Grygorieva Nataliia, Musiienko Anna, Zaverukha Nataliia, Bystrytska Maryna, Povoroznyuk Roksolana
D. F. CHEBOTAREV INSTITUTE OF GERONTOLOGY, NAMS OF UKRAINE, KYIV, UKRAINE.
D. F. CHEBOTAREV INSTITUTE OF GERONTOLOGY, NAMS OF UKRAINE, KYIV, UKRAINE; SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE.
Wiad Lek. 2022;75(12):2920-2925. doi: 10.36740/WLek202212105.
The aim: To assess bone mineral density and 10-year probability of major osteoporotic and hip fractures using the Ukrainian FRAX® version for postmenopausal women with Type II diabetes mellitus and to determine the need for OP treatment according to the algorithm FRAX and BMD.
Materials and methods: 690 females aged 50-89 years (mean age 67.0±7.7 years) were divided into two groups: Group I (n=345) was made of mostly healthy women, Group II (n=345) - patients with Type II diabetes mellitus. Bone mineral density was measured using dual-energy X-ray absorptiometry, 10-year probability of major osteoporotic and hip fractures was calculated using the Ukrainian FRAX® model.
Results: Bone mineral density and 10-year risk of major osteoporotic and hip fractures did not differ depending on the Type II diabetes mellitus presence, however the frequencies of low-energy, vertebral and all previous fractures were higher in Group II. 19% of women with diabetes mellitus and 38% of healthy ones required antiosteoporotic treatment according to dual-energy X-ray absorptiometry and only 8% and 2%, respectively, according to the FRAX. These indices became higher after recalculation of FRAX taking into account bone mineral density, however they were lower in patients with diabetes mellitus compared to the corresponding rate in the Group I (FRAX (high risk) + bone mineral density: 26% and 41%; χ2 = 18.2; p<0.001).
Conclusions: The use of FRAX in combination with bone mineral density resulted in an increased necessity for antiosteoporotic treatment, indicating the urgency of using both indices for osteoporotic fractures prediction in patients with Type II diabetes mellitus.
评估使用乌克兰版FRAX®工具对绝经后2型糖尿病女性的骨密度以及主要骨质疏松性骨折和髋部骨折的10年发生概率，并根据FRAX和骨密度算法确定骨质疏松症治疗的必要性。
材料与方法：690名年龄在50 - 89岁（平均年龄67.0±7.7岁）的女性被分为两组：第一组（n = 345）主要为健康女性，第二组（n = 345）为2型糖尿病患者。使用双能X线吸收法测量骨密度，使用乌克兰版FRAX®模型计算主要骨质疏松性骨折和髋部骨折的10年发生概率。
结果：骨密度以及主要骨质疏松性骨折和髋部骨折的10年风险不受2型糖尿病存在与否的影响，然而第二组低能量骨折、椎体骨折和既往所有骨折的发生率更高。根据双能X线吸收法，19%的糖尿病女性和38%的健康女性需要抗骨质疏松治疗，而根据FRAX分别仅为8%和2%。在考虑骨密度重新计算FRAX后，这些指标有所升高，但糖尿病患者的指标低于第一组的相应比例（FRAX（高风险）+骨密度：26%和41%；χ2 = 18.2；p<0.001）。
结论：FRAX与骨密度联合使用导致抗骨质疏松治疗的必要性增加，表明在2型糖尿病患者中使用这两个指标预测骨质疏松性骨折的紧迫性。
