Osteoporosis and Sarcopenia最新文献_第2页

Unplanned emergency department visits within 90 days of hip hemiarthroplasty for osteoporotic femoral neck fractures: Reasons, risks, and mortalities 髋关节半关节置换术治疗骨质疏松性股骨颈骨折 90 天内的计划外急诊就诊：原因、风险和死亡率

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-06-01 DOI: 10.1016/j.afos.2024.05.005

Yang-Yi Wang , Yi-Chuan Chou , Yuan-Hsin Tsai , Chih-Wei Chang , Yi-Chen Chen , Ta-Wei Tai

Objectives

Bipolar hemiarthroplasty is commonly performed to treat displaced femoral neck fractures in osteoporotic patients. This study aimed to assess the occurrence and outcomes of unplanned return visits to the emergency department (ED) within 90 days following bipolar hemiarthroplasty for displaced femoral neck fractures.

Methods

The clinical data of 1322 consecutive patients who underwent bipolar hemiarthroplasty for osteoporotic femoral neck fractures at a tertiary medical center were analyzed. Data from the patients’ electronic medical records, including demographic information, comorbidities, and operative details, were collected. The risk factors and mortality rates were analyzed.

Results

Within 90 days after surgery, 19.9% of patients returned to the ED. Surgery-related reasons accounted for 20.2% of the patient's returns. Older age, a high Charlson comorbidity index score, chronic kidney disease, and a history of cancer were identified as significant risk factors for unplanned ED visits. Patients with uncemented implants had a significantly greater risk of returning to the ED due to periprosthetic fractures than did those with cemented implants (P = 0.04). Patients who returned to the ED within 90 days had an almost fivefold greater 1-year mortality rate (15.2% vs 3.1%, P < 0.001) and a greater overall mortality rate (26.2% vs 10.5%, P < 0.001).

Conclusions

This study highlights the importance of identifying risk factors for unplanned ED visits after bipolar hemiarthroplasty, which may contribute to a better prognosis. Consideration should be given to the use of cemented implants for hemiarthroplasty, as uncemented implants are associated with a greater risk of periprosthetic fractures.

目的双极半关节置换术通常用于治疗骨质疏松患者的股骨颈移位性骨折。本研究旨在评估双极半关节置换术治疗股骨颈移位性骨折后 90 天内急诊科（ED）意外复诊的发生率和结果。研究人员收集了患者的电子病历数据，包括人口统计学信息、合并症和手术细节。结果术后90天内，19.9%的患者返回急诊室。20.2%的患者返回急诊室的原因与手术有关。年龄较大、夏尔森综合症指数得分较高、慢性肾病和癌症病史被认为是非计划性急诊就诊的重要风险因素。植入非骨水泥假体的患者因假体周围骨折返回急诊室的风险明显高于植入骨水泥假体的患者（P = 0.04）。90天内重返急诊室的患者1年死亡率（15.2% vs 3.1%，P < 0.001）和总死亡率（26.2% vs 10.5%，P < 0.001）几乎高出5倍。应考虑在半关节成形术中使用骨水泥植入物，因为非骨水泥植入物与更高的假体周围骨折风险相关。

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引用次数: 0

Enhancing osteoporosis management through risk assessment tools 通过风险评估工具加强骨质疏松症管理

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-06-01 DOI: 10.1016/j.afos.2024.05.003

Ching-Lung Cheung

引用次数: 0

TOC 技术选择委员会

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-06-01 DOI: 10.1016/S2405-5255(24)00075-X

引用次数: 0

AI-based fully automatic image analysis: Optimal abdominal and thoracic segmentation volumes for estimating total muscle volume on computed tomography scans 基于人工智能的全自动图像分析：估计计算机断层扫描总肌肉体积的最佳腹部和胸部分割体积

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-06-01 DOI: 10.1016/j.afos.2024.04.001

Thomas Ying , Pablo Borrelli , Lars Edenbrandt , Olof Enqvist , Reza Kaboteh , Elin Trägårdh , Johannes Ulén , Henrik Kjölhede

Objectives

Evaluation of sarcopenia from computed tomography (CT) is often based on measuring skeletal muscle area on a single transverse slice. Automatic segmentation of muscle volume has a lower variance and may be a better proxy for the total muscle volume than single-slice areas. The aim of the study was to determine which abdominal and thoracic anatomical volumes were best at predicting the total muscle volume.

