Indeks za određivanje rizika od preloma kostiju (FRAX® skor) u supkliničkom hipertireoidizmu

  • Snežana Polovina Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia
  • Dragan Micić Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Dragana Miljić Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia
  • Nataša Milić Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Dušan Micić Emergency Center, Clinical Center of Serbia, Belgrade, Serbia
  • Vera Popović Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
DOI: https://doi.org/10.2298/5828
Ključne reči: hip fractures||, ||kuk, prelomi, risk assessment||, ||rizik, procena, questionnaires||, ||upitnici, postmenopause||, ||postmenopauza, hyperthyroidism||, ||hipertireoidizam,

Sažetak


Uvod/Cilj. Alat za određivanje rizika od preloma kostiju (FRAX® skor) je matematički model za izračunavanje pretpostavljenog desetogodišnjeg rizika od preloma kostiju koji uključuje kliničke podatke i gustinu koštane mase u predelu vrata i butne kosti izmerene osteodenzitometrijom (dual-energy x-ray absorptiometry – DXA). Cilj ove studije preseka bio je da se proceni primenljivost skora FRAX® u prepoznavanju osoba sa povećanim rizikom od preloma kostiju i utvrdi da li supklinički hipertireoidizam nosi veći rizik od preloma kosti u odnosu na eutireoidno stanje. Metode. Mineralna koštana gustina merena DXA metodom, tireostimulišući hormon (TSH), slobodni tiroksin (fT4), antitela na tireoperoksidazu (TPOAt), osteokalcin i beta cross-laps mereni su kod 27 žena sa nedavno dijagnostikovanim supkliničkim hipertireoidizmom (58,85 ± 7.83 godina, indeks telesne mase (ITM) 27,89 ± 3,46 kg/m2, nastanak menopauze u 46,88 ± 10,21 godini) i 51 žene uporedivih osobina (59,69 ± 5,72 god, ITM 27,68 ± 4,66 kg/m2, nastanak menopauze u 48,53 ± 4,58 godini). FRAX® skor je upotrebljen za procenu rizika od preloma kostiju u obe grupe. Rezultati. Ukupni skor FRAX® (6,50 ± 1,58 vs 4,35 ± 1,56, p = 0,015) i skor FRAX® za prelom kuka (1,33 ± 3,92 vs 0,50 ± 0,46, p= 0,022) bio je značajno veći u grupi sa supkliničkim hipertireoidizmom u odnosu na kontrolnu grupu.  Nije bilo korelacije između nivoa TSH i rizika od frakture (p > 0,05). Kompetentnost skora FRAX® u razlikovanju pre-i postmenopauzalnih žena sa rizikom od frakture i bez rizika (p < 0.001) je prikazana površinom ispod krive (AUC) pomoću ROC analize. Cut-off vrednost skora FRAX® bila je u ovoj analizi 6%, sa pretpostavljenom senzitivnošću i specifičnošću od 95% i 75,9%. Zaključak. Pre- i postmenopauzalne žene sa supkliničkim hipertireoidizmom imaju veći skor FRAX® i time veći rizik od preloma kuka na malu traumu nego eutireoidne žene. Naši rezultati ukazuju na to da primena FRAX® kalkulatora u grupi pre- i postmenopauzalnih žena sa supkliničkim hipertireoidizmom doprinosi prepoznavanju osoba sa povećanim rizikom od preloma kostiju.

Biografija autora

Snežana Polovina, Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia
Center for Obesity

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Objavljeno
2015/07/08
Broj časopisa
Vol. 72 Br. 6 (2015)
Rubrika
Originalni članak