CAJ | 학술논문

目的探讨骨折风险评估工具(FRAX)对中老年2型糖尿病患者骨折风险的预测价值. 方法对153例行骨密度检查的50岁以上2型糖尿病患者进行回顾性分析,根据FRAX指定的危险因子,记录研究对象的年龄、性别、身高、体质量、体质指数、既往脆性骨折史、父母髋部骨折史、当前吸烟史、过量饮酒史、长期使用类固醇激素史、风湿性关节炎、其他继发性骨质疏松症病史,及以股骨颈T值为代表的骨密度值(BMD);分别计算加入BMD的FRAX评分(FRAX/BMD)和不加入BMD的FRAX评分(FRAX/-).根据髋部脆性骨折风险≥3％或其他主要部位脆性骨折风险≥20％的治疗切点,分为治疗建议相同组和治疗建议不同组,应用独立t检验或卡方检验比较两组之间的危险因子. 结果 86.9％(133/153)患者不论是否加入BMD应用FRAX计算出的骨折风险相当,均能给出一致的治疗建议.年龄、性别和股骨颈T值在两组之间比较,差异有统计学意义(均P＜0.001),其他危险因子两组差异无统计学意义. 结论对于中老年2型糖尿病患者,FRAX/-对骨折风险的预测价值与FRAX/BMD基本相当,提示不进行骨密度检查也可预测骨折风险;年龄较小、骨密度值较大及男性对象的FRAX/-对骨折风险有更高的预测价值.
목적 탐토골절풍험평고공구(FRAX)대중노년2형당뇨병환자골절풍험적예측개치. 방법 대153례행골밀도검사적50세이상2형당뇨병환자진행회고성분석,근거FRAX지정적위험인자,기록연구대상적년령、성별、신고、체질량、체질지수、기왕취성골절사、부모관부골절사、당전흡연사、과량음주사、장기사용류고순격소사、풍습성관절염、기타계발성골질소송증병사,급이고골경T치위대표적골밀도치(BMD);분별계산가입BMD적FRAX평분(FRAX/BMD)화불가입BMD적FRAX평분(FRAX/-).근거관부취성골절풍험≥3％혹기타주요부위취성골절풍험≥20％적치료절점,분위치료건의상동조화치료건의불동조,응용독립t검험혹잡방검험비교량조지간적위험인자. 결과 86.9％(133/153)환자불론시부가입BMD응용FRAX계산출적골절풍험상당,균능급출일치적치료건의.년령、성별화고골경T치재량조지간비교,차이유통계학의의(균P＜0.001),기타위험인자량조차이무통계학의의. 결론 대우중노년2형당뇨병환자,FRAX/-대골절풍험적예측개치여FRAX/BMD기본상당,제시불진행골밀도검사야가예측골절풍험;년령교소、골밀도치교대급남성대상적FRAX/-대골절풍험유경고적예측개치.
Objective To evaluate the predictive value of fracture risk assessment tool (FRAX) for determining fracture probabilities in middle-aged and elderly patients with type 2 diabetes.Methods Retrospective analysis was carried out on 153 type 2 diabetic patients aged over 50 years undergoing dual energy X-ray absorptiometry measurements.Fracture risk factors including age,gender,height,weight,body mass index,history of previous fragility fractures,parental history of hip fracture,history of smoking,excessive drinking,long-term use of steroid hormone,history of rheumatoid arthritis,the history of secondary osteoporosis diseases,and femoral neck T-score of bone mineral density (BMD) were recorded.FRAX scores with BMD (FRAX/BMD) and without BMD (FRAX/-) were calculated.Therapeutic interventions were recommended if the 10-year risk of fractures was more than 3％ for hip osteoporotic fractures and more than 20％ for other major fractures.Subjects were separated into the identical treatment recommendation group and the different treatment recommendation.Fracture risk factors were compared between groups.Results 133 (6.9 ％) patients had identical fracture risk predictions in the FRAX calculation,regardless of whether BMD join in or not.Age,gender and femoral neck T scores had significant differences between the two groups (all P＜0.001),while other risk factors had no statistical differences between the two groups (all P＞0.05).Conclusions In most middle-aged and elderly patients with type 2 diabetes,the FRAX/-provides the same prediction as FRAX/BMD value for predicting fracture risk,which shows that fracture risks can be predicted without bone density examination.The FRAX/-has higher predictive values on fracture for people who are younger,male,and has higher BMD.