FRAX 评分评估初诊2型糖尿病患者骨质疏松骨折发生概率的价值

摘要

Objective It is to explore the value of FRAX score for evaluating fracture risk induced by osteoporosis in new-diagnostic type 2 diabetes patients in ten years .Methods These 207 subjects with new-diagnosed diabetes were selected as DM group and 504 healthy subjects as normal -control ( NC group) were enrolled and were collected and their clinical infor-mation were collected .The bone mineral density of lumbar vertebra L 1-4, left femoral neck and Ward's triangle was meas-ured by dual -energy X-ray absorptiometry examination.The 10-year probability of hip fracture(PHF) and a major osteopo-rotic fracture(PMOF) was calculated by FRAX algorithm according to totality , male and female.The bone mineral density of different age group and 10-year probability of fracture between the two groups were compared .Results In the total , male and female subjects the frequency of previous fracture in DM group was higher than that in NC group (P<0.05).The T value at femur neck and lumbar spine L1 in DM group were higher than NC group(P<0.05).The 10-year probability of PHF and a major PMOF in DM group was lower than that in NC group (P<0.05).With age increasing, occurrence rate of bone mineral density decreasing and 10-year probability of fracture increased gradually (P<0.05) in both groups, but there was no sig-nificant difference in occurrence rate of bone mineral density decreasing among the groups with same age in both groups ( P>0.05).In DM group, the 10-year probability of PHF and a major PMOF of the ones whose age >50-60, >60-70, >70 years were obviously lower than that of NC group (P<0.05).Conclusion The 10-year probability osteoporotic fracture had an increased trend with the increasing age .In type 2 diabetes,we should set up more precise algorithm model to predict frac-ture risk of diabetes .%目的：探讨FRAX评分评估初诊2型糖尿病患者10年骨质疏松骨折发生概率的价值。方法选取207例初发糖尿病患者作为糖尿病组，健康体检者504例作为对照组，收集2组相关临床指标，同时采用双能X射线骨密度仪检查腰椎L1—4、左侧股骨颈及Ward＇s三角的骨密度，并按照总体、男性、女性分别通过FRAX公式计算2组10年髋部骨折发生概率和10年主要骨质疏松性骨折发生概率，比较2组不同年龄段骨量情况及10年骨折发生概率。结果糖尿病组中总体、男性以及女性既往骨折发病率均明显高于对照组（P 均＜0．05），糖尿病组股骨颈及L1的骨密度值均高于对照组（P均＜0．05）；糖尿病组10年主要骨质疏松性骨折发生概率和10年髋部骨折发生概率均低于对照组（ P均＜0．05）。随着年龄段的增长，2组骨量减少的发生率及10年骨折发生概率均呈逐渐上升趋势（P均＜0．05），而2组相同年龄段骨量减少发生率比较差异均无统计学意义（ P均＞0．05）；糖尿病组＞50～60岁、＞60～70岁、＞70岁人群10年髋部骨折发生概率和10年主要骨质疏松性骨折发生概率均明显低于对照组（P均＜0．05）。结论随着年龄段的增长，2型糖尿病患者10年骨折发生概率逐渐增高。在2型糖尿病患者中，应当建立更加精准的FRAX评分工具来预测糖尿病患者骨折风险。