Kanis J A, McCloskey E V
WHO Collaborating Centre for Metabolic Bone Diseases, Department of Human Metabolism and Clinical Biochemistry, University of Sheffield Medical School, UK.
Bone. 1996 Mar;18(3 Suppl):127S-132S. doi: 10.1016/8756-3282(95)00493-9.
Hip fracture is the most serious complication of osteoporosis and the incidence is rising worldwide. Bone mineral density measurements can be used not only to diagnose osteoporosis at the hip, but also to give prognostic information on the lifetime risk of hip fracture. A number of additional risk factors enhance the ability of density measurements to assess risk. Candidates include markers of bone resorption, prior fragility fractures, hip axis length, and estimates of postural integrity, each of which improve prognostic value independently of bone mineral assessments. Their use in the stratification of risk will help define intervention thresholds for treatments and improve the design of population screening policies, particularly in elderly women in whom the burden of hip fracture is greatest.
髋部骨折是骨质疏松症最严重的并发症，且在全球范围内发病率呈上升趋势。骨密度测量不仅可用于诊断髋部骨质疏松症，还能提供有关髋部骨折终生风险的预后信息。一些其他风险因素可增强密度测量评估风险的能力。候选因素包括骨吸收标志物、既往脆性骨折、髋轴长度以及姿势完整性评估，每一项因素均能独立于骨矿物质评估提高预后价值。将它们用于风险分层有助于确定治疗的干预阈值，并改进人群筛查政策的设计，特别是在髋部骨折负担最重的老年女性中。
