Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.
Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215006, China.
Diabetes Res Clin Pract. 2024 Nov;217:111904. doi: 10.1016/j.diabres.2024.111904. Epub 2024 Oct 22.
Patients with type 2diabetesmellitus (T2DM) have high fracture risk. This study explored the associations between pancreatic computed tomography (CT) attenuation, a marker of pancreatic fat, and risk of vertebral fracture in T2DM patients.
A total of 1486 T2DM patients who aged 50 years and older and without preexisting vertebral fractures during 2019-2023 at our institutions were followed up untilJanuary 2024. CT attenuation of the pancreas, bone and spleen were measured. Pancreatic attenuation/spleen attenuation ratio (P/S) was calculated. Vertebral fractures were evaluated on spine CT images according to Genant's semiquantitative scoring system.
A total of 135 cases of vertebral fracture were identified during 26 months of follow-up and 270 patients without vertebral fracture were matched. Pancreatic CT attenuation and the P/S ratio were negatively associated with the risk of vertebral fracture (adjusted hazard ratio (aHR) = 0.97, 95 %confidence interval (CI): 0.96-0.99; aHR = 0.26, 95 %CI: 0.12-0.58). Addition of pancreatic attenuation or P/S ratio improved the performance of bone attenuation-based model (area under the curve = 0.72-0.763 vs 0.63-0.728).
Pancreatic fat infiltration is an associated factor for vertebral fracture in T2DM patients. Addition of pancreatic fat infiltration improved the predictive performance of the bone-based model.
2 型糖尿病（T2DM）患者骨折风险较高。本研究旨在探讨胰腺计算机断层扫描（CT）衰减值（胰腺脂肪的标志物）与 T2DM 患者椎体骨折风险之间的关系。
本研究纳入了 2019 年至 2023 年期间在我院年龄≥50 岁且无既往椎体骨折的 1486 例 T2DM 患者，随访至 2024 年 1 月。测量胰腺、骨和脾的 CT 衰减值。计算胰腺衰减值/脾衰减值比值（P/S）。根据 Genant 的半定量评分系统，在脊柱 CT 图像上评估椎体骨折情况。
在 26 个月的随访期间共发现 135 例椎体骨折病例，匹配了 270 例无椎体骨折的患者。胰腺 CT 衰减值和 P/S 比值与椎体骨折风险呈负相关（校正风险比（aHR）=0.97，95%置信区间（CI）：0.96-0.99；aHR=0.26，95%CI：0.12-0.58）。添加胰腺衰减值或 P/S 比值可改善基于骨衰减值的模型性能（曲线下面积=0.72-0.763 与 0.63-0.728）。
胰腺脂肪浸润是 T2DM 患者椎体骨折的相关因素。添加胰腺脂肪浸润可提高基于骨的模型的预测性能。
