| Background:as the population ages,the postmenopausal osteoporosis increasingly become a global problem,with the deepening of scientific research,clinical prevention and treatment for postmenopausal osteoporosis has formed a series of effective solutions,but how to according to different patients to choose reasonable individualized treatment,there is still a controversy.Generally speaking,patients with high fracture risk need more aggressive treatment,but how to accurately identify the high-risk population early is the current problem.While the current fracture prediction system,represented by the FRAX score,can predict fracture risk over the next 10 years,it cannot assess immediate risk,which is more important in the choice of treatment.Objective:This study intends to analyze the related factors of fracture risk in postmenopausal women and try to establish a model for fracture risk assessment of postmenopausal osteoporosis,so as to be simple and effective and provide reference for further determination of clinical treatment.Results:1.A total of 328 patients were included in the study,including 217 patients in the new fracture group and 111 patients in the non-new fracture group.2.With Z4 as the prediction index,the regression equation is logit(Z4)=-5.291+0.062 age-0.466 minimum T,its efficiency is 0.704,and the cutoff point is 0.63,which is consistent with the trend of FRAX prediction results;3.The fracture risk of postmenopausal osteoporosis increased with the decrease of bone mineral density and the increase of age,but the fracture risk was only independent of age after the age of 70;4.The corresponding bone mineral density cutoff values were not the same in different age groups;5.There were statistically significant differences in quality of life and bone metabolism markers between the groups with new fractures and the groups without new fractures.6.There were statistically significant differences in the comprehensive scores between the postmenopausal osteoporosis and low-risk fracture groups,with the mean values of 62.31 and 44.14,respectively.Conclusions:1.For fracture risk prediction,age,LlT and LSD are three significant indicators;2.The more comprehensive related indicators,the more accurate fracture risk assessment.The fracture risk assessment chart based on the Z4 regression equation contains only two indicators of age and bone mineral density,which is simple and practical,and the prediction effect is consistent with the trend predicted by FRAX.3.When the patient is over 70 years old,the patient's age will no longer be the main indicator of fracture risk,while the lowest bone mineral density T value is still the main indicator of fracture risk;4.Thresholds of bone mineral density T value corresponding to fracture risk at different ages are not the same;5.For all patients,new fractures significantly reduced the quality of life of the patients;6.In postmenopausal osteoporosis patients,no matter whether there is a new fracture or not,the immediate risk of fracture based on Z4 model does not significantly affect their quality of life,revealing the reason why the risk of osteoporotic vertebral fracture is not taken seriously by patients;7.In postmenopausal patients with high risk of osteoporosis and fractures,the impact of new-onset fractures on patients' quality of life is not as significant as that of low-risk patients,which may be related to the patients' basic quality of life as well as their subjective attitude towards life.We suggest that patients with a higher incidence of immediate vertebral fractures may need more attention and aggressive treatment. |
PDF Full Text Request