国内骨质疏松性骨折预测方法的研究进展
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摘要
骨质疏松性骨折(osteoporosis fracture,OF)是骨质疏松症的严重并发症,愈后差,严重影响了患者的预期寿命、身心健康,增加家庭和社会的经济负担,早期对其进行预测极为重要。目前主要有以下几种预测骨质疏松性骨折的方法 :骨密度、FRAX检测工具、骨转换生化标志物、定量骨超声等。FRAX是一种应用临床危险因素来评估每一位个体发生骨质疏松性骨折绝对风险的工具,应用广泛。骨密度预测的骨质疏松性骨折风险是一个总体风险。骨转换生化标志物应用于骨折预测的研究结论尚存在争议。定量骨超声不能进行统一质控,临床应用受到限制。研究表明,FRAX工具能够预测个体10年内发生主要部位及髋部的骨质疏松性骨折的概率,比其它的方法更优越。
Osteoporosis fracture(OF) is a serious complication of osteoporosis, which is not good after caring and seriously affects the life expectancy, physical and mental health of patients, and increases the economic burden of family and society. So early predictions are extremely important.At present, there are mainly the following methods of predicting osteoporotic fractures: bone density, FRAX detection tools, biochemical markers of bone turnover, and quantitative bone ultrasound. FRAX is a widely used tool for assessing the absolute risk of osteoporotic fractures in each individual using clinical risk factors. The risk of osteoporotic fracture predicted by bone density is an overall risk. The conclusions of biochemical markers of bone turnover applied to fracture prediction are still controversial. Quantitative bone ultrasound cannot be subjected to uniform quality control, and clinical application is limited. Studies have shown that the FRAX tool can predict the probability of an individual's major site and hip osteoporotic fracture within 10 years, which is superior to other methods.
Osteoporosis fracture(OF) is a serious complication of osteoporosis, which is not good after caring and seriously affects the life expectancy, physical and mental health of patients, and increases the economic burden of family and society. So early predictions are extremely important.At present, there are mainly the following methods of predicting osteoporotic fractures: bone density, FRAX detection tools, biochemical markers of bone turnover, and quantitative bone ultrasound. FRAX is a widely used tool for assessing the absolute risk of osteoporotic fractures in each individual using clinical risk factors. The risk of osteoporotic fracture predicted by bone density is an overall risk. The conclusions of biochemical markers of bone turnover applied to fracture prediction are still controversial. Quantitative bone ultrasound cannot be subjected to uniform quality control, and clinical application is limited. Studies have shown that the FRAX tool can predict the probability of an individual's major site and hip osteoporotic fracture within 10 years, which is superior to other methods.
引文
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[12]Kanis JA,Harvey NC,Johansson H,et al.FRAX and fracture prediction without bone mineral density[J].Climacteric,2015,18:2-9.
[13]Chao AS,Chen FP,Lin YC,et al.Application of the World Health Organization fracture risk assessment tool to predict need for dual-energy X-ray absorptiometry scanning in postmenopausal women[J].Taiwan J Obstet Gynecol,2015,54(6):722-725.
[14]Buckley L,Guyatt G,Fink HA,et al.2017 American College of Rheumatology Guideline for the prevention and treatment of glucocorticoid-induced osteoporosis[J].Arthritis Rheumatol,2017,69:1521-1537.
[15]Wright NC,Saag KG,Dawson-Hughes B,et al.The impact of the new National Bone Health Alliance(NBHA)diagnostic criteria on the prevalence of osteoporosis in the United States:supplementary presentation[J].Osteoporosis International,2017,28(11):3283-3284.
[16]Cosman F,De beur SJ,Leboff MS,et al.Erratum to:Clinician’s guide to prevention and treatment of osteoporosis[J].Osteoporos Int,2015,26(7):2045-2047.
[17]Bauer DC,Black DM,Bouxsein ML,et al.Treatment-related changes in bone turnover and fracture risk reduction in clinical trials of anti-resorptive drugs:a meta-regression[J].J Bone Min Res,2018,33(4):634-642.
[18]Wang J,Yan D,Hou X,et al.Association of adiposity indices with bone density and bone turnover in the Chinese population[J].Osteoporos Int,2017,28:2645-2652.
[19]Mederle OA,Balas M,Loanoviciu SD,et al.Correlations between bone turnover markers,serum magnesium and bone mass density in postmenopausal osteoporosis[J].Clinical Interventions in Aging,2018,13:1383-1389.
[20]Vallipakorn SA,Vallipakorn O,Sophonsritsuk A,et al.The Optimal Cut-Points for Weight and Non-Weight Quantitative Ultrasound of the Calcaneus to Screen Osteoporosis in Postmenopausal Women[J].J Med Assoc Thai,2016,99(3):249-256.
