双能X线吸收法与跟骨定量超声在乌干达感染艾滋病毒儿童骨密度测定中的比较：一项横断面研究。

Comparison between dual energy X-ray absorptiometry and calcaneal quantitative ultrasound for determining bone mineral density in children living with HIV in uganda: A cross- sectional study.

作者信息

Natukunda Eva, Szubert Alexander J, Bamford Alasdair, Doerholt Katja, Gibb Diana M, Wandera Centurio, Nakalyango Aidah, Griffiths Anna, Monkiewicz Lara, Nangiya Joan J, Nambi Esther, Musiime Victor, Musoke Phillipa

机构信息

Joint Clinical Research Centre, Kampala, Uganda.

Medical Research Council Clinical Trials Unit, University College London, London, England.

出版信息

BMC Pediatr. 2025 Jul 4;25(1):529. doi: 10.1186/s12887-025-05881-5.

DOI:10.1186/s12887-025-05881-5

PMID:40615992

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12231623/

Abstract

BACKGROUND

The aim of this study was to compare quantitative ultrasound (QUS) and dual energy X-ray absorptiometry (DXA) for determining bone mineral density (BMD) among children living with HIV (CLWH) who were switching to second-line antiretroviral therapy (ART).

METHODS

We conducted a cross-sectional study among CLWH as a sub-study of the CHAPAS-4 trial. Total body less head (TBLH) BMD and lumbar spine (LS) BMD were determined by DXA while the sound of speed (SOS), broad band ultrasound attenuation (BUA) and bone quality index (BQI) were determined by QUS. We evaluated the correlation between the DXA and QUS measurements using spearman correlation coefficient.

RESULTS

A total of 167 children were enrolled; the median age was 9.4 (interquartile range = 6.0-12.0) years. Eighty-five (50.9%) were male. The median weight- for- age Z- score (IQR) was - 1.29(-2.16, -0.49) and height for age Z-score was - 1.03(-1.56, 0.01). SOS was weakly correlated with TBLH BMD R = 0.35, P < 0.001), lumbar spine bone apparent density (LSBMAD) (R = 0.19, P = 0.01) and LS bone mineral content (BMC) (R = 0.31, P < 0.001). BUA was moderately correlated with TBLH BMD (R = 0.50, P < 0.001), BMC (R = 0.47, P = 0.001), and LS BMC (R = 0.43, P < 0.001) but weakly correlated with LSBMAD (R = 0.28, P < 0.001). BQI was moderately correlated with TBLH BMC (R = 0.46, P < 0.001), TBLH BMD (R = 0.46, P < 0.001) and LSBMC (R = 0.41, P < 0.001). There was weak correlation between LSBMAD and BUA (R = 0.28, P < 0.001) BQI (R = 0.29, P < 0.001). QUS Z-score was weakly correlated with TBLH BMD and (R = 0.30, P < 0.01) and no correlation with LSBMAD (R = 0.07, P = 0.35).

CONCLUSION

In CLWH, there was moderate correlation observed for TBLH measurements when comparing DXA to QUS, and weak correlation was found between LSBMAD and QUS measurements. There was a moderate correlation detected between the LSBMC and QUS.QUS may not be an appropriate substitute for DXA scan.

摘要

背景

本研究的目的是比较定量超声（QUS）和双能X线吸收法（DXA）在接受二线抗逆转录病毒治疗（ART）的感染艾滋病毒儿童（CLWH）中测定骨矿物质密度（BMD）的情况。

方法

作为CHAPAS - 4试验的一项子研究，我们对CLWH进行了一项横断面研究。通过DXA测定全身除头部（TBLH）的骨密度和腰椎（LS）的骨密度，而通过QUS测定声速（SOS）、宽带超声衰减（BUA）和骨质量指数（BQI）。我们使用斯皮尔曼相关系数评估DXA和QUS测量值之间的相关性。

结果

共纳入167名儿童；中位年龄为9.4（四分位间距 = 6.0 - 12.0）岁。85名（50.9%）为男性。年龄别体重Z评分中位数（IQR）为 - 1.29（-2.16， - 0.49），年龄别身高Z评分为 - 1.03（-1.56，0.01）。SOS与TBLH骨密度（R = 0.35，P < 0.001）、腰椎骨表观密度（LSBMAD）（R = 0.19，P = 0.01）和LS骨矿物质含量（BMC）（R = 0.31，P < 0.001）呈弱相关。BUA与TBLH骨密度（R = 0.50，P < 0.001）、BMC（R = 0.47，P = 0.001）和LS BMC（R = 0.43，P < 0.001）呈中度相关，但与LSBMAD呈弱相关（R = 0.28，P < 0.001）。BQI与TBLH BMC（R = 0.46，P < 0.001）、TBLH骨密度（R = 0.46，P < 0.001）和LSBMC（R = 0.41，P < 0.001）呈中度相关。LSBMAD与BUA（R = 0.28，P < 0.001）、BQI（R = 0.29，P < 0.001）之间呈弱相关。QUS Z评分与TBLH骨密度呈弱相关（R = 0.30，P < 0.01），与LSBMAD无相关性（R = 0.07，P = 0.35）。