胸部 CT 扫描的骨衰减与现患椎体骨折之间的关联因椎体骨折部位而异。
Associations between bone attenuation and prevalent vertebral fractures on chest CT scans differ with vertebral fracture locations.
机构信息
Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+ (MUMC+), Postbus 5800, 6202, AZ, Maastricht, The Netherlands.
Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+ (MUMC+), Postbus 5800, 6202, AZ, Maastricht, The Netherlands.
出版信息
Osteoporos Int. 2021 Sep;32(9):1869-1877. doi: 10.1007/s00198-020-05719-z. Epub 2021 Feb 16.
UNLABELLED
Vertebral fracture (VF) locations are bimodally distributed in the spine. The association between VF and bone attenuation (BA) measured on chest CT scans varied according to the location of VFs, indicating that other factors than only BA play a role in the bimodal distribution of VFs.
INTRODUCTION
Vertebral fractures (VFs) are associated with low bone mineral density but are not equally distributed throughout the spine and occur most commonly at T7-T8 and T11-T12 ("cVFs") and less commonly at T4-T6 and T9-T10 ("lcVF"). We aimed to determine whether associations between bone attenuation (BA) and VFs vary between subjects with cVFs only, with lcVFs only and with both cVFs and lcVFs.
METHODS
Chest CT images of T4-T12 in 1237 smokers with and without COPD were analysed for prevalent VFs according to the method described by Genant (11,133 vertebrae). BA (expressed in Hounsfield units) was measured in all non-fractured vertebrae (available for 10,489 vertebrae). Linear regression was used to compare mean BA, and logistic regression was used to estimate the association of BA with prevalent VFs (adjusted for age and sex).
RESULTS
On vertebral level, the proportion of cVFs was significantly higher than of lcVF (5.6% vs 2.0%). Compared to subjects without VFs, BA was 15% lower in subjects with cVFs (p < 0.0001), 25% lower in subjects with lcVFs (p < 0.0001) and lowest in subjects with cVFs and lcVFs (- 32%, p < 0.0001). The highest ORs for presence of VFs per - 1SD BA per vertebra were found in subjects with both cVFs and lcVFs (3.8 to 4.6).
CONCLUSIONS
The association between VFs and BA differed according to VF location. ORs increased from subjects with cVFs to subjects with lcVFs and were highest in subjects with cVFs and lcVFs, indicating that other factors than only BA play a role in the bimodal VF distribution.
TRIAL REGISTRATION
Clinicaltrials.gov identifier: NCT00292552.
目的
椎骨骨折（VF）在脊柱中的位置呈双峰分布。在胸部 CT 扫描上测量的 VF 和骨衰减（BA）之间的关联因 VF 的位置而异，这表明除了 BA 之外，还有其他因素在 VF 的双峰分布中起作用。
背景
VF 与低骨密度有关，但在脊柱中分布不均，最常见于 T7-T8 和 T11-T12（“cVF”），较少见于 T4-T6 和 T9-T10（“lcVF”）。我们旨在确定仅存在 cVF、仅存在 lcVF 以及同时存在 cVF 和 lcVF 的受试者之间，BA 与 VF 之间的关联是否存在差异。
方法
对 1237 名有或无 COPD 的吸烟者的 T4-T12 胸部 CT 图像进行分析，根据 Genant 方法（11,133 个椎体）确定现有 VF。在所有未骨折的椎体中测量 BA（以亨氏单位表示）（可用于 10,489 个椎体）。使用线性回归比较平均 BA，使用逻辑回归估计 BA 与现有 VF 的关联（调整年龄和性别）。
结果
在椎体水平上，cVF 的比例明显高于 lcVF（5.6% vs 2.0%）。与无 VF 的受试者相比，cVF 受试者的 BA 低 15%（p <0.0001），lcVF 受试者的 BA 低 25%（p <0.0001），同时存在 cVF 和 lcVF 的受试者的 BA 低 32%（p <0.0001）。每个椎体 BA 每降低 1SD，存在 VF 的 OR 最高见于同时存在 cVF 和 lcVF 的受试者（3.8 至 4.6）。
结论
VF 和 BA 之间的关联因 VF 位置而异。OR 从仅存在 cVF 的受试者增加到仅存在 lcVF 的受试者，在同时存在 cVF 和 lcVF 的受试者中最高，表明除了 BA 之外，还有其他因素在 VF 的双峰分布中起作用。
临床试验注册
Clinicaltrials.gov 标识符：NCT00292552。
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