Paris Descartes University, Rheumatology department, Cochin Hospital, Paris, France.
Joint Bone Spine. 2013 Oct;80(5):499-502. doi: 10.1016/j.jbspin.2012.12.006. Epub 2013 Mar 1.
Fractal bone analysis (Hmean) is a texture parameter reflecting bone microarchitecture. The BMA device (D3A™ Medical Systems, Orléans, France) is a high-resolution X-ray device that allows assessment of bone texture analysis. We aimed to measure Hmean in rheumatoid arthritis patients at the second and third metacarpal bones, at baseline and after 1 year of follow-up, and to assess the relationship of Hmean and rheumatoid arthritis disease parameters.
Patients with rheumatoid arthritis according to ACR criteria were included. They were assessed over 1 year, in the context of a prospective study conducted in Maastricht. For this substudy, activity of the disease was assessed by erythrocyte sedimentation rate, C-reactive protein and Disease Activity Score 28 performed at each visit. Radiographic bone damage was assessed using hand and feet radiographs at baseline and on a 1-year basis. The bone texture parameters were evaluated on the second and third metacarpal heads of the left hand using BMA device.
One hundred and sixty-five rheumatoid arthritis patients were included in this study. At baseline, Hmean was negatively correlated with age [r=-0.22 (P=0.013)] and erythrocyte sedimentation rate [r=-0.16 (P=0.039)]. No significant correlation was found between Hmean and Disease Activity Score, disease activity Visual Analog Scale, daily corticosteroid dose and C-reactive protein. There was a significant increase in Hmean of second and third metacarpal bones over 1 year (1.6% and 1.3%, P<0.01) except in patients with local second and third metacarpal bones erosion.
The bone texture parameter Hmean is influenced by age, inflammation and local erosions in rheumatoid arthritis.
分形骨分析（Hmean）是反映骨微观结构的纹理参数。BMA 设备（D3A™ Medical Systems，奥尔良，法国）是一种高分辨率 X 射线设备，可用于评估骨纹理分析。我们的目的是在类风湿关节炎患者的第二和第三掌骨处测量 Hmean，基线和 1 年随访时，并评估 Hmean 与类风湿关节炎疾病参数的关系。
纳入符合 ACR 标准的类风湿关节炎患者。他们在 1 年内接受评估，这是在马斯特里赫特进行的一项前瞻性研究的背景下进行的。对于这项子研究，疾病活动通过红细胞沉降率、C 反应蛋白和每次就诊时进行的 28 关节疾病活动评分来评估。基线和 1 年时使用手部和足部射线照相评估放射学骨损伤。使用 BMA 设备在手的第二和第三掌骨头处评估骨纹理参数。
这项研究纳入了 165 例类风湿关节炎患者。基线时，Hmean 与年龄呈负相关 [r=-0.22（P=0.013）] 和红细胞沉降率 [r=-0.16（P=0.039）]。Hmean 与疾病活动评分、疾病活动视觉模拟评分、每日皮质类固醇剂量和 C 反应蛋白之间未发现显著相关性。除了局部第二和第三掌骨侵蚀的患者外，第二和第三掌骨的 Hmean 在 1 年内显著增加（分别为 1.6%和 1.3%，P<0.01）。
在类风湿关节炎中，骨纹理参数 Hmean 受年龄、炎症和局部侵蚀的影响。
