2型糖尿病与非糖尿病患者FRAX骨折风险的比较

发布时间：2018-07-03 01:49

本文选题：FRAX + 骨折　；参考：《复旦学报(医学版)》2017年01期

【摘要】：目的验证FRAX骨折风险评估模型对预测2型糖尿病患者骨折风险的有效性。方法收集2009年10月至2013年1月在复旦大学附属中山医院内分泌科住院治疗的40~90岁的2型糖尿病患者752例(T2DM组);选取同期在我院体检中心体检的未确诊糖尿病的体检者595例(对照组);收集相关资料,测定股骨颈、全髋和腰椎骨密度。比较T2DM组与对照组的骨密度,分析2型糖尿病患者发生骨量异常的风险;比较T2DM组与对照组的FRAX骨折风险。结果根据标准共入选682例T2DM患者和417例对照。与对照组相比,T2DM组的骨密度高。与对照组相比,T2DM组发生骨量异常的风险降低,但在校正年龄、性别、饮酒史、吸烟史、BMI和LDL-c后,差异无统计学意义(OR=0.829,P=0.236)。根据FRAX骨折风险模型,T2DM组未来10年发生主要骨质疏松性骨折与髋部骨折风险均有低于对照组的倾向。结论骨密度和FRAX骨折风险评估模型可能会低估2型糖尿病患者未来10年发生主要骨质疏松性骨折和髋部骨折风险,该模型在糖尿病患者中的应用还需进一步校正。
[Abstract]:Objective to evaluate the effectiveness of frax fracture risk assessment model in predicting fracture risk in type 2 diabetic patients. Methods from October 2009 to January 2013, 752 patients with type 2 diabetes mellitus (T2DM group) who were hospitalized in the Department of Endocrinology, Zhongshan Hospital affiliated to Fudan University, were collected, and the undiagnosed diabetic patients who were examined in the same period in the physical examination center were selected. 595 cases (control group) were examined, and relevant data were collected, Bone mineral density (BMD) of femoral neck, total hip and lumbar vertebrae were measured. The BMD of T2DM group and control group were compared, and the risk of abnormal bone mass in type 2 diabetic patients was analyzed, and the risk of frax fracture in T2DM group and control group was compared. Results A total of 682 patients with type 2 DM and 417 controls were enrolled according to the standard. The BMD of T2DM group was higher than that of control group. The risk of abnormal bone mass in T2DM group was lower than that in control group, but there was no significant difference after adjusting for age, sex, alcohol consumption history, smoking history, BMI and LDL-c (ORP 0.236). According to the risk model of frax fracture, the risk of main osteoporotic fracture and hip fracture in T2DM group was lower than that in control group in the next 10 years. Conclusion the risk assessment model of bone mineral density and frax fracture may underestimate the risk of major osteoporotic fracture and hip fracture in type 2 diabetic patients in the next 10 years. The application of this model in diabetic patients needs further correction.
【作者单位】：复旦大学附属中山医院内分泌科;复旦大学附属中山医院感染病科;河南省郑州市第七人民医院内分泌老年病科;遵义医学院附属医院内分泌科;郑州大学第一附属医院老年内分泌科;复旦大学附属中山医院循证医学中心;
【分类号】：R587.2;R683

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