Institute of Clinical Physiology, National Research Council, Lecce, Italy.
ASL-LE, Ospedale Vito Fazzi, Lecce, Italy.
Aging Clin Exp Res. 2023 Apr;35(4):763-773. doi: 10.1007/s40520-023-02358-2. Epub 2023 Feb 8.
Accurate estimation of the imminent fragility fracture risk currently represents a challenging task. The novel Fragility Score (FS) parameter, obtained during a Radiofrequency Echographic Multi Spectrometry (REMS) scan of lumbar or femoral regions, has been developed for the non-ionizing estimation of skeletal fragility.
The aim of this study was to assess the performance of FS in the early identification of patients at risk for incident fragility fractures with respect to bone mineral density (BMD) measurements.
Data from 1989 Caucasians of both genders were analysed and the incidence of fractures was assessed during a follow-up period up to 5 years. The diagnostic performance of FS to discriminate between patients with and without incident fragility fracture in comparison to that of the BMD T-scores measured by both Dual X-ray Absorptiometry (DXA) and REMS was assessed through ROC analysis.
Concerning the prediction of generic osteoporotic fractures, FS provided AUC = 0.811 for women and AUC = 0.780 for men, which resulted in AUC = 0.715 and AUC = 0.758, respectively, when adjusted for age and body mass index (BMI). For the prediction of hip fractures, the corresponding values were AUC = 0.780 for women and AUC = 0.809 for men, which became AUC = 0.735 and AUC = 0.758, respectively, after age- and BMI-adjustment. Overall, FS showed the highest prediction ability for any considered fracture type in both genders, resulting always being significantly higher than either T-scores, whose AUC values were in the range 0.472-0.709.
FS displayed a superior performance in fracture prediction, representing a valuable diagnostic tool to accurately detect a short-term fracture risk.
目前，准确估计即将发生的脆性骨折风险仍是一项具有挑战性的任务。新型脆性评分（FS）参数是通过对腰椎或股骨区域进行射频超声多谱测量（REMS）扫描获得的，用于非电离性骨骼脆弱性估计。
本研究旨在评估 FS 在早期识别有脆性骨折风险的患者方面的表现，以评估其与骨密度（BMD）测量的相关性。
分析了 1989 名白种人（男女各半）的数据，并在长达 5 年的随访期间评估了骨折的发生率。通过 ROC 分析评估 FS 区分有和无脆性骨折事件的患者的诊断性能，并与双能 X 线吸收法（DXA）和 REMS 测量的 BMD T 评分进行比较。
在预测一般性骨质疏松性骨折方面，FS 对女性的 AUC 值为 0.811，对男性的 AUC 值为 0.780，经年龄和体重指数（BMI）校正后，AUC 值分别为 0.715 和 0.758。对于髋部骨折的预测，相应的 AUC 值分别为女性的 0.780 和男性的 0.809，经年龄和 BMI 校正后，AUC 值分别为 0.735 和 0.758。总体而言，FS 在两性中对任何考虑的骨折类型均具有最高的预测能力，始终显著高于 T 评分（其 AUC 值范围为 0.472-0.709）。
FS 在骨折预测方面表现出优异的性能，是一种准确检测短期骨折风险的有价值的诊断工具。
