Definition of a spine fracture threshold based upon prospective fracture risk.
Definition of a spine fracture threshold based upon prospective fracture risk.
复制标题
根据预期骨折风险定义脊柱骨折阈值。
DOI：
10.1016/8756-3282(87)90001-9
复制
发表时间：
1987
期刊：
影响因子：
4.1
通讯作者：
Vogel,JM
中科院分区：
文献类型：
--
作者：
Ross,PD;Wasnich,RD;Heilbrun,LK;Vogel,JM
如果可以制定合适的治疗方案，骨折阈值（FT）的评估对于确定哪些个体应该进行预防性治疗，以及应该开出何种治疗水平具有重要的临床应用价值。我们建议将FT定义为相对于绝经前妇女，骨折风险增加一倍的骨矿物质含量（BMC），通过对408名绝经后妇女脊柱骨折发生率的logistic回归分析确定。英国《金融时报》的观测值与其他机构基于更为武断的定义所报告的值非常吻合。超过90%的新发非暴力脊柱骨折患者BMC低于骨折阈值，而不到10%的年轻女性（30-45岁）低于此值。虽然并非所有BMC低于FT的女性都发生过骨折，但她们骨折的风险较高。BMC与FT相当的女性在10年内发生骨折的几率至少为5%，并且随着BMC的降低，骨折的几率迅速上升。BMC似乎比年龄或体型（身高或体重）更能预测骨折风险。因此，使用BMC骨折阈值对个体风险进行分类可以为临床决策提供更客观的依据。
Assessment of fracture threshold (FT) could have important clinical application in determining which individuals should be treated preventively, and what level of therapy to prescribe, if suitable treatment regimens can be developed. We propose that FT be defined as the bone mineral content (BMC) at which the risk of fracture doubles, relative to premenopausal women, as determined by logistic regression analysis of spine fracture incidence in a prospective study of 408 postmenopausal women. The observed values for the FT agree well with those reported by others, based upon more arbitrary definitions. More than 90% of individuals with new nonviolent spine fractures have BMC below the fracture threshold, while fewer than 10% of younger women (age 30–45) are below this value. Although not all women with BMC below the FT have had fractures, they are at increased risk of fracture. Women with BMC equivalent to the FT have at least a 5% chance of fracture over a 10-year period, and the probability of fracture rises rapidly as BMC decreases. BMC appears to be a much stronger predictor of fracture risk than age or body size (height or weight). Thus, use of a BMC fracture threshold to categorize individual risk could provide a more objective basis for clinical decision making.