在健康体检人群中采用前臂骨密度测定法进行骨质疏松症的预筛查。
Prescreening for osteoporosis with forearm bone densitometry in health examination population.
作者信息
Yue Chun, Ding Na, Xu Lu-Lu, Fu Ya-Qian, Guo Yuan-Wei, Yang Yan-Yi, Zhao Xian-Mei, Sheng Zhi-Feng
机构信息
Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
出版信息
BMC Musculoskelet Disord. 2022 Apr 22;23(1):377. doi: 10.1186/s12891-022-05325-6.
BACKGROUND
Early detection and timely prophylaxis can retard the progression of osteoporosis. The purpose of this study was to determine the validity of peripheral Dual Energy X-ray Absorptiometry (DXA) test for osteoporosis screening. We examined peripheral bone mineral density (BMD) using AKDX-09 W-I DXA densitometer. Firstly, we acquired BMD data from manufacturer-supplied density-gradient phantoms and 30 volunteers to investigate its accuracy and precision, then we measured BMD for 150 volunteers using both AKDX (left forearm) and Hologic Discovery Wi (left forearm, left hip and L1 - L4 vertebrae) simultaneously. Correlation relationship of BMD results acquired from two instruments was assessed by simple linear regression analysis, the Receiver Operating Characteristic (ROC) curves and Areas Under the Curves (AUCs) were evaluated for the diagnostic value of left forearm BMD measured by AKDX in detecting osteoporosis.
RESULTS
In vitro precision errors of AKDX BMD were 0.40, 0.20, 0.19%, respectively, on low-, medium-, and high-density phantom; in vivo precision was 1.65%. Positive correlation was observed between BMD measured by AKDX and Hologic at the forearm (r = 0.670), L1-L4 (r = 0.430, femoral neck (r = 0.449), and total hip (r = 0.559). With Hologic measured T-score as the gold standard, the sensitivity of AKDX T-score < - 1 for identifying suboptimal bone health was 63.0 and 76.1%, respectively, at the distal one-third radius and at any site, and the specificity was 73.9 and 90.0%, respectively; the AUCs were 0.708 and 0.879. The sensitivity of AKDX T-score ≤ - 2.5 for identifying osteoporosis at the distal one-third radius and at any site was 76.9 and70.4%, respectively, and the specificity was 80.4 and 78.0%, respectively; the AUCs were 0.823 and 0.778.
CONCLUSIONS
Peripheral DXA appears to be a reliable tool for prescreening for osteoporosis.
背景
早期检测和及时预防可延缓骨质疏松症的进展。本研究的目的是确定外周双能X线吸收法（DXA）检测用于骨质疏松症筛查的有效性。我们使用AKDX-09 W-I DXA骨密度仪检测外周骨矿物质密度（BMD）。首先，我们从制造商提供的密度梯度体模和30名志愿者处获取BMD数据，以研究其准确性和精密度，然后我们同时使用AKDX（左前臂）和Hologic Discovery Wi（左前臂、左髋部和L1 - L4椎体）测量150名志愿者的BMD。通过简单线性回归分析评估从两种仪器获得的BMD结果的相关性，评估AKDX测量的左前臂BMD在检测骨质疏松症中的诊断价值的受试者工作特征（ROC）曲线和曲线下面积（AUC）。
结果
AKDX BMD在低、中、高密度体模上的体外精密度误差分别为0.40%、0.20%、0.19%；体内精密度为1.65%。AKDX和Hologic在前臂（r = 0.670）、L1 - L4（r = 0.430）、股骨颈（r = 0.449）和全髋部（r = 0.559）测量的BMD之间存在正相关。以Hologic测量的T值作为金标准，AKDX T值< -1识别骨健康欠佳的敏感性在桡骨远端三分之一处和任何部位分别为63.0%和76.1%，特异性分别为73.9%和90.0%；AUC分别为0.708和0.879。AKDX T值≤ -2.5在桡骨远端三分之一处和任何部位识别骨质疏松症的敏感性分别为76.9%和70.4%，特异性分别为80.4%和78.0%；AUC分别为0.823和0.778。
结论
外周DXA似乎是骨质疏松症预筛查的可靠工具。
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