fa مقایسه میزان انطباق FRAX و FRAX بر اساسTBS در پیش بینی ریسک شکستگی استئوپروتیک در زنان یائسه غدد و متابوليسم Metabolism and Endocrinology تحليلي/مقطعي/توصيفي Survey/Cross Sectional/Descriptive <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span style="font-weight:bold"><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">سابقه و هدف</span></span><i><span lang="FA" style="font-size:12.0pt"><span style="font-family:Nazanin"><span style="font-weight:normal">:</span></span></span></i> <i><span dir="LTR" style="font-size:10.0pt"><span style="font-weight:normal">TBS</span></span></i><i><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="font-weight:normal"> اندکسی است که اطلاعات بیشتری از ریز ساختار استخوانی را به </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-weight:normal">aBMD</span></span></i><i><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="font-weight:normal"> می&shy;افزاید. اخیرا امکان محاسبه </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-weight:normal">FRAX</span></span></i><i><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="font-weight:normal"> بر اساس </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-weight:normal">TBS</span></span></i><i><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="font-weight:normal"> فراهم شده است.</span></span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="font-weight:normal"> هدف این مطالعه</span></span></span></i><i> </i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="font-weight:normal">ارزیابی ارزش بالینی محاسبه </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-weight:normal">FRAX</span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="font-weight:normal"> بر اساس </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-weight:normal">TBS</span></span></i><i><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="font-weight:normal"> بود. </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-weight:normal"></span></span></i></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span style="font-weight:bold"><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">روش بررسی</span></span></span><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt"><span style="font-weight:normal">:</span></span></span></span></i> <i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">545 خانم یائسه (با میانگین سنی 94/7</span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">&plusmn;</span></span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">64/61 سال) که دانسیتومتری استخوان برایشان درخواسته شده بود، مورد بررسی قرار گرفتند و داده&shy;های&nbsp; </span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">TBS</span></span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal"> و </span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">aBMD</span></span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal"> آنها جمع آوری شد. 96 مورد استئوپروتیک و 140 نفر استئوپنیک تشخیص داده شدند. </span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">FRAX</span></span></span></i><i><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal"> و </span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">FRAX-TBS</span></span></span></i><i><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal"> برایشان محاسبه و مقایسه شد.&nbsp; </span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.3pt"><span style="font-weight:normal"></span></span></span></i></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span style="font-weight:bold"><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">یافته</span></span></span><span lang="FA" style="font-size:14.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">&shy;</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">ها:</span></span></span> <i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">متوسط میزان </span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">TBS</span></span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">، 09/0</span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">&plusmn;</span></span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">29/1</span></span></span></span></i><i> </i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">به دست آمد. </span></span></span></span></i><i><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">بیشترین همبستگی مثبت بین</span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">FRAX-TBS </span></span></span></i><i><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">&nbsp;و </span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">FRAX</span></span></span></i><i><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal"> در تخمین ریسک شکستگی ماژور (0001/0></span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">p</span></span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">؛ 836/0=</span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">r</span></span></span></i><i><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">)</span></span></span></span></i><i> </i><i><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">و&nbsp; ریسک شکستگی فمور (0001/0></span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">p</span></span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">؛ 922/0=</span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">r</span></span></span></i><i><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">)</span></span></span></span></i><i> </i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">مشاهده شد</span></span></span></span></i><i><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">. نسبت افراد نیازمند درمان </span></span></span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">بر اساس </span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">FRAX </span></span></span></i><i><span style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">&nbsp;و </span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">&nbsp;FRAX-TBS</span></span></span></i><i><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal"> تغییر معنی&shy;داری داشت</span></span></span></span></i><i><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"><span style="font-weight:normal">.