Journal of Korean Neurosurgical Society

  • 제58권4호
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  • Pages.346-349
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  • 2015
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Usefulness of Fracture Risk Assessment Tool Using Lumbar Bone Mineral Density in Prediction of Osteoporotic Vertebral Fracture

  • Lee, Heui Seung (Department of Neurosurgery, Seoul National University Hospital) ;
  • Lee, Sang Hyung (Department of Neurosurgery, Seoul National University Boramae Medical Center) ;
  • Chung, Young Seob (Department of Neurosurgery, Seoul National University Boramae Medical Center) ;
  • Yang, Hee-Jin (Department of Neurosurgery, Seoul National University Boramae Medical Center) ;
  • Son, Young-Je (Department of Neurosurgery, Seoul National University Boramae Medical Center) ;
  • Park, Sung Bae (Department of Neurosurgery, Seoul National University Boramae Medical Center)
  • 투고 : 2015.07.02
  • 심사 : 2015.10.09
  • 발행 : 2015.10.28
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초록

Objective : To investigate the value of lumbar bone mineral density (BMD) in fracture risk assessment (FRAX) tool. Methods : One hundred and ten patients aged over 60 years were enrolled and divided into 2 groups as non-osteoporotic vertebral fracture (OVF) and OVF groups. The 10-year-risk of major osteoporotic vertebral fracture of each group was calculated by FRAX tool with femoral and lumbar spine BMDs to compare the usefulness of lumbar spine BMD in prediction of OVF. The blood level of osteocalcin and C-terminal telopeptide (CTX) as markers of activities of osteoblast and osteoclast, respectively were analyzed using the institutional database. Results : In the OVF group, the ratio of patients with previous fracture history or use of glucocorticoid was higher than those in non-OVF group (p=0.000 and 0.030, respectively). The levels of T-score of femur neck and lumbar spine in OVF group were significantly lower than those in non-OVF group (p=0.001 and 0.000, respectively). The risk of OVF in FRAX using femur BMD in non-OVF and OVF groups was $6.7{\pm}6.13$ and $11.4{\pm}10.06$, respectively (p=0.007). The risk of using lumbar BMD in the 2 groups was $6.9{\pm}8.91$ and $15.1{\pm}15.08$, respectively (p=0.002). The areas under the receiver operator characteristic curve in the FRAX risk with lumbar and femur neck BMD were 0.726 and 0.684, respectively. The comparison of osteocalcin and CTX was not significant (p=0.162 and 0.369, respectively). Conclusion : In our study, the 10-year risk of major osteoporotic fracture in the OVF group of our study was lower than the recommended threshold of intervention for osteoporosis. Hence, a lower threshold for the treatment of osteoporosis may be set for the Korean population to prevent OVF. In the prediction of symptomatic OVF, FRAX tool using lumbar spine BMD may be more useful than that using femur neck BMD.

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참고문헌

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피인용 문헌

  1. Correlations of Serum Hormones and Bone Mineral Density with Fracture and Balance Ability of Postmenopausal Patients and Effects of Calcitriol vol.24, pp.None, 2015, https://doi.org/10.12659/msm.910792