The effects of a FRAXA® revision for the USA
The effects of a FRAXA® revision for the USA
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DOI：
10.1007/s00198-009-1033-8
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发表时间：
2010-01-01
影响因子：
4
通讯作者：
McCloskey, E. V.
中科院分区：
文献类型：
--
作者：
Kanis, J. A.;Johansson, H.;McCloskey, E. V.
骨折风险评估工具(FRAX(A(R)的修订版(3.0版)是基于美国流行病学信息的更新而开发的。使用修订后的工具，FRAX(A(R))版本2.0和3.0版本之间有很强的相关性(r>；0.99)，但修订后的模型给出了更低的概率估计。本研究的目的是确定修订流行病学数据的影响，该流行病学数据用于计算美国的FRAX(A(R))骨折概率。这些模型包括髋部骨折的十年概率和主要骨质疏松性骨折的十年概率，两者都包括股骨颈骨密度(BMD)。对于每个模型，骨折和死亡风险被计算为连续函数。使用临床危险因素和骨密度的多个组合，通过分段线性回归检验了修订率对骨折概率的影响。在所有年龄段，2.0版和修订版FRAX(A(R))对骨折概率的估计之间有很强的相关性(r>；0.99)。对于严重的骨质疏松性骨折，根据年龄的不同，修订后的模型给出的男性中位概率降低了13%至24%，女性降低了19%至24%。对于髋部骨折概率，修订后的模型给出的中位数骨折概率男性在50岁和60岁时分别降低了40%和27%，女性分别降低了43%和30%。美国修订后的FRAX(A(R))模型(3.0版)没有改变骨折概率的排名，但提供了比2.0版更低的概率估计，特别是在年轻女性和男性中。
A revision (version 3.0) of the fracture risk assessment tool (FRAX(A (R))) is developed based on an update of epidemiological information for the USA. With the revised tool, there were strong correlations (r > 0.99) between versions 2.0 and 3.0 for FRAX(A (R)) estimates of fracture probability, but the revised models gave lower probability estimates.The aim of this study was to determine the effects of a revision of the epidemiological data used to compute fracture probabilities in the USA with FRAX(A (R)).Models were constructed to compute fracture probabilities based on updated fracture incidence and mortality rates in the USA. The models comprised the ten-year probability of hip fracture and the ten-year probability of a major osteoporotic fracture, both including femoral neck bone mineral density (BMD). For each model, fracture and death hazards were computed as continuous functions. The effect of the revised rates on fracture probability was examined by piecewise linear regression using multiple combinations of clinical risk factors and BMD.At all ages, there was a strong correlation (r > 0.99) between version 2.0 and revised FRAX(A (R)) estimates of fracture probability. For a major osteoporotic fracture, the revised model gave lower median probabilities by 13% to 24% in men, depending on age, and by 19% to 24% in women. For hip fracture probability, the revised model gave lower median fracture probabilities by 40% and 27% at the ages of 50 and 60 years in men and by 43% and 30%, respectively, in women. At the ages of 70 years and older the revised model gave similar hip fracture probabilities as version 2.0 in both men and women.The revised FRAX(A (R)) model for the USA (version 3.0) does not alter the ranking of fracture probabilities but provides lower probability estimates than version 2.0, particularly, in younger women and men.