确定绝经后妇女骨折高风险的干预阈值:基于菲律宾FRAX模型的单中心研究

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM Osteoporosis and Sarcopenia Pub Date : 2021-09-01 DOI:10.1016/j.afos.2021.09.003
Julie Li-Yu , Sarath Lekamwasam
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引用次数: 1

摘要

目的:本研究旨在评估菲律宾骨折风险评估工具(FRAX)模型的适当干预阈值,以识别绝经后高骨折风险妇女。方法对体重指数25 kg/m2、年龄50 ~ 80岁、既往脆性骨折且无其他临床危险因素的女性进行sage依赖干预阈值计算。固定阈值是根据1546名绝经后妇女的数据库制定的,这些妇女因临床原因接受了双能x线吸收测定。主要骨折和髋部骨折的风险是通过有或没有骨矿物质密度(BMD)输入的临床危险因素来估计的。根据年龄依赖性阈值,将妇女分为高危组和低危组。利用受者工作特性分析,综合考虑最佳灵敏度和特异性,确定最佳切割点。结果50 ~ 80岁患者主要骨折风险干预阈值在2.8 ~ 6.9%之间,髋部骨折风险干预阈值在0.4 ~ 3.0%之间。3.75%的主骨折阈值和1.25%的髋部骨折阈值是观察到的最佳固定阈值,不包含BMD的骨折风险估计值没有改变。作为混合方法,3%的主要骨折和1%的髋部骨折风险。对于70岁及以上的老人,可建议设定70岁及年龄相关的阈值。结论本研究估计的干预阈值可用于识别菲律宾绝经后高骨折风险妇女。临床医生应该决定最合适的阈值类型。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Intervention thresholds to identify postmenopausal women with high fracture risk: A single center study based on the Philippines FRAX model

Objectives

This study is designed to estimate appropriate intervention thresholds for the Philippines Fracture Risk Assessment Tool (FRAX) model to identify postmenopausal women with high fracture risk.

Methods

Age dependent intervention thresholds were calculated for a woman of body mass index 25 kg/m2 aged 50–80 years with a previous fragility fracture without other clinical risk factors. Fixed thresholds were developed using a database of 1546 postmenopausal women who underwent dual-energy X-ray absorptiometry for clinical reasons. Major and hip fracture risks were estimated using clinical risk factors with and without bone mineral density (BMD) input. Women were categorized to high risk and low risk groups according to the age dependent thresholds. The best cut-points were determined considering the optimum sensitivity and specificity using receiver operating characteristic analysis.

Results

The age dependent intervention thresholds of major fracture risk ranged from 2.8 to 6.9% while hip fracture risk ranged from 0.4 to 3.0% between 50 and 80 years of age. Major fracture threshold of 3.75% and hip fracture threshold of 1.25% were the best fixed thresholds observed and non-inclusion BMD in the fracture risk estimations did not change the values. As a hybrid method, 3% major fracture and 1% hip fracture risks for those < 70 years old and age-dependent thresholds for those aged 70 years and above can be recommended.

Conclusions

The intervention thresholds estimated in the current study can be applied to identify Filipino postmenopausal women with a high fracture risk. Clinicians should decide on the type of thresholds most appropriate.

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来源期刊
Osteoporosis and Sarcopenia
Osteoporosis and Sarcopenia Orthopedics, Sports Medicine and Rehabilitation, Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Geriatrics and Gerontology
自引率
5.00%
发文量
23
审稿时长
66 days
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