重复骨矿物密度查和部和主要骨质疏松性骨折的预测
Sarah D Berry1, Elizabeth J Samelson, Michael J Pencina
1Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131, USA. sarahberry@hsl.harvard.edu
JAMA
|September 26, 2013
概括
在四年内重复对老年人进行骨矿物质密度 (BMD) 查并没有显著改善骨折风险预测. 75岁以上未经治疗的个人可能不需要第二次BMD测试.
科学领域:
- 老年学是一门学科.
- 骨质疏松症研究研究
- 医疗成像医学成像
背景情况:
- 建议老年人进行骨矿物密度 (BMD) 查,以评估骨质疏松症风险.
- 重复BMD测试用于精制骨折风险评估的临床效用仍然不确定.
研究的目的:
- 评估四年内骨质量变化是否提供了超出基线测量额外的骨折风险信息.
- 量化第二次BMD测量如何改变骨折风险分类.
主要方法:
- 一项以人口为基础的队列研究分析了310名男性和492名女性 (平均年龄74.8岁) 的数据,在1987年至1999年期间进行了两次大腿部骨质量测量.
- 骨折风险 (部或主要骨质疏松症) 在平均后续9.6年内进行评估.
- 统计分析包括危险比率,接收器运行特征 (ROC) 曲线和净重新分类指数.
主要成果:
- 观察到 BMD 年平均下降率为 -0.6%. 每年骨质量变化下降1SD与部骨质疏松和骨质疏松重大骨折风险增加有关.
- 然而,将BMD变化添加到基线BMD模型中并没有有意义地改善骨折预测性能 (AUC为0.71比0.68).
- 第二个BMD测量导致参与者重新归类为高风险关节骨折的适度增加3.9%.
结论:
- 在未接受治疗的老年人 (平均年龄75岁) 中,四年后第二次骨质量测量并没有大大提高部或主要骨质疏松性骨折的预测.
- 在四年内重复BMD查可能是不必要的,以改善骨折风险分层在这个人口.
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