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2型糖尿病患者椎体压缩骨折的高风险分析:特定部位的骨体积密度

High-Risk Analysis of Vertebral Compression Fractures With Type 2 Diabetes Mellitus: Site-Specific Volumetric Bone Mineral Density.

作者信息

Liu Ying, Gao Lei, Li Min, Zhang Wei, Wang Yan, Zhao Jian

机构信息

Department of Medical Imaging, Hebei Medical University Third Hospital, Qiaoxi District, Shijiazhuang 050051, Hebei, China.

Department of Endocrinology, Hebei Medical University Third Hospital, Qiaoxi District, Shijiazhuang 050051, Hebei, China.

出版信息

Int J Endocrinol. 2024 Nov 27;2024:7150482. doi: 10.1155/ije/7150482. eCollection 2024.

Abstract

To explore the distribution of site-specific volumetric bone mineral density (vBMD) and analyze the mechanism of vertebral compression fractures with type 2 diabetes mellitus (T2DM) subjects using quantitative computed tomography (QCT). 304 postmenopausal women without T2DM and 274 postmenopausal women with T2DM underwent QCT scan, and all divided into three age subgroups. L1 vertebra was segmented into nine zones based on the corresponding position to the human body. Whether in the T2DM or non-T2DM of each age group, from the ventral to the dorsal side of L1 vertebra, the posterior third zones were the highest, and from the head to the foot of L1 vertebra, the middle third zones were the highest ( < 0.05). Global and most zonal vBMDs of T2DM were higher than those of non-T2DM in the age group of 50-59 years old, vBMD-mp of T2DM was higher in the age group of 60-59 years old, and vBMD-mm of T2DM was higher in the age group of 70-80 years old ( < 0.05). Zonal vBMDs in T2DM were higher than non-T2DM and the difference decreases with age especially in the upper third of L1 vertebra and the lower third of L1 vertebra. Vertebral compression fractures and the confusion between T2DM and vBMD may be all caused by the heterogeneous distribution of vBMDs. The higher risk of T2DM with vertebral compression fractures may be associated with the different loss rate of global and site-specific vBMD, independent of vBMD itself.

摘要

采用定量计算机断层扫描(QCT)技术,探讨特定部位骨体积分数(vBMD)的分布情况,并分析2型糖尿病(T2DM)患者椎体压缩骨折的机制。对304名无T2DM的绝经后女性和274名患有T2DM的绝经后女性进行QCT扫描,并将她们均分为三个年龄亚组。根据L1椎体在人体的相应位置,将其分为九个区域。在各年龄组的T2DM或非T2DM患者中,从L1椎体的腹侧到背侧,后三分之一区域的vBMD最高,从L1椎体的头端到尾端,中间三分之一区域的vBMD最高(P<0.05)。在50 - 59岁年龄组中,T2DM患者的整体和大多数区域的vBMD高于非T2DM患者;在60 - 69岁年龄组中,T2DM患者的平均椎体骨密度(vBMD-mp)较高;在70 - 80岁年龄组中,T2DM患者的平均终板骨密度(vBMD-mm)较高(P<0.05)。T2DM患者各区域的vBMD高于非T2DM患者,且这种差异随年龄增长而减小,尤其是在L1椎体上三分之一和下三分之一区域。椎体压缩骨折以及T2DM与vBMD之间的混淆可能均由vBMD的异质性分布所致。T2DM患者发生椎体压缩骨折的较高风险可能与整体和特定部位vBMD的不同丢失率有关,而与vBMD本身无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9bb/11617046/4298e0564daa/IJE2024-7150482.001.jpg

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