| Abstract | Cilj: Svrha je ovog istraživanja bila ispitati kliničko-demografske karakteristike žena koje dolaze na denzitometrijsko mjerenje u KBC Split te procijeniti njihov rizik za prijelome.
Ispitanici i postupci: Ovo je istraživanje provedeno u Regionalnom centru za dijabetes, endokrinologiju i bolesti metabolizma Kliničkog bolničkog centra Split. U istraživanju je sudjelovalo 30 postmenopauzalnih žena s osteoporozom, 30 s osteopenijom i 30 kontrolnih ispitanica. Za prikupljanje podataka o ispitanicama korištena je medicinska dokumentacija, nalaz denzitometrijskih parametara i rizik za prijelome izračunat putem FRAX® (engl. Fracture Risk Assessment Tool) aplikacije. Ispitanice su podijeljene u tri skupine, ovisno o nalazu T vrijednosti, odnosno koštane mineralne gustoće.
Rezultati: Statistički je značajna razlika postojala pri usporedbi pojavnosti patoloških prijeloma među skupinama (10 ispitanica u skupini s osteoporozom (33,3%), 5 u skupini s osteopenijom (16,7%) i 3 (10%) u kontrolnoj skupini; P=0,024). Nadalje, najveći je broj ispitanica na denzitometrijsko mjerenje upućen od strane liječnika obiteljske medicine (N=31; 34,4%) i specijalista onkologa (N=12; 13,3%). Statistički značajna razlika nije pronađena pri usporedbi indeksa trabekularne kosti među skupinama (1,25 ± 0,07 vs. 1,28 ± 0,09 vs. 1,29 ± 0,13; P=0,250). Prema rezultatima FRAX®-a bez uključenja BMD-a, skupina s osteoporozom imala je najveći rizik za ozbiljan prijelom u odnosu na ostale skupine (8,0 (6,4-14,0) vs. 7,1 (4,9-12,0) vs. 6,1 (4,5-7,6) %; P=0,013). Uključenjem koštane mineralne gustoće (BMD) u izračun, a potom i indeksa trabekularne kosti (TBS), ispitanice s osteoporozom imale su statistički značajno veći rizik za veliki prijelom u odnosu na skupinu s osteopenijom i kontrolnu skupinu u oba navedena slučaja (P<0,001). U ukupnoj ispitivanoj populaciji, FRAX® izračunom desetogodišnja je vjerojatnost ozbiljnog prijeloma iznosila 6,8 (5,0-11,0) %, dodatkom BMD a u izračun 5,7 (4,1-10,0) %, a dodatkom BMD-a i TBS-a 6,6 (4,8-11,0) % (P<0,001). Nadalje, u skupini ispitanica s niskom vjerojatnosti prijeloma (N=62) rizik za prijelom iznosio je 5,9 (4,6-6,9) %, s prilagodbom za BMD 4,9 (3,7-6,2) %, a s prilagodbom za BMD i TBS 5,6 (4,3-6,7) % (P<0,001). U skupini s umjerenom vjerojatnosti za prijelom (N=21) rizik za prijelom iznosio je 13,0 (11,0-16,0) %, s prilagodbom za BMD 10,0 (8,8-14,0) %, a s prilagodbom za BMD i TBS 11,0 (9,2-14,0) % (P<0,001).
Zaključak: Ovo je istraživanje pokazalo da je rizik za prijelome veći u bolesnica s osteoporozom i osteopenijom u odnosu na zdrave postmenopauzalne žene. Također, rizik za prijelome pokazao je najviše vrijednosti u izračunu bez prilagodbe za BMD i TBS u ukupnoj ispitivanoj populaciji. |
| Abstract (english) | Objectives: The aim of this study was to examine the clinical and demographic characteristics of women who come for densitometric measurement at the University Hospital of Split and to assess their risk for fractures.
Subjects and Methods: This study was conducted at the Regional Center for Diabetes, Endocrinology and Metabolic Diseases of the University Hospital of Split. The study included 30 postmenopausal women with osteoporosis, 30 with osteopenia, and 30 control subjects. Medical documentation, densitometric parameters and fracture risk calculated using the FRAX® tool were used to collect data on the subjects. Subjects were divided into three groups, depending on their T score, ie bone mineral density.
Results: There was a significant difference when comparing the incidence of pathological fractures between groups (10 subjects in the group with osteoporosis (33.3%), 5 in the group with osteopenia (16.7%) and 3 (10%) in the control group; P = 0.024). Furthermore, the largest number of respondents were referred to densitometric measurements by general practitioners (N=31; 34.4%) and oncologists (N=12; 13.3%). No statistically significant difference was found when comparing the trabecular bone score between the groups (1.25±0.07 vs. 1.28±0.09 vs. 1.29±0.13; P=0.250). According to the results of FRAX® without the inclusion of BMD, the group with osteoporosis had the highest risk of serious fracture compared to other groups (8.0 (6.4-14.0) vs. 7.1 (4.9-12.0) vs. 6.1 (4.5-7.6) %; P=0.013). By including BMD in the calculation and TBS afterwards, subjects with osteoporosis had a statistically significantly higher risk of major fracture compared to the osteopenia group and the control group in both cases (P<0.001). In the total study population, the ten-year probability of a serious fracture calculated by FRAX® was 6.8 (5.0-11.0) %, by adding BMD to the calculation 5.7 (4.1-10.0) %, and by adding BMD and TBS 6.6 (4.8-11.0) % (P<0.001). Moreover, in the group of subjects with low fracture probability (N=62), the fracture risk was 5.9 (4.6-6.9) %, by adding BMD 4.9 (3.7-6.2) %, and by adding BMD and TBS 5.6 (4.3-6.7) % (P<0.001). In the group with moderate fracture probability (N=21) the fracture risk was 13.0 (11.0-16.0) %, by adding BMD 10.0 (8.8-14.0) %, and by adding BMD and TBS 11.0 (9.2-14.0) % (P <0.001).
Conclusions: This study has shown that the fracture risk is higher in patients with osteoporosis and osteopenia compared to healthy postmenopausal women. Also, the fracture risk was the highest in the calculation without adjustment for BMD and TBS in the total population study. |
