桡骨超远端的骨密度：我们是否忽略了有价值的信息？
Bone mineral density of the ultra-distal radius: are we ignoring valuable information?
作者信息
Schwarz Yair, Goldshtein Inbal, Friedman Yehudit Eden, Peltz-Sinvani Naama, Brodavka Michal, Kowal David, Vered Iris, Tripto-Shkolnik Liana
机构信息
Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
Arch Osteoporos. 2023 Feb 2;18(1):28. doi: 10.1007/s11657-023-01218-w.
UNLABELLED
The current study explored the possible utilization in dual-X-ray-absorptiometry scanning (DXA) of the ultra-distal radius (UDR). This region of interest is currently unused and mostly unstudied in this context. The study findings suggest UDR as potential useful region of interest in DXA scanning and warrant further study of the site.
PURPOSE
Bone mineral density (BMD) measurement of a non-dominant arm is not routinely performed during dual-X-ray-absorptiometry (DXA) test, and the possible utility of ultra-distal (UDR) radius BMD is not well-studied. We evaluated in women, correlations of UDR BMD with fracture prevalence, fracture risk prediction by the fracture risk assessment tool (FRAX), and osteoporosis diagnosed by traditional sites.
METHODS
Women who underwent a routine DXA (including their non-dominant forearm and including UDR BMD) in a tertiary medical center were included. Risk factors relevant to FRAX calculation were assessed via a self-administered questionnaire. Spearman correlations of UDR BMD to 10-year risks of major osteoporotic and hip fractures (assessed by FRAX) were explored. The possible added value of UDR BMD in explaining prevalent osteoporotic fractures was assessed using a multivariable regression model incorporating age and traditional osteoporosis diagnosis.
RESULTS
The study included 1245 women with a median age of 66 years (interquartile range: 59-73), of whom 298 (24%) had UDR T-score ≤ - 2.5 and 154 (12%) reported prior fractures. UDR BMD was significantly negatively correlated with FRAX risk score for hip and major osteoporotic fractures (R = - 0.5 and R = - 0.41, respectively; P < 0.001). UDR T-score ≤ - 2.5 was associated with higher fracture prevalence (19% vs 10%; P < 0.001) and remained significant after adjusting for traditional BMD and age (OR 1.49, 1.01-2.19; P = 0.043).
CONCLUSION
UDR BMD correlates both with prior fractures and with predicted fracture risks and might pose added value over traditional DXA sites.
未标注
本研究探讨了双能X线吸收法扫描（DXA）中尺骨超远端（UDR）的可能用途。目前，该感兴趣区域未被使用，且在此背景下大多未被研究。研究结果表明，UDR是DXA扫描中潜在有用的感兴趣区域，值得对该部位进行进一步研究。
目的
在双能X线吸收法（DXA）检测过程中，通常不会对非优势手臂进行骨密度（BMD）测量，尺骨超远端（UDR）骨密度的可能用途也未得到充分研究。我们评估了女性中UDR骨密度与骨折患病率、骨折风险评估工具（FRAX）预测的骨折风险以及传统部位诊断的骨质疏松症之间的相关性。
方法
纳入在三级医疗中心接受常规DXA检查（包括非优势前臂并测量UDR骨密度）的女性。通过自行填写的问卷评估与FRAX计算相关的风险因素。探讨UDR骨密度与主要骨质疏松性骨折和髋部骨折10年风险（通过FRAX评估）的Spearman相关性。使用包含年龄和传统骨质疏松症诊断的多变量回归模型评估UDR骨密度在解释现患骨质疏松性骨折方面的可能附加价值。
结果
该研究纳入了1245名女性，中位年龄为66岁（四分位间距：59 - 73岁），其中298名（24%）UDR T值≤ - 2.5，154名（12%）报告有既往骨折史。UDR骨密度与髋部和主要骨质疏松性骨折的FRAX风险评分显著负相关（R分别为 - 0.5和 - 0.41；P < 0.001）。UDR T值≤ - 2.5与更高的骨折患病率相关（19%对10%；P < 0.001），在调整传统骨密度和年龄后仍具有显著性（比值比1.49，1.01 - 2.19；P = 0.043）。
结论
UDR骨密度与既往骨折及预测的骨折风险均相关，可能比传统DXA部位具有附加价值。
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