Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.
J Bone Miner Res. 2020 Sep;35(9):1695-1702. doi: 10.1002/jbmr.4046. Epub 2020 Jun 2.
The impact of primary hand osteoarthritis (HOA) on bone mass, microstructure, and biomechanics in the affected skeletal regions is largely unknown. HOA patients and healthy controls (HCs) underwent high-resolution peripheral quantitative computed tomography (HR-pQCT). We measured total, trabecular, and cortical volumetric bone mineral densities (vBMDs), microstructural attributes, and performed micro-finite element analysis for bone strength. Failure load and scaled multivariate outcome matrices from distal radius and second metacarpal (MCP2) head measurements were analyzed using multiple linear regression adjusting for age, sex, and functional status and reported as adjusted Z-score differences for total and direct effects. A total of 105 subjects were included (76 HC: 46 women, 30 men; 29 HOA: 23 women, six men). After adjustment, HOA was associated with significant changes in the multivariate outcome matrix from the MCP2 head (p < .001) (explained by an increase in cortical vBMD (Δz = 1.07, p = .02) and reduction in the trabecular vBMD (Δz = -0.07, p = .09). Distal radius analysis did not show an overall effect of HOA; however, there was a gender-study group interaction (p = .044) explained by reduced trabecular vBMD in males (Δz = -1.23, p = .02). HOA was associated with lower failure load (-514 N; 95%CI, -1018 to -9; p = 0.05) apparent in males after adjustment for functional status. HOA is associated with reduced trabecular and increased cortical vBMD in the MCP2 head and a reduction in radial trabecular vBMD and bone strength in males. Further investigations of gender-specific changes of bone architecture in HOA are warranted. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
原发性手骨关节炎 (HOA) 对受累骨骼区域的骨量、微结构和生物力学的影响在很大程度上尚不清楚。HOA 患者和健康对照者 (HCs) 接受了高分辨率外周定量计算机断层扫描 (HR-pQCT)。我们测量了总、小梁和皮质体积骨矿物质密度 (vBMD)、微结构参数，并进行了骨强度的微有限元分析。使用多元线性回归分析了来自桡骨远端和第二掌骨 (MCP2) 头部测量的失效负荷和比例多维结果矩阵，调整了年龄、性别和功能状态，并报告了总效应和直接效应的调整 Z 分数差异。共纳入 105 例受试者（76 例 HC：46 例女性，30 例男性；29 例 HOA：23 例女性，6 例男性）。调整后，HOA 与 MCP2 头部多维结果矩阵的显著变化相关（p <.001）（由皮质 vBMD 增加（Δz = 1.07，p =.02）和小梁 vBMD 减少（Δz = -0.07，p =.09）解释）。桡骨远端分析未显示 HOA 的总体影响；然而，存在性别-研究组相互作用（p =.044），由男性的小梁 vBMD 减少（Δz = -1.23，p =.02）解释。在调整功能状态后，HOA 与较低的失效负荷（-514 N；95%CI，-1018 至-9；p = 0.05）相关，这在男性中明显。HOA 与 MCP2 头部小梁和皮质 vBMD 减少以及男性桡骨小梁 vBMD 和骨强度减少相关。进一步研究 HOA 中骨结构的性别特异性变化是必要的。© 2020 美国骨与矿物研究学会作者。《骨与矿物研究杂志》出版。
