亚洲和黑人女性骨折风险评估的挑战
Joan C Lo1, Malini Chandra, Wei Yang
1Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612.
The American journal of managed care
|March 8, 2024
概括
亚洲和黑人女性的骨质疏松症查显示,骨矿物密度 (BMD) 和骨折风险评估存在差异. 目前的工具可能无法准确识别少数群体中高风险个体.
科学领域:
- 内分泌学 在内分泌学.
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 骨矿物质密度 (BMD) 和骨折风险计算器,如骨折风险评估工具 (FRAX),对于绝经后妇女的初级预防至关重要.
- 骨质量T分数分类依赖非西班牙裔白人 (NHW) 参考数据,而FRAX集成了骨质量,临床风险因素和人口特异性数据.
- 种族和族群之间的骨质疏松症查和风险评估差异需要调查.
研究的目的:
- 为了比较骨矿物质密度 (BMD) T-分数和骨折风险评估工具 (FRAX) 10年关节骨折风险 (FRAX-Hip) 在亚洲,黑人和非西班牙裔白人 (NHW) 妇女中的分数.
- 评估骨质疏松症的流行率和这些人群中高骨折风险.
- 检查不同种族群体中骨折风险因素和糖尿病状况的差异.
主要方法:
- 追溯横截面研究,比较65-75岁的亚洲,黑人和NHW女性接受BMD测试.
- 测量包括部部BMD (FN-BMD) T-score,高FRAX-Hip风险 (≥3%),特定的FRAX风险因素和糖尿病状态.
- 排除标准:最近的骨折,骨质疏松症治疗,转移性癌症,多发性骨髓瘤,代谢性骨疾病或替代疗法.
主要成果:
- 亚洲女性:23.8%患有骨质疏松症,8.7%高FRAX-Hip风险. 在NHW女性:骨质疏松症12.3%,高FRAX-Hip风险17.2%.
- 黑人女性:骨质疏松4.1%,高FRAX-Hip风险1.8%,其中68.1%的FN-BMD正常.
- 黑人 (36%) 和亚洲 (35%) 妇女的糖尿病患病率明显高于NHW妇女 (16%).
结论:
- 很大一部分亚洲女性表现出不一致的BMD和FRAX得分,使骨质疏松症的管理复杂化.
- 骨质量和FRAX评分发现很少有黑人女性有高骨折风险,这表明这一群体可能低估了风险.
- 需要进一步的研究,以优化骨折风险评估工具的代表性不足的种族少数群体,特别是当查结果是不一致的.
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