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FRAX评分对预测慢性肝病患者肌肉减少症的临床实用性

Clinical Usefulness of FRAX Score for Predicting Sarcopenia in Patients with Chronic Liver Disease.

作者信息

Saeki Chisato, Saito Mitsuru, Kanai Tomoya, Nakano Masanori, Oikawa Tsunekazu, Torisu Yuichi, Saruta Masayuki, Tsubota Akihito

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan.

Division of Gastroenterology, Department of Internal Medicine, Fuji City General Hospital, 50 Takashima-cho, Fuji-shi 417-8567, Shizuoka, Japan.

出版信息

J Clin Med. 2021 Sep 9;10(18):4080. doi: 10.3390/jcm10184080.

Abstract

We investigated the usefulness of the Fracture Risk Assessment tool (FRAX) for predicting sarcopenia in chronic liver disease (CLD). In this cross-sectional study, we evaluated 321 patients with CLD. The FRAX with and without bone mineral density (BMD) was employed to calculate the 10-year risks of major osteoporotic and hip fractures. The FRAX score for high fracture risk was defined as a 10-year major osteoporotic fracture probability of ≥20% or a 10-year hip fracture probability of ≥3%. The diagnosis of sarcopenia was based on the Japan Society of Hepatology criteria. According to the FRAX, with and without BMD, 134 (41.7%) and 193 (60.1%) patients had a high fracture risk, respectively. The high fracture risk group had a significantly higher frequency of sarcopenia than the non-high fracture risk group. FRAX scores of major osteoporotic and hip fractures were negatively correlated with handgrip strength and muscle mass. Using the FRAX with BMD, the cutoff scores of major osteoporotic and hip fractures for predicting sarcopenia were 8.55% (sensitivity/specificity, 0.847/0.568) and 3.35% (0.729/0.746), respectively. Using the FRAX without BMD, they were 18.5% (0.635/0.725) and 7.65% (0.729/0.758), respectively. The FRAX is a simple and convenient screening tool for predicting sarcopenia in patients with CLD.

摘要

我们研究了骨折风险评估工具(FRAX)在预测慢性肝病(CLD)患者肌肉减少症方面的实用性。在这项横断面研究中,我们评估了321例CLD患者。使用包含和不包含骨密度(BMD)的FRAX来计算10年主要骨质疏松性骨折和髋部骨折的风险。高骨折风险的FRAX评分定义为10年主要骨质疏松性骨折概率≥20%或10年髋部骨折概率≥3%。肌肉减少症的诊断基于日本肝脏学会标准。根据包含和不包含BMD的FRAX,分别有134例(41.7%)和193例(60.1%)患者具有高骨折风险。高骨折风险组的肌肉减少症发生率显著高于非高骨折风险组。主要骨质疏松性骨折和髋部骨折的FRAX评分与握力和肌肉量呈负相关。使用包含BMD的FRAX,预测肌肉减少症的主要骨质疏松性骨折和髋部骨折的截断分数分别为8.55%(敏感性/特异性,0.847/0.568)和3.35%(0.729/0.746)。使用不包含BMD的FRAX,它们分别为18.5%(0.635/0.725)和7.65%(0.729/0.758)。FRAX是一种简单便捷的筛查工具,可用于预测CLD患者的肌肉减少症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8586/8465236/85035d105538/jcm-10-04080-g001.jpg

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