绝经后糖尿病患者椎体骨质量评分与骨密度的关系

Relationship between vertebral bone quality score and bone density in postmenopausal women with diabetes

目的探讨腰椎磁共振成像(MRI)椎体骨质量(VBQ)评分评估糖尿病绝经后女性骨密度的应用价值。方法回顾性分析2019年6月至2022年12月在天津医科大学朱宪彝纪念医院诊治的糖尿病绝经后女性145例,根据骨密度结果分为正常组、骨量减少组和骨质疏松组。通过腰椎MRI T1加权像测量VBQ评分,Image J软件计算L3椎体右侧椎旁肌脂肪浸润分数。比较3组各参数的差异,受试者工作特征(ROC)曲线分析VBQ评分诊断骨质疏松的效能,分析VBQ评分和T值及各参数的相关性。结果VBQ评分骨质疏松组>骨量减少组>正常组(P均<0.05)。L3椎体右侧椎旁肌脂肪浸润分数骨质疏松组大于骨量减少组、正常组(P均<0.05)。VBQ评分诊断骨质疏松的ROC曲线下面积为0.830。VBQ评分与L3椎体右侧椎旁肌脂肪浸润分数呈显著弱正相关。VBQ评分与双能X线吸收仪(DXA)最低T值呈显著中度负相关。结论VBQ评分对糖尿病绝经后女性骨密度的评估可能有一定的价值。

Objective To explore the value of vertebral bone quality(VBQ)score of lumbar spine MRI in evaluating bone density of postmenopausal women with diabetes.Methods This was a retrospective analysis of 145 postmenopausal women with diabetes admitted to our hospital from June 2019 to December 2022.According to the results of bone density,they were divided into normal bone,osteopenia,and osteoporosis groups.The VBQ score was measured by T1-weighted MRI of the lumbar spine.The fat infiltration fraction of the right paraspinal muscle at L3 was calculated through Image J software.The differences of parameters among the three groups were compared.The receiver operating characteristic(ROC)curve was used to evaluate the efficiency of VBQ score in the diagnosis of osteoporosis.The correlation between VBQ score and T value and various parameters were analyzed.Results The VBQ score of osteoporosis group was higher than osteopenia group and normal group(all P<0.05).The fat infiltration fraction of L3 right paraspinal muscle in osteoporosis group was higher than osteopenia group and normal group(all P<0.05).The area under the ROC curve for diagnosing osteoporosis by VBQ score was 0.830.The VBQ score was significantly positively correlated with the fat infiltration fraction of the right paraspinal muscle at L3.The VBQ score was significantly and moderately negatively correlated with the lowest T value of DXA.Conclusion The VBQ score may be valuable in evaluating bone density of postmenopausal women with diabetes.