FRAX and the assessment of fracture probability in men and women from the UK.
FRAX and the assessment of fracture probability in men and women from the UK.
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DOI：
10.1007/s00198-007-0543-5
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发表时间：
2008-04
影响因子：
4
通讯作者：
McCloskey, E.
中科院分区：
文献类型：
--
作者：
Kanis, J. A.;Johnell, O.;Oden, A.;Johansson, H.;McCloskey, E.
骨折风险评估工具（FRAX ™）是基于使用临床风险因素开发的，无论是否进行英国骨密度测试。本研究的目的是应用一种评估工具预测骨折的男性和女性的临床危险因素（CRF）的骨折与和不使用股骨颈骨密度（BMD）。从先前的荟萃分析中确定的临床风险因素包括体重指数（BMI，作为连续变量）、既往骨折史、父母髋部骨折史、口服糖皮质激素的使用、类风湿性关节炎和骨质疏松症的其他继发性原因、当前吸烟和每日饮酒3个或更多单位。根据英国骨折流行病学，构建了四种模型来计算骨折概率。这些模型包括髋部骨折的十年概率，有和没有股骨颈BMD，以及严重骨质疏松性骨折的十年概率，有和没有BMD。对于每个模型，将断裂和死亡风险计算为连续函数。每种临床风险因素均影响骨折概率。在没有BMD的情况下，固定BMI（25 kg/m2）女性的髋部骨折概率范围为50岁时无CRF女性的0.2%至80岁时父母有髋部骨折史的22%（约100倍范围）。在男性中，概率较低，范围也较低（在上述示例中为0.1%至11%）。在上面的例子中，对于严重的骨质疏松性骨折，女性的概率范围为3.5%至31%，男性为2.8%至15%。一个或多个风险因素的存在以递增的方式增加了概率。在任何给定的T评分和年龄下，男性和女性之间的概率差异都相当，但老年人除外，由于后者的死亡率较高，女性的概率高于男性。该模型提供了一个框架，通过单独和/或结合BMD的临床风险因素的整合，增强了男性和女性骨折风险的评估。
A fracture risk assessment tool (FRAX™) is developed based on the use of clinical risk factors with or without bone mineral density tests applied to the UK. The aim of this study was to apply an assessment tool for the prediction of fracture in men and women with the use of clinical risk factors (CRFs) for fracture with and without the use of femoral neck bone mineral density (BMD). The clinical risk factors, identified from previous meta-analyses, comprised body mass index (BMI, as a continuous variable), a prior history of fracture, a parental history of hip fracture, use of oral glucocorticoids, rheumatoid arthritis and other secondary causes of osteoporosis, current smoking, and alcohol intake 3 or more units daily. Four models were constructed to compute fracture probabilities based on the epidemiology of fracture in the UK. The models comprised the ten-year probability of hip fracture, with and without femoral neck BMD, and the ten-year probability of a major osteoporotic fracture, with and without BMD. For each model fracture and death hazards were computed as continuous functions. Each clinical risk factor contributed to fracture probability. In the absence of BMD, hip fracture probability in women with a fixed BMI (25 kg/m2) ranged from 0.2% at the age of 50 years for women without CRF’s to 22% at the age of 80 years with a parental history of hip fracture (approximately 100-fold range). In men, the probabilities were lower, as was the range (0.1 to 11% in the examples above). For a major osteoporotic fracture the probabilities ranged from 3.5% to 31% in women, and from 2.8% to 15% in men in the example above. The presence of one or more risk factors increased probabilities in an incremental manner. The differences in probabilities between men and women were comparable at any given T-score and age, except in the elderly where probabilities were higher in women than in men due to the higher mortality of the latter. The models provide a framework which enhances the assessment of fracture risk in both men and women by the integration of clinical risk factors alone and/or in combination with BMD.
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影响因子：
39.2
作者：
Bauer, DC;Ettinger, B;Stone, KL
通讯作者：
Stone, KL
影响因子：
39.2
作者：
Bernstein, CN;Blanchard, JF;Yu, BN
通讯作者：
Yu, BN
影响因子：
27.4
作者：
DONNELLY, S;DOYLE, DV;SPECTOR, TD
通讯作者：
SPECTOR, TD
影响因子：
5.5
作者：
Carroll, J;Testa, MA;El-Hajj Fuleihan, G
通讯作者：
El-Hajj Fuleihan, G
DOI：
10.1046/j.1532-5415.2002.50354.x
发表时间：
2002-08-01
影响因子：
6.3
作者：
Girman, CJ;Chandler, JM;Magaziner, J
通讯作者：
Magaziner, J