Clin Osteol 2020; 25(3): 120-127
Ukrajinská verzia FRAX pre posúdenie rizika zlomenín u žien s reumatoidnou artritídouReview articles
- 1 D. F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
- 2 РІ of the Lviv Regional Council "Lviv Regional Clinical Hospital", Lviv, Ukraine
V súčasnej dobe mnohé štúdie potvrdzujú zvýšené riziko zlomenín u pacientov s reumatoidnou artritídou (RA). FRAX je informatívny nástroj pre posúdenie rizika zlomenín, avšak údaje o jeho použití u pacientov s RA sú obmedzené. Cieľom tejto štúdie bolo určiť pomocou ukrajinskej verzie FRAX 10-ročné riziko závažných osteoporotických zlomenín a zlomenín bedra u pacientok s RA. Vykonali sme prierezovú štúdiu prípadov (case-control study), ktorá skúmala 794 žien vo veku 40-89 rokov, rozdelených do dvoch skupín: 1. skupina (n = 397) - zdraví probandi bez RA, a 2. skupina (n = 397) - pacientky s diagnózou RA. Hodnotenie rizika závažných osteoporotických zlomenín a zlomenín bedra bolo vykonané nástrojom FRAX pre ukrajinskú populáciu. A to bez aj s meraním hustoty kostného minerálu (BMD - Bone Mineral Density). Táto štúdia preukázala, že pacientky s RA majú významne vyššie hodnoty FRAX (vyššie riziko) v porovnaní so zdravými subjektami, a to ako v celkovej skupine, tak aj v rôznych vekových podskupinách. U pacientok s RA bola zistená silná korelácia (r = 0,75) medzi hodnotami FRAX v oboch skupinách. Približne 40 % pacientiek s RA vyžaduje antiporotickú liečbu aj bez výsledku DXA, na základe hodnôt FRAX. 47 % vyžaduje prehodnotenie rizika zlomenín po meraní BMD. Iba 7 % pacientok vyžaduje revíziu liečby osteoporózy po meraní BMD. Pre zníženie rizika osteoporotických zlomenín treba zvažovať všetky výše uvedené skutočnosti.
Keywords: FRAX; riziko zlomenin; pravdepodobnosť osteoporotických zlomenín v období 10 rokov; reumatoidná artritída
Received: August 10, 2020; Accepted: August 31, 2020; Published: December 11, 2020 Show citation
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