RESUMEN
OBJECTIVE: We aimed to analyze the applicability of a fracture risk assessment tool for the prediction of osteoporotic fractures in middle-aged and elderly healthy Chinese adults. METHODS: A standard questionnaire was administered, and bone mineral density was measured in residents visiting the Dongliu Street Community Health Service Center. Paired t-tests were used to compare the FRAX-based probabilities of fractures estimated with and without consideration of bone mineral density. Risk stratification and partial correlation analyses were applied to analyze the associations between FRAX-based probabilities and body mass index or bone mineral density at different sites. RESULTS: A total of 444 subjects were included in this study. Of these subjects, 175 (39.59%) were diagnosed as osteoporotic, and 208 (47.06%) were diagnosed as osteopenic. The Kappa value for the detection of osteoporosis at the L1-L4 lumbar spine and femoral neck was 0.314. The FRAX-based 10-year major osteoporotic fracture probability and hip osteoporotic fracture probability estimated without considering bone mineral density were 4.93% and 1.64%, respectively; when estimated while considering bone mineral density, these probabilities were 4.97% and 1.54%, respectively. A significant positive association was observed between the FRAX-based fracture probabilities estimated with and without consideration of bone mineral density, while significant negative associations between body mass index and the estimated FRAX-based fracture probabilities after adjustment for age and the estimated FRAX-based fracture probabilities and femoral neck bone mineral density were identified. These results remained the same after controlling for lumbar spine bone mineral density. CONCLUSIONS: The Chinese FRAX model could predict osteoporotic fracture risk regardless of whether bone mineral density was considered and was especially appropriate for predicting osteoporotic fractures of the femoral neck.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Osteoporosis/complicaciones , Osteoporosis/fisiopatología , Fracturas Osteoporóticas/etiología , Fracturas Osteoporóticas/fisiopatología , Medición de Riesgo/métodos , Absorciometría de Fotón/métodos , Factores de Edad , Análisis de Varianza , Índice de Masa Corporal , Densidad Ósea/fisiología , China , Fracturas del Cuello Femoral/etiología , Fracturas del Cuello Femoral/fisiopatología , Valor Predictivo de las Pruebas , Valores de Referencia , Reproducibilidad de los Resultados , Factores de Riesgo , Factores Sexuales , Población UrbanaRESUMEN
During everyday activities, bones are submitted to the action of different strengths. While walking, the femur must support loads up to 3 times the body weight. It is for this that the need of knowing the mechanical behavior of the femur submitted to different loads and the place where the fracture would occur is born. This study analyzes, through experimental testing, the maximum resistance of the porcine femur, mechanically comparable to the human femur, submitted to different strengths, to obtain the location of fracture and compare the results obtained with computational simulation and with information described for human femur.
Durante actividades de la vida diaria, los huesos se ven sometidos a la acción de diferentes fuerzas. En la marcha, el fémur debe soportar cargas de hasta 3 veces el peso corporal. Es por esto que nace la inquietud de conocer el comportamiento mecánico del fémur sometido a distintos tipos de cargas, y el lugar de falla donde se produciría una fractura. Este estudio analiza, mediante ensayo experimental, la resistencia máxima del fémur porcino, mecánicamente comparable al fémur humano, frente a distintas cargas, para obtener así el sitio de fractura y luego comparar los resultados obtenidos con simulación computacional y con datos descritos para el fémur humano.