Zheng Xin, Qi Yanyan, Zhou Hongjun, Kang Haiqiong, Tong Yanming, Bi Lina
Department of Endocrinology, China Rehabilitation Research Center, Beijing, People's Republic of China.
School of Rehabilitation Medicine, Capital Medical University, Beijing, People's Republic of China.
Int J Gen Med. 2021 Mar 26;14:1121-1129. doi: 10.2147/IJGM.S297660. eCollection 2021.
Spinal cord injury (SCI) can lead to disuse osteoporosis. The most vulnerable sites for fragility-induced fractures are the distal femur (DF) and proximal tibia (PT). The aim of this study was to evaluate changes in bone mineral density (BMD) at the DF and PT, as well as related factors, during the first year of SCI.
Thirty-six SCI patients within 12 months of their injury were selected, as were 36 healthy controls. The dual-energy X-ray absorptiometry was used to measure BMDs at the DF, PT, and hip of all subjects. According to the duration of SCI when receiving DXA scan, 36 SCI patients were divided into three subgroups. The BMDs of overall patients and subgroups were compared to those of controls. Biochemical markers of bone metabolism were detected in SCI patients.
The BMDs at the DF, PT, and hips of overall SCI patients were significantly lower than those of controls. The percentage difference of BMD between SCI patients and controls at the DF and PT was higher than at the hip. The BMD at the PT of SCI within 6 weeks post-injury was lower than that of controls. The BMDs at the DF and PT of SCI during 6 weeks-3 months post-injury were lower than those of controls. Whereas there was no difference in the BMD at the hip during the first 3 months of SCI. Age and 25OHD were the influencing factors of DF BMD. Age and gender were found to influence PT BMD.
The rapid loss of BMD at the PT and DF during the first year of SCI occurred significantly earlier than that of the hip. It is recommended to monitor the BMD of DF and PT in early-stage SCI patients, combined with detection of biochemical markers of bone metabolism.
脊髓损伤（SCI）可导致废用性骨质疏松。因脆性增加而导致骨折的最易受损部位是股骨远端（DF）和胫骨近端（PT）。本研究的目的是评估SCI后第一年股骨远端和胫骨近端的骨密度（BMD）变化以及相关因素。
选取36例受伤后12个月内的SCI患者以及36例健康对照者。采用双能X线吸收法测量所有受试者股骨远端、胫骨近端和髋部的骨密度。根据接受双能X线吸收扫描时SCI的病程，将36例SCI患者分为三个亚组。将所有患者及其亚组的骨密度与对照组进行比较。检测SCI患者的骨代谢生化指标。
总体SCI患者股骨远端、胫骨近端和髋部的骨密度显著低于对照组。SCI患者与对照组在股骨远端和胫骨近端的骨密度百分比差异高于髋部。受伤后6周内SCI患者胫骨近端的骨密度低于对照组。受伤后6周 - 3个月内SCI患者股骨远端和胫骨近端的骨密度低于对照组。而在SCI的前3个月内髋部骨密度无差异。年龄和25羟维生素D是股骨远端骨密度的影响因素。发现年龄和性别影响胫骨近端骨密度。
SCI后第一年胫骨近端和股骨远端骨密度的快速下降明显早于髋部。建议对早期SCI患者监测股骨远端和胫骨近端的骨密度，并结合检测骨代谢生化指标。
