Wáng Yì Xiáng J
Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Quant Imaging Med Surg. 2024 Jun 1;14(6):4202-4214. doi: 10.21037/qims-24-227. Epub 2024 May 24.
It has been frequently cited that ''. For the reports with T-score measured around the time of a hip fracture, we conducted a systematic literature search in December 2022, and resulted in 10 studies with five for Caucasian women and five for East Asian women. Femoral neck (FN) T-score was reported in five Caucasian studies and three East Asian studies, three of five Caucasian studies had a mean T-score ≤-2.5, and one study had the majority of their patients measuring a mean T-score ≤-2.5. All three East Asian studies reported a mean FN T-score ≤-2.7. Total hip T-score was reported in two Caucasian studies and three East Asian studies, the two Caucasian studies both had a mean T-score ≤-2.5, and all three East Asian studies had a mean T-score ≤-2.6. A new literature search conducted in April 2024 results in additional three studies, with results being consistent with the data described above. A trend was noted that 'younger' patients suffer from hip fractures at a 'higher' T-score. For the highly cited articles where the notion the majority of FF occur at non-osteoporotic BMD was derived from, authors reported prospective epidemiological studies where BMD was not measured at the timepoint of hip fracture, instead, BMD was measured at the study baseline. These epidemiological studies suggest that >50% of hip fractures likely occur in women with an osteoporotic FN or hip T-score. However, a pattern was seen that older men suffer from hip fracture at a notably higher T-score than older women. For the cases of radiographic vertebral FF, despite varying criteria being used to classify these FFs, the majority of female patients had spine densitometric osteoporosis. Literature shows, compared with the cases of hip fracture, distal forearm fracture occurs at a 'younger' age and 'higher' BMD, suggesting distal forearm fracture is more likely associated with a 'higher' trauma energy level.
经常有人引用“……”。对于在髋部骨折前后测量T值的报告，我们于2022年12月进行了系统的文献检索，结果得到10项研究，其中5项针对白人女性，5项针对东亚女性。5项白人研究和3项东亚研究报告了股骨颈（FN）T值，5项白人研究中有3项的平均T值≤ -2.5，1项研究中的大多数患者平均T值≤ -2.5。所有3项东亚研究报告的平均FN T值≤ -2.7。2项白人研究和3项东亚研究报告了全髋T值，2项白人研究的平均T值均≤ -2.5，所有3项东亚研究的平均T值≤ -2.6。2024年4月进行的新一轮文献检索又得到3项研究，结果与上述数据一致。值得注意的是一种趋势，即“更年轻”的患者在T值“更高”时发生髋部骨折。对于那些多数脆性骨折发生在非骨质疏松性骨密度情况下这一观点所源自的高引用文章，作者报告的前瞻性流行病学研究中，骨密度并非在髋部骨折时测量，而是在研究基线时测量。这些流行病学研究表明，超过50%的髋部骨折可能发生在股骨颈或髋部T值为骨质疏松的女性中。然而，有一种模式是老年男性发生髋部骨折时的T值明显高于老年女性。对于影像学椎体脆性骨折病例，尽管用于分类这些骨折的标准各不相同，但大多数女性患者存在脊柱骨密度骨质疏松。文献表明，与髋部骨折病例相比，桡骨远端骨折发生的年龄“更年轻”且骨密度“更高”，这表明桡骨远端骨折更可能与“更高”的创伤能量水平相关。
