Amarowicz Jarosław, Czerwiński Edward, Kumorek Anna, Warzecha Maja, Berwecka Małgorzata, Hans Didier
Department of Bone and Joint Diseases, Jagiellonian University Medical College, Krakow, Poland.
Krakow Medical Centre, Krakow, Poland.
Reumatologia. 2018;56(2):80-86. doi: 10.5114/reum.2018.75518. Epub 2018 May 9.
The aim of our study was to determine a possible correlation between vertebral fractures (indicated by VFA - vertebral fracture assessment), TBS (trabecular bone score) and muscle strength (measured by means of handgrip strength test results) in a group of postmenopausal women.
The study was conducted between 2014 and 2015 in a group of patients of Krakow Medical Centre (KMC). Women who participated in the study were referred to KMC by an attending physician for suspected vertebral fracture. Apart from VFA, patients were additionally tested for bone density (including TBS), muscle strength (by means of a handgrip strength test) and height loss. Altogether 35 patients with an average age of 69.7 years (49-95, SD = 10.49) were included in the study.
In the group of 35 women, VFA analysis demonstrated vertebral fractures in 17 patients (40%). Vertebral height loss suggesting a fracture was revealed in 77 vertebrae. The mean result of the TBS was 1.195 (0.982-1.409, SD = 0.09), which suggests high risk of fracture. The majority of the subjects (65.7%) displayed major bone microarchitecture degradation (TBS < 1.23) and also the highest number of fractures ( = 62, 80.5% of all). There was no correlation between the spine bone mineral density (BMD) score and the TBS result, which confirms studies showing that subjects with the same bone density may have completely different TBS. Bone density (spine BMD) was similar (osteopenic) in groups with or without vertebral fracture (in VFA). We noted a significant correlation ( = 0.45, < 0.05) between the number of fractured vertebrae and the handgrip score.
VFA should be a part of a standard diagnostic procedure for patients with osteoporotic fractures. When it comes to identifying patients at risk of fracturing vertebrae, muscle strength (handgrip) may have potential use in clinical practice. The predictive value of the TBS in reference to vertebral fractures should be evaluated in bigger randomized studies.
我们研究的目的是确定一组绝经后女性中椎体骨折（通过椎体骨折评估即VFA来表明）、骨小梁骨评分（TBS）和肌肉力量（通过握力测试结果来测量）之间可能存在的相关性。
该研究于2014年至2015年在克拉科夫医疗中心（KMC）的一组患者中进行。参与研究的女性由主治医生转介至KMC，怀疑有椎体骨折。除了VFA外，还对患者进行了骨密度（包括TBS）、肌肉力量（通过握力测试）和身高降低情况的检测。共有35名平均年龄为69.7岁（49 - 95岁，标准差 = 10.49）的患者纳入研究。
在这35名女性组中，VFA分析显示17名患者（40%）有椎体骨折。77个椎体显示有提示骨折的椎体高度降低。TBS的平均结果为1.195（0.982 - 1.409，标准差 = 0.09），这表明骨折风险高。大多数受试者（65.7%）显示出严重的骨微结构退化（TBS < 1.23），并且骨折数量也最多（ = 62，占所有骨折的80.5%）。脊柱骨矿物质密度（BMD）评分与TBS结果之间无相关性，这证实了一些研究表明骨密度相同的受试者可能有完全不同的TBS。有或无椎体骨折（在VFA中）的组之间骨密度（脊柱BMD）相似（骨质减少）。我们注意到骨折椎体数量与握力评分之间存在显著相关性（ = 0.45， < 0.05）。
VFA应成为骨质疏松性骨折患者标准诊断程序的一部分。在识别有椎体骨折风险的患者方面，肌肉力量（握力）在临床实践中可能有潜在用途。TBS对椎体骨折的预测价值应在更大规模的随机研究中进行评估。