</span></span></span></span></i></span></span></span></span></span></span><br> <b><span dir="RTL" lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">نتیجه</span></span></b><span dir="RTL" lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">&shy;<b>گیری</b><i>:</i></span></span> <i><span dir="RTL" lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">در این مطالعه، تفاوت&nbsp; معنی&shy;داری در مقایسه </span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.2pt">FRAX-TBS</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> و </span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.2pt">FRAX </span></span></span><span dir="RTL" lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">&nbsp;در تعیین نیاز به درمان استئوپروز مشاهده شد.</span></span></span></i> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:11.0pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Background</span></b><span style="font-size:11.0pt">: Trabecular Bone Score (TBS) is an index of bone microarchitecture that provides additional skeletal information to areal Bone Mineral Density (aBMD). Recently TBS data has been used to optimize the Fracture Risk Assessment Tool (FRAX) predictive value. Aim of this study was to evaluate the clinical value of TBS on FRAX algorithm. </span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:11.0pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Materials and methods</span></b><span style="font-size:11.0pt">: 545 postmenopausal women (mean age 61.64&plusmn;7.94</span> <span style="font-size:11.0pt">years</span><span style="font-size:11.0pt">) </span><span style="font-size:11.0pt">indicated for bone densitometry were tested for aBMD and TBS. 96 women was diagnosed as osteoporotic and 140 osteopenic women were identified. FRAX and TBS adjusted FRAX (FRAX-TBS) were calculated and compared. </span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:11.0pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Results</span></b><span style="font-size:11.0pt">: Mean score of TBS was 1.29&plusmn; 0.09. A strong positive correlation was observed between FRAX and FRAX-TBS in predicting the risk of major osteoporotic fracture (r=0.836, p< 0.0001), and hip fracture (r=0.922, p< 0.0001). aBMD adjusted FRAX and FRAX-TBS was assessed in all sample and the osteopenic group. There was significant difference in number of cases need to treatment based on FRAX and FRAX-TBS.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:11.0pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Conclusion</span></b><span style="font-size:11.0pt">: This study showed significant clinical benefit for TBS and adding TBS data to FRAX for decision making in the treatment.</span></span></span></span></span></span><br> &nbsp; استئوپروز, دانسیتومتری استخوان (aBMD), درجه ی ترابکولار استخوانی (TBS) , شکستگی ناشی از استئوپروز Osteoporosis, TBS, aBMD, FRAX 409 418 http://tmuj.iautmu.ac.ir/browse.php?a_code=A-10-1386-2&slc_lang=fa&sid=1 Roxana Peysepar رکسانا پی سپار drroxanapaysepar@gmail.com 100319475328460010917 100319475328460010917 No Internal Medicine Specialist, Department of Internal medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran متخصص بیماری های داخلی، بخش بیماری های داخلی ، دانشکده پزشکی، علوم پزشکی تهران، دانشگاه آزاداسلامی، تهران، ایران Laleh Ghanei لاله قانعی Ghanei.laleh@gmail.com 100319475328460010918 100319475328460010918 Yes Endocrinologist, Department of Internal medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran , Iran فوق تخصص غدد، بخش بیماری های داخلی ، علوم پزشکی تهران، دانشگاه آزاداسلامی، تهران، ایران Sahar Ghareh سحر قره sghareh@yahoo.com 100319475328460010919 100319475328460010919 No Endocrinologist,, Department of Internal medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran , Iran فوق تخصص غدد، بخش بیماری های داخلی، دانشکده پزشکی، علوم پزشکی تهران، دانشگاه آزاداسلامی، تهران، ایران Shahla Abolghasemi شهلا ابوالقاسمی shahlamarmim@yahoo.com 100319475328460010920 100319475328460010920 No Rheumatologist, Department of Internal medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran , Iran فوق تخصص روماتولوژی، بخش بیماری‌های داخلی ، دانشکده پزشکی، علوم پزشکی تهران، دانشگاه آزاداسلامی، تهران، ایران Alipasha Meysamie علی پاشا میثمی MEYSAMIE@tums.ac.ir 100319475328460010921 100319475328460010921 No Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran دپارتمان پزشکی اجتماعی دانشگاه علوم پزشکی تهران Parima Hoseini پریما حسینی Pari.hoseini@mail.sbu.ac.ir 100319475328460010922 100319475328460010922 No Depratment of Radiation Application, Shahid Beheshti University, Tehran, Iran لیسانس فیزیک هسته ای، دانشجوی فوق لیسانس مهندسی کاربرد پرتو دانشگاه شهید بهشتی