MRS评估骨关节炎患者骨髓脂肪含量的变化

MR spectroscopy-determined marrow fat content in osteoarthritis

目的探讨氢质子磁共振波谱成像(MRS)评估绝经后女性髋部骨关节炎(OA)患者骨髓脂肪分数(FF)的变化。方法收集绝经后髋部骨关节炎患者(n=31)及健康对照组(n=22)行腰3椎体MRS检查及骨密度测定,计算骨髓FF。测定骨代谢标记物总I型前胶原氨基端肽(PINP)及骨吸收标志物I型胶原羧基端肽β(β-CTX)。结果 OA患者骨密度、PINP及β-CTX均高于正常对照组,差异有统计学意义。OA患者骨髓FF(58.5%±6.3%)较正常对照组(50.2%±5.2%)增高14.2%(t=2.411,P<0.001),校正骨密度值,组间骨髓FF仍存在统计学差异。OA组及健康对照组骨髓FF均与骨密度(r分别为-0.532、-0.497,P均<0.001)存在负相关性,但与PINP及β-CTX无线性相关性。结论绝经后髋部OA骨量虽然并未明显下降,但OA存在骨髓脂肪增多,提示OA存在骨脆性增高。

Objective To detect the change of vertebral marrow fat fraction （FF） using MR spectroscopy （MRS） in postmenopausal osteoarthritis （OA） women.Methods This cross-sectional study included OA patients （n=31） and healthy controls （n=22） who underwent MRS and bone density examinations.Marrow FF was calculated, and serum PINP and β-CTX levels were determined.Results Marrow FF in OA patients （58.5%±6.3%） was higher than in controls （50.2%±5.2%） （t=2.411, P〈0.001）.Even after adjustment for bone density, there was significant difference in marrow FF between OA and healthy control groups.Additionally, bone density, PINP and β-CTX of OA patients were higher than those of controls.Marrow FF in both OA patients and controls was negatively associated with bone density （r=-0.532 and-0.497, respectively;all P〈0.001） but had no correlations with PINP and β-CTX.Conclusion Postmenopausal OA women exhibit marrow fat accumulation, which indicates OA patients have risk of fragility fractures.