Sezgin Aydan, Güvenç Saçıntı Huriye, Osmanlı Elşad, Mangır Kübra, Saçıntı Koray Görkem, Sezgin Erdem Aras
Gazi Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, 06560 Yenimahalle, Ankara, Türkiye.
Jt Dis Relat Surg. 2025 Jan 2;36(1):142-147. doi: 10.52312/jdrs.2025.1995. Epub 2024 Dec 9.
This study aimed to evaluate the impact of integrating obstetric parameters into the Fracture Risk Assessment Tool (FRAX) on the precision of risk assessment.
In this retrospective study, patients who experienced postmenopausal fragility fractures of the distal radius, proximal femur, or lumbar vertebrae between January 1, 2021, and December 31, 2023, were included. Obstetric histories, along with standard FRAX parameters, were obtained by phone interviews. Based on the FRAX major osteoporotic fracture risk score calculated without bone mineral density, patients were classified into high-, intermediate-, and low-risk group categories. Differences in age at menarche, age at menopause, lactation duration, gravidity, and parity were analyzed across risk categories.
A total of 328 patients (mean age: 64.5±5.8 years; range, 55 to 75 years) were included. The mean FRAX score was 16±8.8 (range, 3 to 58), and 85, 191, and 52 patients were classified as high-, intermediate-, and low-risk, respectively. A positive correlation was observed between FRAX scores and both later age at menarche and earlier menopause (p<0.001 and p=0.008, respectively). The mean age at menopause was significantly different between the high- and low-risk groups (46.4 vs. 49.3 years, p=0.016). The intermediate-risk group was also evaluated, showing no significant differences in obstetric parameters compared to the low-risk group (p>0.05).
Although late menarche is not explicitly included in FRAX, its association with higher fracture risk was evident. The established influence of early menopause on FRAX scores supports its role in fracture risk estimation. However, the inclusion of additional obstetric parameters did not enhance the predictive accuracy of FRAX in this cohort.
本研究旨在评估将产科参数纳入骨折风险评估工具（FRAX）对风险评估精度的影响。
在这项回顾性研究中，纳入了2021年1月1日至2023年12月31日期间发生绝经后桡骨远端、股骨近端或腰椎脆性骨折的患者。通过电话访谈获取产科病史以及标准的FRAX参数。根据未使用骨密度计算的FRAX主要骨质疏松性骨折风险评分，将患者分为高风险、中风险和低风险组。分析各风险类别在初潮年龄、绝经年龄、哺乳时间、妊娠次数和产次方面的差异。
共纳入328例患者（平均年龄：64.5±5.8岁；范围为55至75岁）。FRAX评分的平均值为16±8.8（范围为3至58），分别有85例、191例和52例患者被分类为高风险、中风险和低风险。FRAX评分与初潮年龄较晚和绝经较早均呈正相关（分别为p<0.001和p=0.008）。高风险组和低风险组之间的平均绝经年龄存在显著差异（46.4岁对49.3岁，p=0.016）。还对中风险组进行了评估，结果显示与低风险组相比，产科参数无显著差异（p>0.05）。
尽管初潮较晚未明确纳入FRAX，但它与较高骨折风险的关联是明显的。绝经较早对FRAX评分的既定影响支持了其在骨折风险评估中的作用。然而，在该队列中纳入额外的产科参数并未提高FRAX的预测准确性。
