Department of Rheumatology and Clinical Immunology/Allergology, University of Bern, Bern, Switzerland.
Rheumatology (Oxford). 2010 May;49(5):977-81. doi: 10.1093/rheumatology/keq014. Epub 2010 Feb 15.
Recent studies have suggested that areal BMD (aBMD) measured by DXA is elevated in patients with DISH. We used peripheral QCT (pQCT) to assess volumetric BMD (vBMD) and bone geometry of the radius, tibia and the third metacarpal bone.
Patients with established DISH and a control group of healthy individuals were recruited. pQCT measurements were performed at the distal epiphyses and mid-shafts of the radius, the tibia and the third metacarpal bone. At the epiphyses cross-sectional area (CSA), total BMD and trabecular BMD were measured. At the shafts, total bone CSA, cortical CSA, cortical wall thickness and cortical BMD were determined. In addition, muscle and fat CSA of the forearm and lower leg were assessed. Bone parameters were compared between the two groups using independent t-tests.
Thirty DISH patients and 30 controls comparable with regard to age and height were included in this study. None of the measured bone parameters differed between groups.
In contrast to suggestions based on DXA, pQCT revealed that DISH patients do not have increased vBMD and bone geometry in the appendicular skeleton. Ossification at tendon or ligament insertion sites may lead to overestimation of aBMD if assessed by DXA.
最近的研究表明，DISH 患者的 DXA 测量的面积骨密度（aBMD）升高。我们使用外周定量 CT（pQCT）评估桡骨、胫骨和第三掌骨的容积骨密度（vBMD）和骨几何形状。
招募了患有明确 DISH 和健康对照组的患者。在桡骨、胫骨和第三掌骨的远端骨骺和骨干处进行 pQCT 测量。在骨骺处测量横截面积（CSA）、总骨密度和小梁骨密度。在骨干处，确定总骨 CSA、皮质 CSA、皮质壁厚度和皮质骨密度。此外，还评估了前臂和小腿的肌肉和脂肪 CSA。使用独立 t 检验比较两组之间的骨参数。
本研究纳入了 30 名 DISH 患者和 30 名年龄和身高相匹配的对照组。两组之间没有测量的骨参数存在差异。
与基于 DXA 的建议相反，pQCT 显示 DISH 患者在附肢骨骼中没有增加的 vBMD 和骨几何形状。如果通过 DXA 评估，肌腱或韧带插入部位的骨化可能导致 aBMD 的高估。
