Shin Y H, Gong H S, Gang D H, Shin H S, Kim J, Baek G H
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, South Korea.
Osteoporos Int. 2016 Dec;27(12):3559-3565. doi: 10.1007/s00198-016-3686-4. Epub 2016 Jun 24.
We compared bone mineral density (BMD) and trabecular bone score (TBS) in postmenopausal women with a distal radius fracture older than 50 years with controls. Total hip BMD was significantly different, but TBS was not different between two groups, suggesting TBS does not reflect microarchitectural changes of the distal radius.
The purpose of this study was to determine whether trabecular bone score (TBS) has additive value for discriminating distal radius fracture (DRF) independent of BMD.
We compared BMD and TBS in 258 postmenopausal women with a DRF older than 50 years of age with age- and body mass index (BMI)-matched controls who had no history of osteoporotic fracture. BMD was measured at the lumbar spine and hip using dual energy X-ray absorptiometry scans (GE Lunar Prodigy). TBS was calculated on the same spine image. A multivariate logistic regression analysis was used to analyze the odds ratio (OR) for the occurrence of DRF using age, BMI, lumbar spine BMD, total hip BMD, and TBS.
Patients with a DRF had significantly lower BMDs at hip (neck, trochanter and total) than those of controls: 0.752 ± 0.097, 0.622 ± 0.089, and 0.801 ± 0.099 in patients and 0.779 ± 0.092, 0.648 ± 0.089, 0.826 ± 0.101 in controls. However, lumbar spine BMD and TBS were not significantly different between the groups (p = 0.400 and 0.864, respectively). The multivariate analysis indicated that only total hip BMD was significantly associated with the occurrence of DRF (OR, 10.231; 95 % confidence interval, 1.724-60.702; p = 0.010).
TBS was not different between women with a DRF and those without a history of osteoporotic fracture, suggesting that TBS measured at the lumbar spine does not reflect early microarchitectural changes of the distal radius. Only total hip BMD is associated with the risk of DRF in Korean women.
我们比较了年龄超过50岁的绝经后桡骨远端骨折女性与对照组的骨密度（BMD）和小梁骨评分（TBS）。两组之间全髋部骨密度存在显著差异，但TBS无差异，这表明TBS不能反映桡骨远端的微结构变化。
本研究的目的是确定小梁骨评分（TBS）在独立于骨密度的情况下，对于鉴别桡骨远端骨折（DRF）是否具有附加价值。
我们比较了258例年龄超过50岁的绝经后桡骨远端骨折女性与年龄及体重指数（BMI）匹配且无骨质疏松性骨折病史的对照组的骨密度和TBS。使用双能X线吸收法扫描（GE Lunar Prodigy）测量腰椎和髋部的骨密度。在同一脊柱图像上计算TBS。采用多因素逻辑回归分析，使用年龄、BMI、腰椎骨密度、全髋部骨密度和TBS分析桡骨远端骨折发生的比值比（OR）。
桡骨远端骨折患者髋部（颈部、大转子和全髋）的骨密度显著低于对照组：患者分别为0.752±0.097、0.622±0.089和0.801±0.099，对照组分别为0.779±0.092、0.648±0.089、0.826±0.101。然而，两组之间腰椎骨密度和TBS无显著差异（分别为p = 0.400和0.864）。多因素分析表明，只有全髋部骨密度与桡骨远端骨折的发生显著相关（OR，10.231；95%置信区间，1.724 - 60.702；p = 0.010）。
桡骨远端骨折女性与无骨质疏松性骨折病史的女性之间TBS无差异，这表明在腰椎测量的TBS不能反映桡骨远端早期的微结构变化。在韩国女性中，只有全髋部骨密度与桡骨远端骨折风险相关。
