Chavda Sumant, Chavda Bharti, Dube Rajani
Orthopedics, Ras Al Khaimah (RAK) Medical and Health Sciences University, Ras Al Khaimah, ARE.
General Surgery, Bristol Medical Center, Sharjah, ARE.
Cureus. 2022 Jul 2;14(7):e26518. doi: 10.7759/cureus.26518. eCollection 2022 Jul.
Osteoporosis is a widely prevalent condition among postmenopausal women characterized by low bone mass and skeletal fragility that increases the risk of fractures specifically in the hip, spine, wrist, humerus, and pelvis. It has become a major public health problem around the world. An osteoporotic fracture affects one in every three women and one in every five men aged 50 and above. Hip and spine fractures are linked to a higher death rate and can cause ambulation problems, depression, chronic pain, independence loss, and persistent discomfort. It not only puts a lot of strain on the individual but also causes a significant cost to society. Osteoporosis is a silent disease that goes unrecognized until a patient develops a pathological fracture. Diagnosis of osteoporosis is based on bone mineral density (BMD) estimation by dual-energy x-ray absorptiometry (DXA) as defined by WHO. However, in many resource-constrained and underdeveloped or low-middle income countries, it is not widely available. There are a number of questionnaire-based techniques available to identify such postmenopausal women and older men who may be at risk of having low BMD and osteoporosis. Our aim of the study is to search and compile such simple yet useful and validated screening and assessment tools for osteoporosis that can help to identify people at risk of having low BMD and the potential candidate who can benefit from BMD estimation in a resource-restricted geographical area or low/middle-income countries and benefit from treatment. Though these tools are not diagnostic can have broader applicability in general clinical practice and usefulness in identifying high-risk individuals and may prove cost-effective. Although it has limitations, FRAX is a widely used osteoporotic fracture risk assessment tool around the globe and when used with femoral neck BMD it has greater accuracy.
骨质疏松症在绝经后女性中广泛流行，其特征是骨量低和骨骼脆弱，这增加了骨折风险，尤其是髋部、脊柱、腕部、肱骨和骨盆骨折的风险。它已成为全球主要的公共卫生问题。每三名50岁及以上的女性中就有一人、每五名男性中就有一人会发生骨质疏松性骨折。髋部和脊柱骨折与较高的死亡率相关，可导致行走问题、抑郁、慢性疼痛、失去独立生活能力和持续不适。它不仅给个人带来很大压力，也给社会造成巨大成本。骨质疏松症是一种隐匿性疾病，在患者发生病理性骨折之前都未被发现。根据世界卫生组织的定义，骨质疏松症的诊断基于通过双能X线吸收法（DXA）估算骨密度（BMD）。然而，在许多资源有限、欠发达或低收入和中等收入国家，这种方法并不普遍可用。有多种基于问卷的技术可用于识别可能存在低骨密度和骨质疏松症风险的绝经后女性和老年男性。我们这项研究的目的是搜索并汇编此类简单但有用且经过验证的骨质疏松症筛查和评估工具，这些工具可帮助在资源有限的地理区域或低收入/中等收入国家识别有低骨密度风险的人群以及可能从骨密度估算中受益并接受治疗的潜在候选人。尽管这些工具并非诊断性工具，但在一般临床实践中可能具有更广泛的适用性，在识别高危个体方面有用，并且可能具有成本效益。尽管FRAX有局限性，但它是全球广泛使用的骨质疏松性骨折风险评估工具，与股骨颈骨密度一起使用时具有更高的准确性。