Methods

A cloud-based artificial intelligence tool (recomia.org) was used to segment all skeletal muscle of the torso of 994 patients who had performed whole-torso CT 2008–2020 for various clinical indications. Linear regression models for several anatomical volumes and single-slice areas were compared with regard to predicting the total torso muscle volume.

Results

The muscle volume from the tip of the coccyx and 25 cm cranially was the best of the abdominal volumes and was significantly better than the L3 slice muscle area (R² 0.935 vs 0.830, P < 0.0001). For thoracic volumes, the muscle volume between the top of the sternum to the lower bound of the Th12 vertebra showed the best correlation with the total volume, significantly better than the Th12 slice muscle area (R² 0.892 vs 0.775, P < 0.0001). Adjusting for body height improved the correlation slightly for all measurements but did not significantly change the ordering.

Conclusions

We identified muscle volumes that can be reliably segmented by automated image analysis which is superior to single slice areas in predicting total muscle volume.

目的通过计算机断层扫描（CT）评估肌肉疏松症通常基于测量单个横向切片上的骨骼肌面积。自动分割肌肉体积的方差较小，可能比单片面积更能代表肌肉的总体积。研究的目的是确定哪些腹部和胸部解剖容积最能预测肌肉总体积。方法使用基于云的人工智能工具（recomia.org）对 2008-2020 年期间因各种临床适应症接受全躯干 CT 检查的 994 名患者的躯干所有骨骼肌进行分割。结果从尾骨顶端到头颅 25 厘米处的肌肉体积是腹部体积中最好的，明显优于 L3 切片肌肉面积（R2 0.935 vs 0.830，P <0.0001）。在胸腔容积方面，胸骨顶部到第 12 节脊椎下缘之间的肌肉容积与总容积的相关性最好，明显优于第 12 节切片肌肉面积（R2 0.892 vs 0.775，P < 0.0001）。结论我们确定了可通过自动图像分析进行可靠分割的肌肉体积，在预测肌肉总体积方面优于单切片面积。

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引用次数: 0

Relationship between the perioperative prognostic nutritional index and postoperative gait function in elderly hip fractures 老年髋部骨折患者围手术期预后营养指数与术后步态功能之间的关系

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-06-01 DOI: 10.1016/j.afos.2024.05.006

Kumiko Yotsuya , Kaoru Yamazaki , Junichiro Sarukawa , Tatsuya Yasuda , Yukihiro Matsuyama

Objectives

We investigated the relationship between the perioperative nutritional status and postoperative walking ability in patients with hip fractures.

Methods

We included 246 surgically treated elderly patients with hip fractures who were ambulatory before the injury. Patients were divided into two groups: group A, who were able to walk at discharge, and group B, who were unable to walk at discharge. We pair-matched these two groups according to age, preoperative subdivided walking ability, and fracture site to form groups A′ and B'. The prognostic nutritional index (PNI; PNI = 10 × serum albumin (g/dL) + 0.005 × blood total lymphocyte count (/mm³)) before surgery and 1 day, 1 week, and 2 weeks after surgery and energy intake 1 and 2 weeks after surgery were compared.

Results

After adjustments for age, preoperative subdivided walking ability, and fracture site, there were 51 patients in group A' (mean age 84.6 years) and 51 patients in group B' (mean age 84.7 years). In group A'/group B′, PNI was 43.38/42.60 (P = 0.19) before surgery, 33.87/33.31 (P = 0.44) 1 day after surgery, 34.99/32.35 (P = 0.01) 1 week after surgery, and 37.33/35.69 (P = 0.15) 2 weeks after surgery. Energy intake was 1380.8/1203.1 kcal (P = 0.01) 1 week after surgery and 1382.0/1335.6 kcal (P = 0.60) 2 weeks after surgery.

Conclusions

PNI and energy intake at 1 week postoperatively were associated with early postoperative nutrition and the recovery of walking ability.

