定量CT测量分析髋部骨折人群腰椎与股骨近段骨密度的相关性

The correlation study between lumbar vertebra BMD and proximal femur BMD derived from QCT in people with hip fracture

目的在髋部脆性骨折人群中采用定量CT分析腰椎与股骨近段骨密度的相关性。方法纳入行髋部和低剂量肺CT的髋部脆性骨折患者201例,使用QCT Pro测量,获得全髋、股骨颈、大转子、转子间整体与松质骨的体积骨密度和面积骨密度(aBMD)以及腰椎(L_(1、2))松质骨体积骨密度(vBMD)。分析腰椎与髋部各感兴趣区骨密度相关性。结果男女性腰椎松质骨vBMD与髋部各感兴趣区BMD均线性相关(P<0.05)。女性腰椎松质骨vBMD与全髋松质骨vBMD标准化回归系数最高(β=0.465,P<0.05)。男性腰椎松质骨vBMD与转子间松质骨vBMD标准化回归系数最高(β=0.532,P<0.05)。结论在髋部脆性骨折人群中,相对于髋部整体骨密度,腰椎松质骨vBMD与髋部松质骨骨密度的相关性更高;女性腰椎松质骨vBMD与全髋松质骨体积骨密度相关性最高;男性腰椎松质骨vBMD与转子间松质骨vBMD相关性最高。

Objective The aim of this study was to analyze the correlation between the lumbar vertebra and the proximal femur bone mineral density(BMD)derived from quantitative computed tomography(QCT)in people with a fragility fracture of the hip.Methods We recruited 201 patients with hip fragility fractures who underwent both hip and low-dose lung CT examinations.The areal and volumetric BMD of the integrity and trabecula of the total hip(TH),femoral neck(FN),intertrochanter(IT),trochanter(TR),and lumbar vertebra(L1 and L2)trabecular volumetric BMD(LVT vBMD)were measured by QCT Pro soft.The correlation between the lumbar vertebra and all regions of interest(ROIs)of the hip was evaluated.Results The LVT vBMD was linearly correlated with the BMD of each hip region of interest(ROI)in both male and female populations(P<0.05).The standardized correlation coefficient(β=0.465,P<0.05)between LVT vBMD and total hip trabecular vBMD(THT vBMD)was the highest in the female population.The standardized correlation coefficient(β=0.532,P<0.05)of LVT vBMD with intertrochanter trabecular vBMD(ITT vBMD)was highest in the male population.Conclusion In the hip fragility fracture population,lumbar trabecular bone vBMD has a higher correlation with hip trabecular BMD than hip integral BMD.The correlation between LVT vBMD and THT vBMD was the highest in the female population.The correlation of LVT vBMD with ITT vBMD was highest in the male population.