Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
J Clin Densitom. 2021 Apr-Jun;24(2):190-199. doi: 10.1016/j.jocd.2020.05.005. Epub 2020 May 22.
INTRODUCTION/BACKGROUND: Both areal bone mineral density (aBMD) and bone microarchitecture have been associated with vertebral deformity (VD), but there are limited data on the utility of bone microarchitecture measures in combination with aBMD in discriminating VD. This study aimed to describe whether radial bone microarchitecture measures alone or in combinations with radial volumetric bone mineral density (vBMD) or spine aBMD can improve discrimination of VD in adults.
Data on 196 subjects (mean age (standard deviation, SD) = 72 (7) years, female 46%) were utilized. VD of T4-L4 and spine aBMD were measured using dual-energy X-ray absorptiometry. VD was defined if anterior to posterior height ratio was more than 3-SD, 4-SD below, or >25% decrease compared with the sex-matched normal means. Bone microarchitecture parameters at distal radius were collected using high-resolution peripheral quantitative computed tomography and analyzed using StrAx.
The strongest associations were seen for the cortical thickness (odds ratios (ORs): 2.63/SD decrease for 25% and 2.38/SD decrease for 3-SD criterion) and compact cortical area (OR: 3.33/SD decrease for 4-SD criterion). The area under the receiver operating characteristic curve (AUC) for spine aBMD for VD was 0.594, 0.597, and 0.634 for 25%, 3-SD and 4-SD criteria, respectively (all p < 0.05). Compact cortical area, cortical thickness and compact cortical thickness alone had the largest AUCs for VD (0.680-0.685 for 25% criterion, 0.659-0.674 for 3-SD criterion, and 0.699-0.707 for 4-SD criterion). Adding spine aBMD or radial vBMD to each cortical measure did not improve VD discrimination (∆ AUC 0.8%-2.1%).
Cortical measures had the best utility for discriminating VD when used alone. Adding either spine aBMD or radial vBMD did not improve the utility of cortical measures.
简介/背景：骨密度（aBMD）和骨微观结构都与椎体变形（VD）有关，但关于骨微观结构测量值与 aBMD 联合使用来区分 VD 的效用的数据有限。本研究旨在描述桡骨微观结构测量值单独或与桡骨容积骨密度（vBMD）或脊柱 aBMD 联合使用是否可以改善成人 VD 的区分。
利用 196 名受试者的数据（平均年龄（标准差，SD）= 72（7）岁，女性 46%）。使用双能 X 射线吸收法测量 T4-L4 和脊柱 aBMD 的 VD。如果前-后高度比大于 3-SD、4-SD 以下或与性别匹配的正常平均值相比下降超过 25%，则定义为 VD。使用高分辨率外周定量计算机断层扫描收集桡骨远端的骨微观结构参数，并使用 StrAx 进行分析。
最强的关联见于皮质厚度（比值比（ORs）：2.63/SD 下降 25%和 2.38/SD 下降 3-SD 标准）和致密皮质面积（OR：4-SD 标准下降 3.33/SD）。脊柱 aBMD 对 VD 的曲线下面积（AUC）分别为 0.594、0.597 和 0.634，用于 25%、3-SD 和 4-SD 标准（均 p<0.05）。单独使用致密皮质面积、皮质厚度和致密皮质厚度时，对 VD 的 AUC 最大（25%标准为 0.680-0.685，3-SD 标准为 0.659-0.674，4-SD 标准为 0.699-0.707）。在每个皮质测量值中添加脊柱 aBMD 或桡骨 vBMD 并不能改善 VD 的鉴别（Δ AUC 0.8%-2.1%）。
皮质测量值单独使用时对区分 VD 最有效。添加脊柱 aBMD 或桡骨 vBMD 并不能提高皮质测量值的效用。
