在有脆弱的老年人中FRAX的性能:弗雷明汉心脏研究
Tanchanok Chattaris1,2, Laiji Yang2, Helena Johansson3
1Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Nakhon Pathom, Thailand.
概括
对于脆弱的个体,FRAX骨折风险工具的准确性较低. 在FRAX中包括骨矿物质密度 (BMD),可以提高其在脆弱人群中预测主要骨质疏松性骨折 (MOF) 的性能.
科学领域:
- 老年学是一门学科.
- 流行病学 流行病学
- 整形外科 整形外科 整形外科
背景情况:
- 脆弱是骨折的一个已知的危险因素.
- 为预测骨折风险而设计的FRAX工具尚未在脆弱人群中得到验证.
- 了解脆弱个体的FRAX性能对于准确的骨折风险评估至关重要.
研究的目的:
- 为了比较FRAX工具 (v4.3) 在有和没有虚弱的个体中的预测性能.
- 评估是否结合骨矿物质密度 (BMD) 提高了脆弱个体的FRAX准确性.
主要方法:
- 通过使用来自弗雷明汉心脏研究 (3554名参与者) 的数据进行了一项队列研究.
- 使用弗里德表型来评估脆弱性.
- 在10年的随访期间确定了严重骨质疏松性骨折 (MOF).
- 根据FRAX的区分和校准,使用受体下面区域运行特征曲线 (AUC) 和观察到预测的概率进行评估,按脆弱状态分层.
主要成果:
- 在15.5%的参与者中存在脆弱性,这些参与者年龄较大,FRAX平均得分较高.
- 在脆弱个体中,MOF的发病率为6.9%,而非脆弱个体中为3.0%.
- 与非脆弱个体相比,FRAX在脆弱个体中显示出较低的预测准确性 (AUC) (0.584比0.695).
- 在FRAX模型中包括BMD显著提高了脆弱个体的预测准确性 (AUC增加到0.658).
- FRAX倾向于高估MOF风险,特别是在非脆弱个体中.
结论:
- 在脆弱的个体中,FRAX识别骨折风险的能力降低,除非包括骨损伤.
- BMD似乎捕捉了与脆弱人群相关的基本骨折预测因素.
- 未来的研究应该专注于开发骨折预测模型,专门针对脆弱的个体.
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