绝经后骨质疏松症是目前患病率最高的慢病之一,在40~65岁妇女中有很高的患病率。骨质疏松症容易导致脆性骨折,尤其是髋部骨折危险性最大,常是老年人的死亡原因。目前,公认的骨质疏松症诊断金标准是利用双能X线吸收仪进行骨密度的测量,由于检测费用比较昂贵,且需要有专业医务人员进行操作,不便于在广大人群中筛查使用。我们往往借助于通过简单的筛检工具来判断是否处于骨质疏松高风险状态,再运用DXA检测进行确诊。现有的PMOP筛检工具纳人的评估指标过少,特异度较低,在实际应用中存在一定的局限性。中医证素与骨密度之间存在着的一定的相关关系,在现有PMOP风险评估工具中,融人中医证素的相关内容,建立基于GPLM的PMOP风险预测模型,开发适用于我国人群特征的包含现代医学危险因素和中医证素的PMOP筛检工具,必将有助于PMOP的早期发现,提高PMOP高危人群的筛检率,为采取有效的防治性干预措施提供科学的依据。
Postmenopausal osteoporosis (PMOP) is one of chronic diseases with highest morbidity rate among women aged 40-65 years. Osteoporosis (OP) results in fragile fractures easily, especially in high risk of hip fracture, which is the common cause for elder people's death. At present, the recognized gold standard of osteoporosis diagnosis is bone mineral density (BMD) test using dual energy X-ray absorptiometry (DXA). However, the BMD test needs professional staff to operate and costs much money. So it is not suitable to apply in large population. We often use a simple screening tool to determine whether a person is in high risk of OP, and then conduct accurate diagnosis with DXA. The existing PMOP screening tools have some limitations in application, with less evaluation parameters and lower specificity. TCM syndrome factors are related with BMD. So we develop a PMOP risk prediction model applying generalized partial linear model (GPLM) on the base of present PMOP risk assessment tools, and combining with TCM syndrome factors. We also develop a PMOP screening tool suitable for Chinese population, combining the modern medical risk factors and TCM syndrome factors, which is helpful to detect PMOP earlier and to improve PMOP screening rate for high-risk population. This will provide scientific basis for effective intervention of prevention and treatment.