in conjunction with mammography. Of these women, 10,967 returned fully completed questionnaires regarding clinical risk factors. In total 605 fractures (including 355 major osteoporotic fractures and 18 hip fractures) occurred during the follow-up period (median follow-up time was 3.3 years). Women with fractures were older and had lower DXR T-score compared with those without. DXR T-score correlated with fracture risk. HR/SD T-score decrease was 2.15 (CI 1.55-3.00) for hip, 1.47 (CI 1.36-1.59) for major osteoporotic and 1.33 (CI 1.26-1.42) for any clinical fracture. The AUCs for the different fracture types were 0.79 (hip), 0.69 (major osteoporotic) and 0.65 (any clinical).
DXR T-score is negatively correlated with risk of fracture in a general female population. This indicates a potential use of DXR in population-based screening for osteoporosis.
评估数字 X 射线放射测角术（DXR）对参加常规乳腺摄影筛查的女性骨折的预测能力。
在巢式病例对照研究中，年龄在 40 岁至 75 岁之间的女性参加了区域性乳腺摄影筛查计划，通过 DXR 评估其骨量，并提供有关骨质疏松症临床危险因素的信息。通过与国家患者登记处交叉引用进行随访。检查了 DXR、临床危险因素和骨折风险之间的关系。绘制了 DXR T 评分和不同骨折类型的受试者工作特征曲线，并计算了各自的 AUC。
骨折（髋部、主要骨质疏松性和任何临床骨折）。骨折诊断从国家患者登记处检索。
14841 名女性进行了骨量检查与乳腺摄影相结合。在这些女性中，有 10967 名女性完整地返回了有关临床危险因素的完整问卷。在随访期间共发生 605 例骨折（包括 355 例主要骨质疏松性骨折和 18 例髋部骨折）（中位随访时间为 3.3 年）。与无骨折的女性相比，有骨折的女性年龄较大，DXR T 评分较低。DXR T 评分与骨折风险相关。HR/SD T 评分降低髋部骨折为 2.15（CI 1.55-3.00），主要骨质疏松性骨折为 1.47（CI 1.36-1.59），任何临床骨折为 1.33（CI 1.26-1.42）。不同骨折类型的 AUC 分别为 0.79（髋部）、0.69（主要骨质疏松性）和 0.65（任何临床）。
在一般女性人群中，DXR T 评分与骨折风险呈负相关。这表明 DXR 在骨质疏松症的人群筛查中具有潜在的应用价值。