[21]Casciaro S,Conversano F,Pisani P,et al.New perspectives in echographic diagnosis of osteoporosis on hip and spine[J].Clin Cases Miner Bone Metab,2015,12:142-150.
[2]Noel SE,Mangano KM,Griffith JL,et al.Prevalence of osteoporosis and low Bone mass among puerto rican older adults[J].Journal of Bone and Mineral Research,2018,33(3):396-403.
[3]周君琳,王东.骨质疏松性骨折的诊断与治疗[J].北京医学,2017,39(2):123-125.
[4]Black DM,Cauley JA,Wagman R,et al.The ability of a single BMD and fracture history assessment to predict fracture over 25 years in postmenopausal women:The Study of Osteoporotic Fractures[J].JBone Miner Res,2018,33(3):389-395.
[5]Curtis Elizabeth M,Moon Rebecca J,Harvey Nicholas C,et al.The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide[J].Bone,2017,104:29-38.
[6]邱贵兴,裴福兴,胡侦明,等.中国骨质疏松性骨折诊疗指南(骨质疏松性骨折诊断及治疗原则)[J].中华骨与关节外科杂志,2015,8(5):371-374.
[7]Wang X,Yan S,Liu C,et al.Fracture risk and bone mineral density levels in patients with systemic lupus erythematosus:a systematic review and meta-analysis[J].Osteoporos Int,2016:1413-1423.
[8]何渝煦,魏庆中,熊启良,等.骨质疏松性骨折与骨密度关系的研究进展[J].中国骨质疏松杂志,2014,20(2):219-224.
[9]Aspray TJ.Fragility fracture:recent developments in risk assessment[J].Ther Adv Musculoskelet Dis,2015,7:17-25.
[10]Looker AC,Sarafrazi Isfahani N,Fan B,et al.FRAX-based Estimates of 10-year Probability of Hip and Major Osteoporotic Fracture Among Adults Aged 40 and over:United Stated,2013 and2014[J].Nat Health Stat Report,2017(103):1-16.
[11]Leslie WD,Majumdar SR,Morin SN,et al.FRAX for fracture prediction shorter and longer than 10 years:the Manitoba BMDregistry[J].Osteoporos Int,2017,28(9):2557-2564.
[12]Kanis JA,Harvey NC,Johansson H,et al.FRAX and fracture prediction without bone mineral density[J].Climacteric,2015,18:2-9.
[13]Chao AS,Chen FP,Lin YC,et al.Application of the World Health Organization fracture risk assessment tool to predict need for dual-energy X-ray absorptiometry scanning in postmenopausal women[J].Taiwan J Obstet Gynecol,2015,54(6):722-725.
[14]Buckley L,Guyatt G,Fink HA,et al.2017 American College of Rheumatology Guideline for the prevention and treatment of glucocorticoid-induced osteoporosis[J].Arthritis Rheumatol,2017,69:1521-1537.
[15]Wright NC,Saag KG,Dawson-Hughes B,et al.The impact of the new National Bone Health Alliance(NBHA)diagnostic criteria on the prevalence of osteoporosis in the United States:supplementary presentation[J].Osteoporosis International,2017,28(11):3283-3284.
[16]Cosman F,De beur SJ,Leboff MS,et al.Erratum to:Clinician’s guide to prevention and treatment of osteoporosis[J].Osteoporos Int,2015,26(7):2045-2047.
[17]Bauer DC,Black DM,Bouxsein ML,et al.Treatment-related changes in bone turnover and fracture risk reduction in clinical trials of anti-resorptive drugs:a meta-regression[J].J Bone Min Res,2018,33(4):634-642.
[18]Wang J,Yan D,Hou X,et al.Association of adiposity indices with bone density and bone turnover in the Chinese population[J].Osteoporos Int,2017,28:2645-2652.
[19]Mederle OA,Balas M,Loanoviciu SD,et al.Correlations between bone turnover markers,serum magnesium and bone mass density in postmenopausal osteoporosis[J].Clinical Interventions in Aging,2018,13:1383-1389.
[20]Vallipakorn SA,Vallipakorn O,Sophonsritsuk A,et al.The Optimal Cut-Points for Weight and Non-Weight Quantitative Ultrasound of the Calcaneus to Screen Osteoporosis in Postmenopausal Women[J].J Med Assoc Thai,2016,99(3):249-256.
[21]Casciaro S,Conversano F,Pisani P,et al.New perspectives in echographic diagnosis of osteoporosis on hip and spine[J].Clin Cases Miner Bone Metab,2015,12:142-150.