使用FRAX和便携式脉冲回波超声进行基于社区的骨质疏松症预筛查：来自奥地利西部的一项试点研究

摘要(中文译文)

一项基于社区的预筛查方法，采用奥地利FRAX®模型和便携式脉冲回波超声，识别出相当比例的成人，其检查结果可能需要进一步的骨质疏松评估。我们的结果表明，本地预筛查路径可支持更早的识别和转诊，尤其是在女性中。早期识别骨质疏松风险增加的成人仍然具有挑战性。我们评估了一种基于社区的预筛查方法，该方法在奥地利西部蒂罗尔州的成人中使用奥地利FRAX®和便携式脉冲回波超声。50-90岁的成人自愿参加免费的社区筛查活动。参与者完成了奥地利FRAX问卷，并接受了胫骨脉冲回波超声检查（Bindex®），由此得出密度指数（DI）。FRAX概率使用更新的奥地利阈值进行分类，DI分为绿色（> 0.844）、黄色（0.779-0.844）或红色（< 0.779）。结合FRAX和DI分类来描述与进一步骨质疏松评估相关的检查结果负担和分布。共有664名成人参与。女性的FRAX估计骨折概率高于男性，DI值低于男性。女性10年主要骨质疏松性骨折概率中位数为6.6%，男性为4.6%；髋部骨折概率中位数分别为1.2%和0.8%。DI处于绿色范围的女性占54.4%，男性占92.9%。当FRAX和DI结合时，30.2%的女性尽管FRAX概率低于奥地利干预阈值，但DI异常，而男性中这种不一致不常见。基于社区的预筛查识别出大量可能受益于正式骨质疏松评估的成人。在骨折负担高且护理差距持续存在的地区，此类本地路径可支持更早识别骨质疏松风险。

Abstract

A community-based prescreening approach using the Austrian FRAX® model and portable pulse-echo ultrasound identified a substantial proportion of adults with findings that may warrant further osteoporosis evaluation. Our results suggest that local prescreening pathways could support earlier identification and referral, particularly in women. Early identification of adults at increased osteoporosis risk remains challenging. We evaluated a community-based prescreening approach using Austrian FRAX® and portable pulse-echo ultrasound in adults from Tyrol, Western Austria. Adults aged 50-90 years voluntarily attended free community screening events. Participants completed the Austrian FRAX questionnaire and underwent tibial pulse-echo ultrasound (Bindex®), from which the density index (DI) was derived. FRAX probabilities were categorized using updated Austrian thresholds, and DI was classified as green (> 0.844), yellow (0.779-0.844), or red (< 0.779). Combined FRAX and DI classifications were used to describe the burden and distribution of findings relevant to further osteoporosis assessment. A total of 664 adults participated. Women had higher FRAX-estimated fracture probabilities and lower DI values than men. Median 10-year major osteoporotic fracture probability was 6.6% in women and 4.6% in men, and median hip fracture probability was 1.2% and 0.8%, respectively. DI was in the green range in 54.4% of women and 92.9% of men. When FRAX and DI were combined, 30.2% of women had abnormal DI despite FRAX probabilities below Austrian intervention thresholds, whereas discordance was uncommon in men. Community-based prescreening identified a substantial number of adults who may benefit from formal osteoporosis assessment. In a region with high fracture burden and persistent care gaps, such local pathways could support earlier identification of osteoporosis risk.

如何引用

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