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| 題 名 | 運用骨折風險評估工具FRAX®與TBS FRAX®評估良性前列腺肥大對腰椎骨質密度與骨折率增加之影響=Using the Fracture Risk Assessment Tool FRAX® and TBS FRAX® to Evaluate the Impact of Benign Prostatic Hyperplasia on the Increased Lumbar Spine Bone Mineral Density and Fracture Rate |
|---|---|
| 作 者 | 陳保良; 王昱豐; 蘇聖祐; 莊紫翎; | 書刊名 | Annals of Nuclear Medicine and Molecular Imaging |
| 卷 期 | 38:1 2025.03[民114.03] |
| 頁 次 | 頁1-13 |
| 分類號 | 416.67 |
| 關鍵詞 | 骨質密度; 良性前列腺肥大; 骨折風險評估工具; 骨小樑指數; 骨小樑指數調整後骨折風險評估工具; Bone mineral density; BMD; Benign prostatic hyperplasia; BPH; Fracture risk assessment tool; FRAX®; Trabecular bone score; TBS; TBS FRAX®; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6332/ANMMI.202503_38(1).0001 |
| 中文摘要 | 背景:本篇研究評估了良性前列腺肥大(benign prostatic hyperplasia, BPH) 與 腰椎骨質密度(bone mineral density, BMD) 增加之間的關聯。同時我們運用 了十年骨折風險評估工具(fracture risk assessment tool, FRAX®) 和骨小樑指 數調整後骨折風險評估工具(TBS-adjusted FRAX®, TBS FRAX®),來評估患 者的十年骨折風險。透過這些評估工具,我們能夠更準確地預測在患有BPH 的患者中,骨折風險的增加情況。研究結果不僅有助於瞭解BPH 與BMD、 TBS 之間的關係,及是否會造成骨折率增加,還能夠為臨床醫生提供更有效 的骨折預防策略,從而改善患者骨頭的健康狀況。 方法:共有4,927 名接受健康檢查的50–90 歲中年男性納入了本研究。所有 參與者的數據均採回溯性收集。分成正常前列腺與BPH 兩組,BPH 診斷採 用超音波掃描確認,由醫師判定受檢者是否有BPH,也利用雙能量X 光吸 收儀(dual X-ray absorptiometry) 儀器,掃描BMD 結果搭配TBS 軟體判斷 骨小樑骨骼品質。最後使用FRAX® 與TBS FRAX® 比較確認是否會因腰椎 BMD 增加,而降低骨折風險。 結果:本篇研究結果發現,不論BMD 正常、低骨密度或骨質疏鬆,在不同 TBS 狀態下,BPH 與正常前列腺組相比兩組間之TBS 均未達統計差異。腰 椎BMD 對於BPH 與正常前列腺組相比,BPH 者有較高的BMD,獨獨是在 腰椎區域有顯著增加。而TBS FRAX® 與FRAX® 十年骨折率相比,FRAX® 均高於TBS FRAX® 且達顯著差異。 結論:在臨床上,男性骨質疏鬆症容易被忽略,BPH 也隨著年紀增加而增 加,部分患者可能因BMD 檢查結果正常,而被忽略導致骨折率增加,進而 導致高骨折的風險,因此本篇研究建議當患者被診斷出BPH 時,建議除了 定期追蹤BMD之外,還須搭配計算FRAX® 與TBS FRAX® 來評估骨折風險, 降低男性骨折風險。另外本篇研究也提供臨床醫師在診斷腰椎BMD 增加同 時患有BPH 時,能注意患者的骨折率是否也增加。本篇研究建議以FRAX® 來評估骨折風險,可以讓臨床醫師更小心處理BPH 者的脆性骨骼問題。 |
| 英文摘要 | Background: This study explores the relationship between benign prostatic hyperplasia (BPH) and increased lumbar spine bone mineral density (BMD), utilizing the Fracture Risk Assessment Tool (FRAX®) and the Trabecular Bone Score-adjusted FRAX® (TBS FRAX®) to evaluate the 10- year fracture risk in affected patients. By employing these tools, we aim to predict fracture risks in men with BPH more precisely. The findings not only shed light on whether BPH-associated BMD changes contribute to a higher fracture rate but also provide clinicians with more effective strategies for fracture prevention, thereby enhancing patient bone health. Methods: A retrospective analysis was conducted on 4,927 middle-aged men aged 50–90 and above who underwent routine health checkups. Participants were classified into two groups: those with a normal prostate and those diagnosed with BPH via ultrasound, confirmed by physicians. BMD was assessed using dual-energy X-ray absorptiometry, and trabecular bone quality was evaluated with TBS software. Subsequently, FRAX® and TBS FRAX® were applied to ascertain whether increased lumbar spine BMD correlates with a reduced fracture risk. Re sul t s : The s tudy revealed that across various TBS states, whether BMD is normal, low, or indicative of osteoporosis, the TBS values between the BPH group and the normal prostate group did not demons t rat e any statistically significant differences. Lumbar spine BMD was notably higher in the BPH group than in the normal pros tate group, wi th s igni f icant increases observed specifically in the lumbar spine region. Furthermore, FRAX® indicated significantly higher 10-year fracture risks than TBS FRAX®, highlighting meaningful distinctions between the two assessment tools. Conclusion: Osteoporosis in men is frequently underrecognized in clinical practice, while the prevalence of BPH increases with age. Some patients may face an elevated fracture risk with normal BMD results that could potentially be overlooked. Therefore, this study recommends that in addition to regular BMD monitoring, FRAX® and TBS FRAX® should be employed in BPH patients to accurately assess fracture risk and mitigate osteoporosisrelated fractures. Clinicians should be particularly vigilant of the heightened fracture risk in patients diagnosed with both increased lumbar spine BMD and BPH, and FRAX® should be regarded as an essential tool in assessing fracture ri sk, al lowing cl inicians to more cautiously address the issue of fragile bones in patients with BPH. |
本系統中英文摘要資訊取自各篇刊載內容。