Epi-Centre for Healthy Ageing (ECHA), IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, PO Box 281, Barwon Health, Geelong, VIC, 3220, Australia.
Barwon Health, Geelong, Australia.
Arch Osteoporos. 2021 Nov 26;16(1):178. doi: 10.1007/s11657-021-00996-5.
Peripheral quantitative computed tomography (pQCT) assesses bone quantity and quality, complementary to current standard practice, and has potential to improve prediction of fracture risk. This study explored whether pQCT parameters were associated with prior fracture in men and found a number of parameters to be associated, particularly at the radius.
Peripheral quantitative computed tomography (pQCT) provides information about bone structure and density complementary to dual x-ray absorptiometry. This study aimed to determine which pQCT parameters are associated with prior fracture.
Participants were men (n = 508, age 33-96 years) from the Geelong Osteoporosis Study. Parameters at 4% (n = 469) and 66% (n = 436) of radial length, and 4% (n = 449) and 66% (n = 437) of tibial length were acquired (pQCT XCT 2000, Stratec Medizintechnik, Pforzheim, Germany), and mean standardised. Low trauma prior fractures in adulthood (≥ age 20 years) were radiologically confirmed when possible. Cross-sectional associations between pQCT and fracture were tested using logistic regression adjusting for confounders.
Prior low trauma fractures were identified for 106 participants. Fracture was negatively associated with parameters at the 4% radius site: bone mass (adjusted OR = 0.67; 95%CI = 0.52-0.86), total density (OR = 0.61; 95%CI = 0.47-0.78), trabecular density (OR = 0.62; 95%CI = 0.48-0.79) and cortical subdensity (OR = 0.61; 95%CI = 0.47-0.77). At the 66% radius site, fracture was associated with total density (OR = 0.69; 95%CI = 0.55-0.87) and cortical thickness (OR = 0.68; 95%CI = 0.54-0.86). Fracture was associated with the ratio of the cortical area at the 66% site to the total area at the 4% site (OR = 0.74; 95%CI = 0.58-0.94). Prior fracture was negatively associated with parameters at the 4% tibial site: total density (OR = 0.67; 95%CI = 0.52-0.86), trabecular density (OR = 0.64; 95%CI = 0.50-0.82) and cortical subdensity (OR = 0.72; 95%CI = 0.56-0.92). Fracture was negatively associated with cortical density at the 66% site (OR = 0.74; 95%CI = 0.58-0.94), and the ratio of the cortical area at the 66% site to the total area at the 4% site (OR = 0.65; 95%CI = 0.46-0.91), but were attenuated in adjusted models. No other associations were identified.
Prior fracture was associated with parameters at both the radius and tibia. This study highlights key pQCT parameters that may aid in the prediction of fracture risk.
外周定量计算机断层扫描（pQCT）评估骨量和质量，与当前标准实践相辅相成，具有提高骨折风险预测的潜力。本研究探讨了 pQCT 参数是否与男性既往骨折有关，发现了一些与骨折有关的参数，尤其是在桡骨。
外周定量计算机断层扫描（pQCT）提供了与双能 X 射线吸收法互补的骨结构和密度信息。本研究旨在确定哪些 pQCT 参数与既往骨折有关。
参与者为来自 Geelong 骨质疏松症研究的男性（n=508，年龄 33-96 岁）。在桡骨 4%（n=469）和 66%（n=436）长度处，胫骨 4%（n=449）和 66%（n=437）长度处获取参数（pQCT XCT 2000，Stratec Medizintechnik，Pforzheim，Germany），并进行平均标准化。当可能时，通过放射学确认成年后（≥20 岁）的低创伤性既往骨折。使用逻辑回归调整混杂因素后，测试 pQCT 与骨折之间的横断面关联。
确定了 106 名参与者的既往低创伤性骨折。骨折与桡骨 4%部位的参数呈负相关：骨量（调整后的 OR=0.67；95%CI=0.52-0.86）、总密度（OR=0.61；95%CI=0.47-0.78）、小梁密度（OR=0.62；95%CI=0.48-0.79）和皮质亚密度（OR=0.61；95%CI=0.47-0.77）。在桡骨 66%部位，骨折与总密度（OR=0.69；95%CI=0.55-0.87）和皮质厚度（OR=0.68；95%CI=0.54-0.86）有关。骨折与 66%部位皮质面积与 4%部位总面积的比值呈负相关（OR=0.74；95%CI=0.58-0.94）。既往骨折与桡骨 4%部位的参数呈负相关：总密度（OR=0.67；95%CI=0.52-0.86）、小梁密度（OR=0.64；95%CI=0.50-0.82）和皮质亚密度（OR=0.72；95%CI=0.56-0.92）。骨折与 66%部位皮质密度（OR=0.74；95%CI=0.58-0.94）和 66%部位皮质面积与 4%部位总面积的比值（OR=0.65；95%CI=0.46-0.91）呈负相关，但在调整后的模型中减弱。没有发现其他关联。
既往骨折与桡骨和胫骨的参数有关。本研究强调了可能有助于预测骨折风险的关键 pQCT 参数。
