Comparative Study Of BMD, OSTA And FRAX In The Prediction Of Osteoporotic Fracture Risk In Postmenopausal Type 2 Diabetes Patients

Objective: To compare the application value of BMD,OSTA and FRAX(non-BMD model)on the prediction of osteoporotic fracture risk in postmenopausal type 2 diabetes patients,and to provide a suitable tool of osteoporotic fracture for Chinese postmenopausal type 2 diabetes women.Methods: Collect a total of 122 postmenopausal type 2 diabetes patients(T2DM group)who underwent bone mineral density examination in the Third Hospital of Hebei Medical University from April 2018 to December 2018,in addition,a total of 128 postmenopausal non-diabetes women(control group)who underwent bone mineral density examination were selected.Collect relevant data,compare the left femoral neck T-score,OSTA and FRAX between T2 DM group and control group.Draw the ROC curves based on the baseline data and the occurrence of actual fractures,and compare the value of the left femoral neck T-score,OSTA,and FRAX on predicting the risk of osteoporotic fracture in postmenopausal type 2 diabetes patients.Results:The morbidity of prior osteoporotic fracture in the T2 DM group was higher than that in the control group,and the difference was statistically significant.There were no significant differences in the left femoral neck T-score,OSTA and FRAX between the T2 DM group and the control group,the non-fracture patients in the T2 DM group and the non-fracture patients in the control group.There were no significant differences in the OSTA and FRAX between the fracture patients in the T2 DM group and the fracture patients in the control group.The left femoral neck T-score in the fracture patients of T2 DM group was higher than that in the control group,and the difference was statistically significant.In the T2 DM group,the left femoral neck T-score and OSTA in patients with fracture were lower than those without fracture,the FRAX in patients with fracture was higher than that without fracture,and the differences were statistically significant.AUC areas of ROC curves of the left femoral neck T-score,OSTA and FRAX(non-BMD)were 0.719(95%CI:0.617-0.822,P=0.000),0.617(95%CI:0.486-0.748,P=0.061)and 0.943(95%CI:0.901-0.985,P=0.000),respectively.The best cutoff values were-1.7,-0.7and 7.2%,respectively.Conclusion:BMD,OSTA,and FRAX may underestimate the risk of osteoporotic fracture in postmenopausal type 2 diabetes patients.The application of those models above in postmenopausal type 2 diabetes patients needs further correction.Comparing the three tools,FRAX is more valuable in assessing the risk of osteoporotic fractures in postmenopausal type 2 diabetes patients,and the diagnostic cutoff value is 7.2%.