骨质疏松症筛查和治疗对选定的老年男性可能是具有成本效益的

根据8月8日出版的《美国医学会杂志》(JAMA)上的一项研究，根据年龄和之前是否有过骨折的情况，对选定的老年骨质疏松患者进行筛查和治疗可能是划算的。

根据这篇文章的背景信息，骨质疏松性骨折被认为是老年男性中常见且严重的健康问题，60岁的白人男性在其余生中发生此类骨折的几率为29%。三分之一的髋部骨折发生在男性，与发生在女性的髋部骨折的患病人数相同，死亡风险也更高。尽管男性骨质疏松症问题很重要，但缺乏关于常见诊断和治疗干预的成本效益的证据。

John T. Schousboe, M.D., M.S., of Park Nicollet Health Services, Minneapolis, and colleagues conducted a study to estimate the lifetime costs and health benefits of bone densitometry (measurement of bone density) followed by 5 years of oral bisphosphonate (a class of drugs used to strengthen bone) therapy for men found to have osteoporosis. The researchers created a computer simulation model for hypothetical groups of white men age 65, 70, 75, 80, or 85 years, with or without prior clinical fracture. Data from several sources were used to estimate fracture costs and population-based age-specific fracture rates and associations among prior fractures, bone density and incident fractures. The authors estimated the costs per quality-adjusted life-years (QALYs) gained for the densitometry and follow-up treatment strategy compared with no intervention, calculated from lifetime costs and accumulated QALYs for each strategy.

研究人员发现，前骨折的男性股骨颈骨质疏松症的估计患病率为65岁的14.5％，达到85岁至33.6％。骨质疏松症在没有现有临床骨折的情况下较低，从65岁的7.6％到85岁的7.6％到17.6％。密度测定和治疗策略适度降低了65岁男性的临床骨折的绝对10年发病率为2.1％，而85岁男性在85岁男性中为8.5％，患有先前的骨折。

资料来源:《美国医学会杂志》和《档案杂志》

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