Kanterewicz E, Yañez A, Del Rio L, Diez Pérez A, Carbonell J
Rheumatology Unit, Hospital General de Vic, Vic (Barcelona), and Universitat Autònoma de Barcelona, Barcelona, Spain.
J Clin Densitom. 2003 Winter;6(4):359-66. doi: 10.1385/jcd:6:4:359.
Colles' fracture (CF) in younger postmenopausal women is associated with low bone mineral density (BMD) and with an increased risk of other osteoporotic fractures; however, the prevalence of vertebral deformities has been not studied in CF patients. Vertebral morphometry (MXA) using dual-energy X-ray absorptiometry (DXA) is a research tool developed to evaluate the presence of vertebral deformities, but its clinical use is still limited. The goals of this work were to know the prevalence of vertebral deformities in women with CF, to study the morphometric characteristics of height ratios, and to determine the correlation between MXA findings and BMD. MXA was evaluated within an incident case-control study in which 58 women with a recent CF and 83 population-based control women were enrolled. Anterior (Ha), middle (Hm), and posterior (Hp) heights were measured, and wedge (Ha/Hp) and mid-wedge (Hm/Hp) ratios were calculated. A vertebral deformity was defined when at least one ratio fell 3 SD below the reference mean of that ratio at any vertebral level. The mean age of cases was 65.8 yr and in controls 58.7 (p < 0.05). Morphometric vertebral deformities were found in 19% of cases against 11% of controls (nonsignificant). The cases had a lower mid-wedge ratio than controls at each vertebral level (p < 0.05), while wedge ratio results did not show significant results. When the sample was stratified by age, CF showed a trend to be associated with vertebral deformity only in the younger (<65 yr) group. A low but significant coefficient of correlation was found between mid-wedge ratio and BMD, mainly at hip level. By using MXA we found that younger Colles' fracture cases were likely to have more vertebral deformities than healthy controls of the same age range.
绝经后年轻女性的科雷氏骨折(CF)与低骨密度(BMD)相关,且发生其他骨质疏松性骨折的风险增加;然而,CF患者中椎体畸形的患病率尚未得到研究。使用双能X线吸收法(DXA)进行的椎体形态测量(MXA)是一种用于评估椎体畸形存在情况的研究工具,但其临床应用仍然有限。本研究的目的是了解CF女性中椎体畸形的患病率,研究身高比值的形态测量特征,并确定MXA结果与BMD之间的相关性。在一项病例对照研究中对MXA进行了评估,该研究纳入了58例近期发生CF的女性和83例基于人群的对照女性。测量了椎体前部(Ha)、中部(Hm)和后部(Hp)的高度,并计算了楔形变(Ha/Hp)和中楔形变(Hm/Hp)比值。当任何椎体水平上至少有一个比值低于该比值参考均值3个标准差时,定义为椎体畸形。病例组的平均年龄为65.8岁,对照组为58.7岁(p<0.05)。19%的病例发现有形态测量椎体畸形,而对照组为11%(无显著性差异)。病例组在每个椎体水平的中楔形变比值均低于对照组(p<0.05),而楔形变比值结果无显著差异。当按年龄分层时,CF仅在较年轻(<65岁)组中显示出与椎体畸形相关的趋势。中楔形变比值与BMD之间存在低但显著的相关性,主要在髋部水平。通过使用MXA,我们发现较年轻的科雷氏骨折病例比同年龄范围的健康对照者更可能有更多的椎体畸形。