Ferrar Lynne, Jiang Guirong, Cawthon Peggy M, San Valentin Ria, Fullman Robin, Lambert Lori, Cummings Steven R, Black Dennis M, Orwoll Eric, Barrett-Connor Elizabeth, Ensrud Kris, Fink Howard A, Eastell Richard
Academic Unit of Bone Metabolism, University of Sheffield, United Kingdom.
J Bone Miner Res. 2007 Sep;22(9):1434-41. doi: 10.1359/jbmr.070608.
Non-osteoporotic SVH may mimic VF but is excluded in ABQ. In men, this led to discordance between ABQ and other methods, but SVH was not linked to low bone density. Exclusion of SVH could reduce false positives.
Non-osteoporotic short vertebral height (SVH) may mimic vertebral fracture (VF). The aims were to (1) compare the prevalence of VF in elderly men using the algorithm-based qualitative (ABQ), semiquantitative (SQ), and triage-quantitative morphometric (triage-QM) methods; (2) identify reasons for discordance between methods; and (3) determine whether SVH identified by ABQ is linked to low BMD.
We studied a subset of 732 men ages > or =65 yr participating in the Osteoporotic Fractures in Men (MrOS) Study. Criteria for VF were (1) ABQ: endplate depression; (2) SQ: estimated vertebral height reduction > or =20%; (3) triage-QM: vertebral height ratio >3 SD below the reference mean, on radiographs showing evidence of VF. Criteria for SVH (ABQ) were apparent "reduction" in vertebral height > or = approximately 15%, without evidence of endplate depression.
The prevalence of at least one VF was 10% (ABQ); 13% (SQ) and 11% (QM-triage) and of at least one SVH (ABQ) was >50%. Agreement between methods was moderate (kappa = 0.42-0.62). Discordance between methods related mainly to classification of mild thoracic wedging or possible traumatic VF by ABQ. Mean BMD was lower in men with VF (any diagnostic method) than in those without (two-sample t-test, p < 0.05). For ABQ, BMD was similar in men with SVH (no VF) and men with normal vertebrae (ANOVA, p > 0.05). Mean BMD was significantly lower than expected in 40 men with VF identified by all three methods and average or more than average in those identified by a single method.
Among elderly men (1) the prevalence of VF ranges from 10% to 13%: (2) agreement between diagnostic methods is moderate: discordance relates mainly to differential classification of mild thoracic deformities or ABQ definition of VF as traumatic; and (3) SVH identified by ABQ is common and not linked to low BMD.
非骨质疏松性短椎体高度（SVH）可能会模仿椎体骨折（VF），但在基于算法的定性（ABQ）评估中可排除。在男性中，这导致了ABQ与其他方法之间的不一致，但SVH与低骨密度无关。排除SVH可减少假阳性。
非骨质疏松性短椎体高度（SVH）可能会模仿椎体骨折（VF）。目的是：（1）使用基于算法的定性（ABQ）、半定量（SQ）和分类定量形态学（分类-QM）方法比较老年男性中VF的患病率；（2）确定方法之间不一致的原因；（3）确定ABQ识别出的SVH是否与低骨密度相关。
我们研究了参与男性骨质疏松性骨折（MrOS）研究的732名年龄≥65岁男性的一个子集。VF的标准为：（1）ABQ：终板凹陷；（2）SQ：估计椎体高度降低≥20%；（3）分类-QM：在显示VF证据的X线片上，椎体高度比低于参考平均值3个标准差以上。SVH（ABQ）的标准为椎体高度明显“降低”≥约15%，且无终板凹陷证据。
至少有一处VF的患病率为10%（ABQ）；13%（SQ）和11%（分类-QM），至少有一处SVH（ABQ）的患病率>50%。方法之间的一致性为中等（kappa = 0.42 - 0.62）。方法之间的不一致主要与ABQ对轻度胸椎楔形变或可能的创伤性VF的分类有关。有VF（任何诊断方法）的男性的平均骨密度低于无VF的男性（两样本t检验，p < 0.05）。对于ABQ，有SVH（无VF）的男性和椎体正常的男性的骨密度相似（方差分析，p > 0.05）。在所有三种方法都识别出的40名有VF的男性中，平均骨密度显著低于预期，而在仅由一种方法识别出的男性中，平均骨密度为平均水平或高于平均水平。
在老年男性中，（1）VF的患病率为10%至13%；（2）诊断方法之间的一致性为中等：不一致主要与轻度胸椎畸形的不同分类或ABQ将VF定义为创伤性有关；（3）ABQ识别出的SVH很常见，且与低骨密度无关。
