Wáng Yi Xiang Jshiang, Diacinti Davide, Iannacone Antonio, Kripa Endi, Leung Jason Chi Shun, Kwok Timothy Chi Yui, Diacinti Daniele
Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
Aging Clin Exp Res. 2023 Nov;35(11):2583-2591. doi: 10.1007/s40520-023-02537-1. Epub 2023 Aug 30.
Compared with Caucasians, East Asians have a lower incident of back pain, lower prevalence and severity of osteoporotic vertebral fracture and lumbar spine degeneration.
This study compares radiographic spine degeneration features of older Chinese women (as an example of East Asians) and older Italian women (as an example of Caucasians) with a focus on the thoracic spine.
From two population-based epidemiological studies conducted in Hong Kong, China and Rome, Italy, 297 pairs (mean age: 73.6 years) age-matched older community women's lateral spine radiographs were sampled. Existence (or absence) of seven degeneration features were assessed including: (1) hyper-kyphosis, (2) disc space narrowing (T3/T4 ~ T11/T12), (3) osteoarthritic (OA) wedging (T4 ~ T12), (4) generalised osteophyte formation (T4 ~ T12); (5) acquired short vertebrae (T4 ~ T12), (6) Schmorl node (T4 - L5), (7) disc calcification (T4-L5).
Italian women were more likely to have hyper-kyphosis (53.4% vs 25.6%), disc space narrowing (34.4% vs. 17.2%), OA wedging (6.4% vs. 0.67%), Schmorl node (19.5% vs. 4.4%, all P < 0.001). However, there was no statistically significant difference in osteophyte formation (7.7% vs. 9.4%, P > 0.1) and acquired short vertebrae (8.0% vs. 10.4%, P > 0.1). Disc calcification was uncommon among both Chinese and Italians.
For the first time, this study documented a lower prevalence of a number of thoracic spine degeneration features among Chinese. This study further affirms the concept of a generally healthier spine in older Chinese relative to older Caucasians. The observed differences may reflect a foundational background influence of genetic predisposition that represents an important line of future research.
与高加索人相比，东亚人的背痛发生率较低，骨质疏松性椎体骨折以及腰椎退变的患病率和严重程度也较低。
本研究比较了老年中国女性（作为东亚人的例子）和老年意大利女性（作为高加索人的例子）的脊柱影像学退变特征，重点关注胸椎。
从在中国香港和意大利罗马进行的两项基于人群的流行病学研究中，抽取了297对年龄匹配的老年社区女性（平均年龄：73.6岁）的脊柱侧位X线片。评估了七种退变特征的存在（或不存在）情况，包括：（1）脊柱后凸加重，（2）椎间盘间隙变窄（T3/T4至T11/T12），（3）骨关节炎性楔形变（T4至T12），（4）广泛性骨赘形成（T4至T12）；（5）获得性短节段椎体（T4至T12），（6）许莫氏结节（T4 - L5），（7）椎间盘钙化（T4 - L5）。
意大利女性更易出现脊柱后凸加重（53.4%对25.6%）、椎间盘间隙变窄（34.4%对17.2%）、骨关节炎性楔形变（6.4%对0.67%）、许莫氏结节（19.5%对4.4%，所有P<0.001）。然而，骨赘形成（7.7%对9.4%，P>0.1）和获得性短节段椎体（8.0%对10.4%，P>0.1）在统计学上无显著差异。椎间盘钙化在中国人和意大利人中均不常见。
本研究首次记录了中国人中多种胸椎退变特征的患病率较低。本研究进一步证实了相对于老年高加索人，老年中国人脊柱总体更健康的概念。观察到的差异可能反映了遗传易感性的基础背景影响，这代表了未来研究的一个重要方向。
