Yokota Takeru, Otani Koji, Endo Yuji, Tominaga Ryoji, Kameda Takuya, Kobayashi Kenji, Watanabe Takehiro, Sekiguchi Miho, Konno Shin-Ichi, Matsumoto Yoshihiro
Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.
JB JS Open Access. 2024 Aug 23;9(3). doi: 10.2106/JBJS.OA.23.00161. eCollection 2024 Jul-Sep.
Previous studies have recognized the potential of the Vertebral Bone Quality (VBQ) score for predicting fractures. However, these studies often have lacked longitudinal perspectives and have not focused on community populations. Our study aimed to enhance the predictive capacity of the VBQ score by investigating its correlation with new vertebral fractures (NVFs) that were detected 11 years later in a community-based cohort and by developing a comprehensive prediction model.
This study was a population-based study conducted in the Minami-Aizu area in Fukushima Prefecture, Japan. One hundred and thirty participants voluntarily underwent T1-weighted magnetic resonance imaging (MRI) of the lumbar spine in 2004 and 2015. VBQ scores were ascertained from the 2004 scans. NVFs that occurred between 2004 and 2015 were detected based on a ≥20% reduction in vertebral height on the midsagittal sections of the MRI. Other predictors that were considered included age, sex, body mass index, smoking history, heart disease, cerebrovascular disease, respiratory disease, and existing vertebral fractures (EVFs). A logistic regression analysis was conducted.
The logistic regression analysis indicated that the VBQ score, age, sex, and EVFs were significant predictors of NVFs. The prediction model showed an area under the curve of 0.84, suggesting excellent discriminatory power. The calibration capacity was confirmed using the Hosmer-Lemeshow test.
The VBQ score was significantly correlated with the long-term incidence of NVFs in a community population. The prediction model exhibited satisfactory discrimination and calibration capacities, highlighting the use of the VBQ score as a potential tool for long-term prediction of NVFs.
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
以往研究已认识到椎体骨质量（VBQ）评分在预测骨折方面的潜力。然而，这些研究往往缺乏纵向视角，且未聚焦于社区人群。我们的研究旨在通过调查其与11年后在一个基于社区的队列中检测到的新发椎体骨折（NVF）的相关性，并开发一个综合预测模型，来提高VBQ评分的预测能力。
本研究是一项在日本福岛县南会津地区开展的基于人群的研究。2004年和2015年，130名参与者自愿接受了腰椎的T1加权磁共振成像（MRI）检查。VBQ评分通过2004年的扫描确定。基于MRI矢状面椎体高度降低≥20%来检测2004年至2015年期间发生的NVF。其他考虑的预测因素包括年龄、性别、体重指数、吸烟史、心脏病、脑血管疾病、呼吸系统疾病和既往椎体骨折（EVF）。进行了逻辑回归分析。
逻辑回归分析表明，VBQ评分、年龄、性别和EVF是NVF的显著预测因素。预测模型的曲线下面积为0.84，表明具有出色的区分能力。使用Hosmer-Lemeshow检验确认了校准能力。
VBQ评分与社区人群中NVF的长期发生率显著相关。该预测模型表现出令人满意的区分和校准能力，突出了将VBQ评分用作NVF长期预测的潜在工具。
预后II级。有关证据水平的完整描述，请参阅作者指南。
