骨小梁分数在成都地区人群中变化及临床应用精确度评估

Changes of trabecular bone score in the population of Chengdu and assessment of the precision in clinical application

目的观察骨小梁分数(trabecular bone score,TBS)在成都地区人群中的分布及变化;评估TBS用于骨质疏松症治疗监测的精确度。方法选择2022年10月至2023年7月在四川省医学科学院·四川省人民医院就诊或体检者4963例,其中女性3708人,男性1255人,均行双能X线(DXA)检查测量腰椎TBS及骨密度(bone mineral density,BMD),结果以均值±标准差(SD)表示。选取30例患者每人行两次DXA检查,计算BMD、TBS的精确度误差。结果(1)TBS在男性20~29岁、女性30~39岁时达到峰值,之后均随增龄逐渐下降;(2)男、女TBS与年龄呈负相关,与体质量指数(body mass index,BMI)呈弱正相关;TBS与L1~4BMD呈正相关;(3)低骨量组男、女TBS受损者占比分别为19.6%、35.1%;BMD正常TBS受损+部分受损者占比分别为22.9%、40.5%。L_(1~4)BMD的CV%和LSC-CV%分别为1.089%、3.015%;TBS的CV%和LSC%分别为1.429%、3.958%。结论(1)本组TBS数据为成都地区人群骨质疏松防治、骨折风险评估提供了参考依据,随增龄BMD、TBS逐渐丢失,以女性更为明显;(2)TBS有较好的精确度,可用于骨质疏松症的治疗监测。

Objective To observe the distribution and changes of trabecular bone score(TBS)in the population of Chengdu region.To evaluate the precision of TBS for monitoring osteoporosis treatment.Methods A total of 4963 patients,including 3708 females and 1255 males were selected from October 2022 to July 2023.Dual energy X-ray Absorptiometry(DXA)examination were performed to measure lumbar BMD and TBS.The result were expressed as mean±standard deviation(SD).30 patients were selected to undergo two DXA examinations each.The precision errors of BMD and TBS were calculated.Results①The TBS reaches its peak in males aged 20-29 and females aged 30-39,and Gradually decreases with age thereafter.②TBS were negatively correlated with age and weakly positively correlated with BMI both in male and female.TBS was positively correlated with L 1-4 BMD.③The proportion of degraded TBS in male and female in low bone mass group were 19.6%and 35.1%,respectively;The proportion of degraded or partially degraded TBS in men and women with normal BMD were 22.9%and 40.5%,respectively.The CV%and LSC-CV%of L_(1-4)BMD were 1.089%and 3.015%,respectively;and in TBS were 1.429%and 3.958%,respectively.Conclusion①This group of TBS data provided a reference basis for treatment of osteoporosis and the risk assessment of fractures for the population in Chengdu region.BMD and TBS gradually losed with age,especially in women.②TBS has good precision and can be used for monitoring the treatment of osteoporosis.