绝经后骨质疏松症患者骨密度及骨小梁评分与脆性骨折的关系

Relationship between bone mineral density,trabecular bone score and osteoporotic fracture in patients with postmenopausal osteoporosis

目的分析绝经后骨质疏松症患者骨密度及骨小梁评分与脆性骨折的关系。方法分析2022年8月至2023年12月四川省人民医院内分泌科门诊及住院绝经后骨质疏松症患者117例,根据病史及影像学检查分为脆性骨折组78例及非骨折组39例,比较两组人口学资料、实验室指标及影像学指标,分析绝经后骨质疏松症脆性骨折相关危险因素。结果两组患者在体重指数、患病史、骨密度及实验室指标方面差异无统计学意义(P>0.05),两组年龄、骨小梁评分比较,差异有统计学意义(P<0.05),骨折组与非骨折组骨小梁评分与L1~L4骨密度均呈显著相关(r=0.433;r=0.537,P<0.001)。回归分析显示骨小梁评分为绝经后骨质疏松症脆性骨折独立危险因素。结论绝经后骨质疏松症患者骨小梁评分与腰椎骨密度显著正相关,骨小梁评分是绝经后骨质疏松症患者脆性骨折的独立危险因素。

Objective To analyze the relationship between bone mineral density,trabecular bone score and osteoporotic fracture in patients with postmenopausal osteoporosis.Methods One hundred and seventeen patients with postmenopausal osteoporosis at the Department of Endocrinology of Sichuan Provincial People’s Hospital from August 2022 to December 2023 were selected.According to medical history and imaging examination,the patients were divided into a fracture group(n=78)and a non-fracture group(n=39).The demographic data,laboratory and imaging indexes were compared between the two groups.Relative risk factors of osteoporotic fractures in patients with postmenopausal osteoporosis were analyzed.Results There was no significant difference in body mass index,disease history,bone mineral density and laboratory indexes between the two groups.There was a significant difference in trabecular bone score and age between the two groups(P<0.05).There was a significant correlation between trabecular bone score and L1-L4 bone density in both fracture group and non-fracture group(r=0.433 and r=0.537,P=0.000).Logistics analysis showed that trabecular bone score was an independent risk factor for osteoporotic fractures in patients with postmenopausal osteoporosis.Conclusions The trabecular bone score in patients with postmenopausal osteoporosis is significantly positively correlated with lumbar spine bone density.The trabecular bone score is an independent risk factor for fragility fractures in patients with postmenopausal osteoporosis.