Korkmaz Nurdan, Yardımcı Gökhan, Özgen Ayşe Naz Kalem, Köroğlu Özlem, Yılmaz Bilge
Department of Physical Medicine and Rehabilitation, Gülhane School of Medicine, Gaziler Physical Medicine and Rehabilitation Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Department of Physical Medicine and Rehabilitation, Gaziler Physical Medicine and Rehabilitation Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
J Bone Miner Metab. 2025 Sep 17. doi: 10.1007/s00774-025-01643-6.
Bone loss is most common around the knee region in spinal cord injury (SCI) population. However, bone mineral density (BMD) measurement and T score in the knee region, which indicate osteoporosis, are not clear. This study aimed to examine BMD, T and Z scores at hip and knee including femoral neck (FN), total hip (TH), proximal tibia (PT), and distal femur (DF) in individuals with SCI, to investigate the relationship between BMD of the knee and hip, and to define DF and PT T scores thresholds that predict osteoporosis at the hip.
This cross-sectional study used dual-energy x-ray absorptiometry to assess BMD in 94 SCI individuals. The medial and lateral parts of the PT and DF were defined as PT-1 and PT-2, DF-1 and DF-2, respectively. T and Z scores of PT and DF were calculated with a tool recommended by ISCD.
All knee BMD values showed positive correlations with the hip BMD. Applying a PT-1 T-score threshold of - 1.55, the overall specificity was 83.9% and the sensitivity was 84.2% in detecting osteoporosis at FN or TH.
Low hip BMD values are associated with low knee BMD values in SCI individuals. A T score of -1.55 in PT-1 probably indicates osteoporosis of the hip. However, there is a prompt need for standardization of the T-cut off value in the knee region, where the risk of fracture risk is high. Body mass index, time since injury, wheelchair use, and injury severity were associated with bone loss in the PT-1.
在脊髓损伤（SCI）人群中，膝关节周围的骨质流失最为常见。然而，用于指示骨质疏松症的膝关节区域骨密度（BMD）测量值和T值尚不清楚。本研究旨在检测脊髓损伤个体髋部和膝部包括股骨颈（FN）、全髋（TH）、胫骨近端（PT）和股骨远端（DF）的骨密度、T值和Z值，研究膝关节与髋部骨密度之间的关系，并确定预测髋部骨质疏松症的DF和PT T值阈值。
本横断面研究采用双能X线吸收法评估94例脊髓损伤个体的骨密度。PT和DF的内侧和外侧部分分别定义为PT-1和PT-2、DF-1和DF-2。PT和DF的T值和Z值使用国际临床骨密度学会（ISCD）推荐的工具进行计算。
所有膝关节骨密度值均与髋部骨密度呈正相关。采用PT-1 T值阈值为-1.55时，检测FN或TH处骨质疏松症的总体特异性为83.9%，敏感性为84.2%。
脊髓损伤个体中，髋部低骨密度值与膝关节低骨密度值相关。PT-1处T值为-1.55可能表明髋部骨质疏松。然而，膝关节区域骨折风险高，迫切需要对T值截断值进行标准化。体重指数、受伤时间、轮椅使用情况和损伤严重程度与PT-1处的骨质流失有关。
