Department of Radiology, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Kunshan, Suzhou, 215300, Jiangsu, China.
Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Kunshan, Suzhou, 215300, Jiangsu, China.
BMC Musculoskelet Disord. 2023 Sep 27;24(1):762. doi: 10.1186/s12891-023-06812-0.
To explore the independent association between lumbar endplate damage and bone mineral density (BMD) in patients with degenerative disc disease (DDD).
This retrospective investigation was based out of a prospectively collected database from the Affiliated Kunshan Hospital of Jiangsu University. Data from 192 DDD patients, collected between December 2018 and January 2022, were chosen for the final analysis. The average total endplate score (TEPS) of lumbar(L) 1-L4 was assessed by magnetic resonance imaging (MRI), and represents the extent of endplate damage. Osteoporosis severity was assessed via the L1-L4 BMD evidenced by dual-energy x-ray absorptiometry (DXA). Other analyzed information included gender, age, body mass index (BMI), and osteophyte score (OSTS). Uni- and multivariate linear regression analyses were employed to evaluate the association between average TEPS and BMD of L1-L4. Moreover, the generalized additive model (GAM) was employed for non-linear association analysis.
Upon gender, age, BMI, and OSTS adjustments, a strong independent inverse relationship was observed between average TEPS and BMD (β, -0.021; 95% CI, -0.035 to -0.007, P-value = 0.00449). In addition, the gender stratification analysis revealed a linear relationship in males, and a non-linear relationship in females. Specifically, there was a significantly stronger negative relationship between average TEPS and BMD in females, when the average TEPS was < 3.75 (β, -0.063; 95% CI, -0.114 to -0.013; P-value = 0.0157). However, at an average TEPS > 3.75, the relationship did not reach significance (β, 0.007; 95% CI, -0.012 to 0.027; P-value = 0.4592).
This study demonstrated the independent negative association between average TEPS and BMD values of L1-L4. Upon gender stratification, a linear relationship was observed in males, and a non-linear association in females. The findings reveal that patients with osteoporosis or endplate damage require more detailed examinations and treatment regimen.
探讨腰椎终板损伤与退变性椎间盘疾病（DDD）患者骨密度（BMD）之间的独立关联。
本回顾性研究基于江苏大学附属医院前瞻性收集的数据库。从 2018 年 12 月至 2022 年 1 月期间选择了 192 名 DDD 患者的数据进行最终分析。通过磁共振成像（MRI）评估腰椎（L）1-L4 的平均终板总评分（TEPS），以代表终板损伤的程度。通过双能 X 射线吸收法（DXA）评估 L1-L4 的 BMD 来评估骨质疏松症的严重程度。分析的其他信息包括性别、年龄、体重指数（BMI）和骨赘评分（OSTS）。采用单变量和多变量线性回归分析评估平均 TEPS 与 L1-L4 的 BMD 之间的关联。此外，还采用广义加性模型（GAM）进行非线性关联分析。
在校正性别、年龄、BMI 和 OSTS 后，平均 TEPS 与 BMD 之间存在强烈的独立负相关关系（β，-0.021；95%CI，-0.035 至 -0.007，P 值=0.00449）。此外，性别分层分析显示男性呈线性关系，女性呈非线性关系。具体来说，当平均 TEPS<3.75 时，女性平均 TEPS 与 BMD 之间的负相关关系明显更强（β，-0.063；95%CI，-0.114 至 -0.013；P 值=0.0157）。然而，当平均 TEPS>3.75 时，这种关系没有达到显著性（β，0.007；95%CI，-0.012 至 0.027；P 值=0.4592）。
本研究表明，平均 TEPS 与 L1-L4 的 BMD 值之间存在独立的负相关关系。在性别分层的情况下，男性呈线性关系，女性呈非线性关系。研究结果表明，骨质疏松症或终板损伤患者需要更详细的检查和治疗方案。
