使用亚区软骨厚度变化的有序值可提高检测骨关节炎进展风险因素的敏感性。
Using ordered values of subregional cartilage thickness change increases sensitivity in detecting risk factors for osteoarthritis progression.
机构信息
StatAnswers Consulting LLC, San Diego, CA 92122, USA.
出版信息
Osteoarthritis Cartilage. 2011 Mar;19(3):302-8. doi: 10.1016/j.joca.2010.12.006. Epub 2010 Dec 22.
OBJECTIVE
To examine whether ordered values of (sub)regional femorotibial cartilage thickness change are superior to region-based approaches in detecting risk factors for cartilage loss in osteoarthritis (OA).
METHODS
58 women with knee OA had 3 Tesla MR images acquired at baseline and 24 months. Changes in cartilage thickness (∆ThCtAB) were determined in eight medial femorotibial subregions. An ascending sort of individual ∆ThCtAB measurements was done to create "ordered values". Risk factors for cartilage loss considered were: age, BMI, anatomical knee axis (AAA), minimal (medial) joint space width (mJSW), and percent of medial tibial plateau covered by the meniscus (percent cover). All change metrics were tested for association with the risk factors using Kendall's τ and relative sensitivity of multiple tests of subregions and ordered values were compared with single metrics of change from plate and compartment summaries and the first ordered value.
RESULTS
The associations between subregion ∆ThCtAB and AAA (P=0.0002), mJSW (P=0.016), and age (P=0.011) were significant, but only AAA (at α=0.05) and age (at α=0.1) remained significant after adjusting for multiple subregions. In contrast, cMFTC had P-values<0.05 for AAA (P=0.0001), mJSW (P=0.016), and meniscus subluxation (0.04). The first ordered value had significant associations with AAA (P=0.0004), mJSW (P=0.003), meniscus subluxation (P=0.02) and percent cover (P=0.031) all of which were significant at α=0.05 after adjusting for tests on multiple risk factors.
CONCLUSION
Ordered values of ∆ThCtAB were more sensitive in detecting risk factors of cartilage loss than subregional ∆ThCtAB. Sensitivity was further enhanced by considering the minimum ordered value as a single test, thus not requiring adjustment for multiple tests. Using ordered values there was a significant association between ∆ThCtAB and baseline AAA, mJSW, meniscus subluxation and meniscus percent cover. This study provides an important step in validating ordered values of cartilage change.
目的
研究按序排列的（亚）分区股骨胫骨软骨厚度值变化是否优于基于区域的方法，以检测骨关节炎（OA）中软骨丢失的危险因素。
方法
58 名膝关节 OA 女性在基线和 24 个月时接受 3T MRI 检查。在 8 个内侧股骨胫骨亚区中确定软骨厚度变化（∆ThCtAB）。对个体 ∆ThCtAB 测量值进行升序排序，以创建“有序值”。考虑的软骨丢失危险因素包括：年龄、BMI、解剖学膝关节轴（AAA）、最小（内侧）关节间隙宽度（mJSW）和半月板覆盖的内侧胫骨平台百分比（覆盖百分比）。使用 Kendall's τ 检验所有变化指标与危险因素的关联，并比较亚区和有序值的多重测试的相对敏感性与来自板和隔室总结的单一变化指标以及第一个有序值。
结果
亚区 ∆ThCtAB 与 AAA（P=0.0002）、mJSW（P=0.016）和年龄（P=0.011）之间存在显著关联，但在调整多个亚区后，仅 AAA（在 α=0.05）和年龄（在 α=0.1）仍然显著。相比之下，cMFTC 对 AAA（P=0.0001）、mJSW（P=0.016）和半月板半脱位（P=0.04）的 P 值<0.05。第一个有序值与 AAA（P=0.0004）、mJSW（P=0.003）、半月板半脱位（P=0.02）和覆盖百分比（P=0.031）均存在显著关联，在调整多个危险因素的测试后，所有这些关联在 α=0.05 时均具有统计学意义。
结论
与亚区 ∆ThCtAB 相比，∆ThCtAB 的有序值在检测软骨丢失的危险因素方面更敏感。通过将最小有序值视为单一测试，进一步提高了敏感性，因此无需进行多次测试的调整。使用有序值，∆ThCtAB 与基线 AAA、mJSW、半月板半脱位和半月板覆盖百分比之间存在显著关联。本研究为验证软骨变化的有序值提供了重要步骤。
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