Lin Wentao, Chen Tao, Zheng Guanghao, Yin Houjie, Xie Faqin, Huang Chunchao, Wang Xiaoqian, Mao Raobing, Wang Zhiyun
Department of Spine Surgery, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, Guangdong, China.
The Second Clinical Medical College of Southern Medical University, Guangzhou, Guangdong, China.
Spine (Phila Pa 1976). 2025 Sep 15;50(18):1296-1302. doi: 10.1097/BRS.0000000000005209. Epub 2024 Nov 14.
A longitudinal cohort study.
The study aims to assess the lumbar MRI-based vertebral bone quality (VBQ) score and dual energy x-ray absorptiometry (DXA) T score in a longitudinal cohort of postmenopausal women and to evaluate the performance of these scores in predicting VF over 5 years of follow-up.
VBQ scores can be used for osteoporosis screening and identification of vertebral fractures (VFs). However, due to limitations in prior cross-sectional studies, definitive conclusions about the causal associations between the VBQ score and incident VF have not been drawn.
Postmenopausal women with baseline DXA and lumbar MRI data were enrolled. Follow-up assessments were conducted over 5 years after the baseline examination; both anteroposterior- and lateral-view thoracolumbar spine radiographs were captured to evaluate incident VF. At baseline, correlation analyses between the VBQ score and osteoporosis or preexisting VF were performed. A Cox regression model for multivariate logistic regression was used to analyze the risk factors for incident VF. The hazard ratio (HR) was calculated.
One hundred thirty-seven postmenopausal women were included. The VBQ score was moderately correlated with lumbar bone mineral density at baseline (r=0.4, P<0.001). Patients with incident VF had significantly lower T scores (-3.4 vs. -1.87, P<0.001) and higher VBQ scores (4.62 vs. 4.03, P<0.001) at baseline than those without incident VF. After adjusting for age, weight, creatinine clearance, and alkaline phosphatase levels, the HRs for the VBQ score and T score were 1.93 and 0.71, respectively. After adjusting for the T score, an increased VBQ score was independently associated with an increased risk of incident VF, with an HR of 1.87.
The VBQ score was moderately correlated with the DXA T score and was a predictor of incident VF risk independent of bone mineral density in postmenopausal women.
纵向队列研究。
本研究旨在评估绝经后女性纵向队列中基于腰椎MRI的椎体骨质量（VBQ）评分和双能X线吸收法（DXA）T评分，并评估这些评分在预测5年随访期内椎体骨折（VF）方面的表现。
VBQ评分可用于骨质疏松症筛查和椎体骨折（VFs）的识别。然而，由于既往横断面研究存在局限性，尚未得出关于VBQ评分与新发VF之间因果关联的明确结论。
纳入具有基线DXA和腰椎MRI数据的绝经后女性。在基线检查后进行5年的随访评估；采集胸腰椎前后位和侧位X线片以评估新发VF。在基线时，对VBQ评分与骨质疏松症或既往存在的VF进行相关性分析。使用Cox回归模型进行多因素逻辑回归分析新发VF的危险因素。计算风险比（HR）。
纳入137名绝经后女性。基线时VBQ评分与腰椎骨密度呈中度相关（r = 0.4，P < 0.001）。与无新发VF的患者相比，新发VF患者在基线时的T评分显著更低（-3.4对-1.87，P < 0.001），VBQ评分更高（4.62对4.03，P < 0.001）。在调整年龄、体重、肌酐清除率和碱性磷酸酶水平后，VBQ评分和T评分的HR分别为1.93和0.71。在调整T评分后，VBQ评分升高与新发VF风险增加独立相关，HR为1.87。
VBQ评分与DXA T评分呈中度相关，并且是绝经后女性新发VF风险的预测指标，独立于骨密度。
