Rheumatology Department, Military Hospital Mohammed V, Rabat, Morocco.
Bone. 2012 Apr;50(4):853-7. doi: 10.1016/j.bone.2011.12.018. Epub 2012 Jan 3.
Recognition of vertebral fractures (VFs) change the patient's diagnostic classification, estimation of fracture risk, and threshold for pharmacological intervention. Vertebral fracture assessment (VFA) enables the detection of VFs in the same session as bone mineral density (BMD) testing.
To study prevalence and risk factors of VFs using VFA in asymptomatic men and measure its impact on patients' management.
We enrolled 791 men aged between 45 and 89 (mean age, weight and BMI of 62.4±8.6) (45 to 89) years, 74.9±12.7 (40 to 163) and 26.3±4.0 (16.6 to 43.8) kg/m(2), respectively. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative (SQ) approach and morphometry.
VFs were identified in 318 (40.3%): 206 (26.0%) had grade 1 and 112 (14.2%) had grade 2 or 3. As would be expected, the prevalence of VFA-detected fractures globally increased significantly with age and as BMI and BMD declined. A fracture was identified on VFA in 85 (32.4%) of men with normal BMD (6.9% had grade 2/3 VFs) and in 144 (35.8%) with osteopenia (11.7% had grade 2/3 VFs). Stepwise regression analysis showed that presence of VFs was independently related to the osteoporotic status (OR=4.761, 95%CI [2.956-7.668]; p<0.0001) and current smoking (OR=1.717, 95%CI [1.268-2.323]; p=0.002).
Our results support the recommendation to enlarge the indications of VFA to all the men referred for DXA measurement.
椎体骨折（VF）的识别改变了患者的诊断分类、骨折风险评估和药物干预阈值。椎体骨折评估（VFA）可在与骨密度（BMD）检测相同的检查中检测到 VF。
使用 VFA 研究无症状男性 VF 的患病率和危险因素，并评估其对患者管理的影响。
我们招募了 791 名年龄在 45 岁至 89 岁（平均年龄 62.4±8.6 岁、体重和 BMI 分别为 74.9±12.7kg/m²[40 至 163kg]和 26.3±4.0kg/m²[16.6 至 43.8kg/m²]）的男性。使用通用电气医疗保健公司的 Lunar Prodigy 骨密度仪获取侧位 VFA 图像和腰椎及股骨近端扫描。VF 采用 Genant 半定量（SQ）方法和形态计量学相结合进行定义。
318 名（40.3%）男性发现了 VF：206 名（26.0%）为 1 级，112 名（14.2%）为 2 级或 3 级。如预期的那样，VFA 检测到的骨折的总体患病率随着年龄的增长以及 BMI 和 BMD 的下降而显著增加。在 85 名（32.4%）BMD 正常的男性（6.9%有 2/3 级 VF）和 144 名（35.8%）骨质疏松症患者（11.7%有 2/3 级 VF）中发现了 VFA 骨折。逐步回归分析显示，VF 的存在与骨质疏松状态独立相关（OR=4.761，95%CI[2.956-7.668]；p<0.0001）和当前吸烟（OR=1.717，95%CI[1.268-2.323]；p=0.002）。
我们的结果支持将 VFA 的适应证扩大到所有接受 DXA 测量的男性的建议。
