Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, S10 2RX, Sheffield, UK.
Arch Osteoporos. 2021 Mar 1;16(1):51. doi: 10.1007/s11657-021-00905-w.
The hip fracture rates in South Africa were used to create ethnic-specific FRAX® models to facilitate fracture risk assessment.
The aim of this study was to develop FRAX models to compute the 10-year probability of hip fracture and major osteoporotic fracture and assess their potential clinical application.
Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for the White, Black African, Coloured and Indian population of South Africa. Age-specific 10-year probabilities of a major osteoporotic fracture were calculated in women to determine fracture probabilities at a femoral neck T score of -2.5 SD, or those equivalent to a woman with a prior fragility fracture. Fracture probabilities were compared with those from selected countries.
Probabilities were consistently higher in Indian than in Coloured men and women, in turn, higher than in Black South Africans. For White South Africans, probabilities were lower than in Indians at young ages up to the age of about 80 years. When a BMD T score of -2.5 SD was used as an intervention threshold, FRAX probabilities in women age 50 years were approximately 2-fold higher than in women of the same age but with an average BMD and no risk factors. The increment in risk associated with the BMD threshold decreased progressively with age such that, at the age of 80 years or more, a T score of -2.5 SD was no longer a risk factor. Probabilities equivalent to women with a previous fracture rose with age and identified women at increased risk at all ages.
These FRAX models should enhance accuracy of determining fracture probability amongst the South African population and help guide decisions about treatment.
南非的髋部骨折率被用于创建特定种族的 FRAX®模型，以促进骨折风险评估。
本研究旨在开发 FRAX 模型，以计算 10 年髋部骨折和主要骨质疏松性骨折的概率，并评估其潜在的临床应用。
将年龄和性别特异性髋部骨折发生率和国家死亡率纳入南非白种人、黑非洲人、有色人和印度人的 FRAX 模型。计算女性年龄特异性 10 年主要骨质疏松性骨折概率，以确定股骨颈 T 评分为-2.5 SD 的骨折概率，或相当于有脆性骨折史的女性的骨折概率。将骨折概率与选定国家进行比较。
印度男性和女性的概率始终高于有色人，有色人又高于南非黑人。对于南非白人，在大约 80 岁之前，年轻年龄段的概率低于印度人。当 BMD T 评分-2.5 SD 用作干预阈值时，50 岁女性的 FRAX 概率约为同年龄但平均 BMD 且无风险因素的女性的 2 倍。与 BMD 阈值相关的风险增加随着年龄的增长逐渐降低，以至于 80 岁或以上时，T 评分-2.5 SD 不再是一个风险因素。与既往骨折女性相当的概率随着年龄的增长而增加，并在所有年龄段识别出风险增加的女性。
这些 FRAX 模型应提高南非人群确定骨折概率的准确性，并有助于指导治疗决策。
