目的：通过分析骨折风险评估工具（FRAX R）不同模式预测不同临床危险因子联合/不联合左侧股骨颈骨密度（BMD）老年低骨量男性10年内骨折概率的差异，评估各种模式识别骨质疏松性骨折高危患者的能力。方法收集老年低骨量温州男性患者389例，记录所有受试者年龄、身高、体重、脆性骨折史、父母脆性骨折史、口服激素史、类风湿关节炎史、吸烟史、饮酒史和BMD。使用FRAX R中国大陆、中国台湾、韩国和中国香港4种模式，联合/不联合BMD计算受试个体的10年内骨折概率[10年内骨质疏松引起的主要骨折概率（PMOF）和10年内髋部骨折概率（PHF）]，同时筛选达到骨质疏松性骨折高危患者诊断标准（PMOF≥20%或PHF≥3%）的个体。结果 FRAX R中国大陆模式PMOF、PHF低于其他3种模式（P＜0.01）；FRAX R中国大陆模式达到骨质疏松性骨折高危患者的个体数少于其他3种模式。FRAX R中国大陆、中国台湾、韩国和中国香港4种模式预测联合/不联合BMD的PMOF≥20%的个体数分别为0、1、0、1和0、1、0、0例。结论 FRAX R中国大陆模式低估了老年男性的PMOF和PHF，不能早期发现老年低骨量男性骨质疏松性骨折高危患者；FRAX R中国大陆、中国台湾、中国香港和韩国4种模式均低估了老年男性的PMOF。%Objective To assess the application of different versions of WHO fracture risk assessment tool (FRAX R ) in predicting fracture risks for elderly male individuals with low bone mass. Methods Demographic and clinical data were col ect-ed from 389 elderly male subjects with low bone mass in Wenzhou, including age, height, weight, history of fragility fracture, parental history of fragility fractures, oral steroid history, history of rheumatoid arthritis, smoking history, history of alcohol con-sumption and bone mass density (BMD). The probability of fracture in 10 years, including probability of a major osteoporotic fracture (PMOF) and probability of hip fracture (PHF) was calculated by different FRAX R versions:China mainland, Taiwan, South Korea and Hong Kong with or without femoral neck BMD (T value). The individuals which achieve the diagnostic criteria of high risk with osteoporotic fractures (PMOF≥20%or PHF≥3%) were screened. Results PMOF and PHF calculated by China main-land version of FRAX R were significantly lower than those by Taiwan, South Korea and Hong Kong versions (P<0.01). Less in-dividuals at high risk of osteoporotic fractures which were screened out by China mainland version of FRAX R than those screened with other versions. Individuals designated by four FRAX R versions with or without BMD as PMOF exceeding 20%were 0, 1, 0, 1 cases and 0, 1, 0, 0 cases, respectively. Conclusion China mainland version of FRAX R underestimates PMOF and PHF in elderly male individuals. Fracture risk calculated by four FRAX R versions al underestimate PMOF in elderly male individ-uals.
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