肝移植患者骨健康的五年评估:开发一个风险评分,预测骨脆弱性在第一年之后的进展
Ejigayehu G Abate1, Amanda McKenna1, Liu Yang2
1Division of Endocrinology, Mayo Clinic, Jacksonville, FL, United States.
Frontiers in endocrinology
|March 7, 2025
概括
肝移植接受者面临着持续的骨损失风险. 一个新的风险评分有助于识别那些需要在移植后的第一年以外进行骨健康监测的人.
科学领域:
- 腎病學和泌尿病學.
- 免疫学 免疫学 免疫学
- 内分泌学 在内分泌学.
背景情况:
- 肝移植 (LT) 接受者有明显的骨损失和骨折风险,特别是在移植后的第一年.
- 对于一些人来说,这种风险可能会持续超过最初的一年,需要持续监测.
- 识别长期风险因素对于这种人群的骨健康主动管理至关重要.
研究的目的:
- 在肝移植后的第一年之后,识别骨损失和骨折的危险因素.
- 为临床医生开发一个风险评分工具,以识别高风险的LT接受者.
主要方法:
- 对264名肝移植接受者的回顾性评估,随访时间为5年.
- 临床记录每年在LT后对骨矿物密度 (BMD),骨质疏松症治疗和新骨折进行评估.
主要成果:
- 在平均3.6年的时间里,40名患者表现出疾病进展 (骨质疏松症恶化,新的骨质疏松症治疗或骨折).
- 进展的危险因素包括女性性别,高加索种族,先前的骨折,急性排斥事件和LT后较低的DXA得分.
- 开发了一个具有良好的歧视性风险评分 (C指数0.771),将患者分为低风险,中风险和高风险.
结论:
- 一个简单的,临床上适用的风险评分可以预测肝移植后第一年后的骨病进展.
- 这种工具可以帮助临床医生指导LT接受者的骨健康后续检查.
- 建议对风险评分进行前性验证.
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