■乳糜泻(CD)患者患骨质疏松症和骨折的风险增加。目前,基线双能X线骨密度仪(DXA)适用于所有新诊断的CD患者.我们旨在确定骨质疏松症的患病率以及骨折风险评估工具(FRAX)在预测经活检证实的CD患者的严重骨质疏松性骨折(MOF)中的临床实用性。
■我们回顾性收集了2001年至2015年间经活检证实为CD的连续成年患者的数据,这些患者在诊断后1年内接受了DXA扫描,并随访了至少7年。使用FRAX评分评估骨折风险,并分析了随访期间严重骨质疏松性骨折的发生率。
■共有593名患者(中位年龄45.0岁,68.5%女性)被包括在内。骨量减少和骨质疏松的患病率分别为32.3%和14.5%,分别。年龄增加(OR1.06,p<0.0001),降低BMI(OR0.90,p=0.003),较高的基线免疫球蛋白A组织组织转谷氨酰胺酶滴度(OR1.04,p=.03)与骨质疏松症风险增加显著相关.敏感性,特异性,FRAX工具预测MOF的阳性和阴性预测值为21.2%,91.3%,16.3%,93.5%,分别。较高的骨折风险与持续的麸质暴露有关(OR1.86,p=0.02),先前的骨折(OR2.69,p=0.005),年龄较大(OR1.03,p<0.0001)。
■骨质疏松症是CD患者的常见发现。FRAX工具在预测骨质疏松性骨折方面显示出高特异性,在某些情况下可用于帮助患者选择DXA扫描。
UNASSIGNED: People with coeliac disease (CD) are at increased risk of osteoporosis and fractures. Currently, baseline dual-energy X-ray absorptiometry (DXA) is recommended for all patients with newly diagnosed CD. We aimed to determine the prevalence of osteoporosis and the clinical utility of the Fracture Risk Assessment Tool (FRAX) in predicting major osteoporotic fractures (MOF) in patients with biopsy-proven CD.
UNASSIGNED: We retrospectively collected data for consecutive adult patients with biopsy-proven CD between 2001 and 2015 who underwent DXA scanning within 1 year of diagnosis and were followed up for a minimum of 7 years. Fracture risk was assessed using FRAX scores, and the incidence of major osteoporotic fractures during the follow-up period was analysed.
UNASSIGNED: A total of 593 patients (median age 45.0 years, 68.5% female) were included. The prevalence of osteopenia and osteoporosis were 32.3% and 14.5%, respectively. Increasing age (OR 1.06, p < .0001), decreasing BMI (OR 0.90, p = .003), and higher baseline immunoglobulin A-tissue tissue transglutaminase titre (OR 1.04, p = .03) were significantly associated with increased risk of osteoporosis. The sensitivity, specificity, positive and negative predictive values of the FRAX tool to predict MOF were 21.2%, 91.3%, 16.3%, 93.5%, respectively. A higher risk of fractures was associated with ongoing gluten exposure (OR 1.86, p = .02), previous fractures (OR 2.69, p = .005), and older age (OR 1.03, p < .0001).
UNASSIGNED: Osteoporosis is a common finding in patients with CD. The FRAX tool showed high specificity in predicting osteoporotic fractures and could be used to aid with patient selection for DXA scanning in some cases.