Osteoporosis Research and Diagnosis Center - CEDOES, Vitoria, Brazil.
Federal University of Espirito Santo, Vitoria, Brazil.
Arch Osteoporos. 2023 Nov 28;18(1):144. doi: 10.1007/s11657-023-01354-3.
Fracture probabilities derived from the original FRAX model for Brazil were compared to those from an updated model based on more recent regional estimates of the incidence of hip fracture. Fracture probabilities were consistently lower in the updated FRAX model. Despite large differences between models, differences in the rank order of fracture probabilities were minimal.
Recent epidemiological data indicate that the risk of hip fracture in Brazil is lower than that used to create the original FRAX model. This paper describes the epidemiology of hip fracture in Brazil and the synthesis of an updated FRAX model with the aim of comparing this new model with the original model.
Hip fracture rates from three cities in three regions were combined, weighted by the population of each region. For other major fractures, incidence rates for Brazil were estimated using Swedish ratios for hip to other major osteoporotic fracture (humerus, forearm or clinical vertebral fractures). Mortality estimates were taken from the UN.
Compared to the original FRAX model, the updated model gave lower 10-year fracture probabilities in men and women at all ages. Notwithstanding, there was a very close correlation in fracture probabilities between the original and updated models (r > 0.99) so that the revisions had little impact on the rank order of risk.
The disparities between the original and updated FRAX models indicate the importance of updating country-specific FRAX models with the advent of significant changes in fracture epidemiology.
比较了源自巴西原始 FRAX 模型的骨折概率与基于最近区域髋部骨折发生率的更新模型的骨折概率。更新的 FRAX 模型中的骨折概率始终较低。尽管两个模型之间存在较大差异，但骨折概率的排序差异最小。
最近的流行病学数据表明，巴西髋部骨折的风险低于创建原始 FRAX 模型时使用的风险。本文描述了巴西髋部骨折的流行病学，并综合了一个更新的 FRAX 模型，旨在比较这个新模型与原始模型。
将来自三个地区三个城市的髋部骨折发生率进行组合，按每个地区的人口加权。对于其他主要骨折，使用瑞典髋部与其他主要骨质疏松性骨折（肱骨、前臂或临床椎体骨折）的比值估计巴西的发生率。死亡率估计取自联合国。
与原始 FRAX 模型相比，更新模型在所有年龄段的男性和女性中都给出了较低的 10 年骨折概率。尽管如此，原始和更新模型之间的骨折概率非常密切相关（r>0.99），因此修订对风险的排序几乎没有影响。
原始和更新的 FRAX 模型之间的差异表明，随着骨折流行病学的显著变化，使用国家特定的 FRAX 模型进行更新非常重要。