方法我们纳入了 246 名接受过手术治疗的老年髋部骨折患者，这些患者在受伤前可以行走。患者被分为两组：出院时能行走的 A 组和出院时不能行走的 B 组。我们根据年龄、术前细分行走能力和骨折部位将这两组患者配对，形成 A′组和 B'组。比较了手术前、手术后 1 天、1 周和 2 周的预后营养指数（PNI；PNI = 10 × 血清白蛋白（g/dL）+ 0.005 × 血液总淋巴细胞计数（/mm³））以及手术后 1 周和 2 周的能量摄入量。结果经调整年龄、术前步行能力和骨折部位后，A′组有 51 名患者（平均年龄 84.6 岁），B′组有 51 名患者（平均年龄 84.7 岁）。在 A'/B′ 组中，术前 PNI 为 43.38/42.60 (P = 0.19)，术后 1 天为 33.87/33.31 (P = 0.44)，术后 1 周为 34.99/32.35 (P = 0.01)，术后 2 周为 37.33/35.69 (P = 0.15)。术后一周的能量摄入量为 1380.8/1203.1 千卡（P = 0.01），术后两周的能量摄入量为 1382.0/1335.6 千卡（P = 0.60）。

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引用次数: 0

Regional variation in bone mineral density of the distal radius 桡骨远端骨矿密度的区域差异

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-06-01 DOI: 10.1016/j.afos.2024.03.001

Helen Morgan, Katy Knight, Robert Meertens

Objectives

This study investigates the regional variation in areal bone mineral density (aBMD) at the distal radius, a critical site for osteoporosis-related fractures. Understanding aBMD distribution is essential for accurate diagnosis and management of osteoporosis.

Methods

The study involved 261 participants aged over 50. Using dual-energy X-ray absorptiometry (DXA) scans, aBMD was recorded across contiguous regions of the distal radius. Factors considered include age, sex, and hand dominance, providing a comprehensive view of aBMD distribution.

Results

The findings indicated a consistent pattern in aBMD distribution along the radius, with a plateau around the one-third distance from the wrist. Notably, significant differences in aBMD were observed between age groups, especially among post-menopausal women. The study also recorded minor variations in aBMD between dominant and non-dominant forearms.

Conclusions

The study's insights into aBMD variation at the distal radius have implications for osteoporosis research and clinical diagnosis. It highlights the importance of standardized region of interest placement in DXA scans for accurate assessment.

目的：本研究调查了桡骨远端骨矿密度（aBMD）的区域性变化，桡骨远端是骨质疏松症相关骨折的关键部位。了解 aBMD 的分布对于准确诊断和管理骨质疏松症至关重要。使用双能 X 射线吸收测定法（DXA）扫描，记录桡骨远端连续区域的 aBMD。结果研究结果表明，桡骨的 aBMD 分布具有一致的模式，在距腕部三分之一处出现高原。值得注意的是，不同年龄组之间的 aBMD 存在明显差异，尤其是绝经后妇女。该研究还记录了优势前臂和非优势前臂之间在 aBMD 上的微小差异。它强调了在 DXA 扫描中标准化感兴趣区位置对准确评估的重要性。

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引用次数: 0

Implications of the diagnosis of locomotive syndrome stage 3 for long-term care 运动综合征 3 期诊断对长期护理的影响

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-06-01 DOI: 10.1016/j.afos.2024.05.001

Koichiro Ide , Yu Yamato , Tomohiko Hasegawa , Go Yoshida , Mitsuru Hanada , Tomohiro Banno , Hideyuki Arima , Shin Oe , Tomohiro Yamada , Yuh Watanabe , Kenta Kurosu , Hironobu Hoshino , Haruo Niwa , Daisuke Togawa , Yukihiro Matsuyama

Objectives

Locomotive syndrome stage 3 (LS3), which has been established recently, may imply a greater need for care than LS stage 0 (LS0), LS stage 1 (LS1), and LS stage 2 (LS2). The relationship between LS3 and long-term care in Japan is unclear. Therefore, this study aimed to examine this relationship.

Methods

A total of 531 patients (314 women and 217 men; mean age, 75 years) who were not classified as requiring long-term care and underwent musculoskeletal examinations in 2012 were grouped according to their LS stage. Group L comprised patients with LS3 and Group N comprised those with LS0, LS1, and LS2. We compared these groups according to their epidemiology results and long-term care requirements from 2013 to 2018.

Results

Fifty-nine patients (11.1%) were diagnosed with LS3. Group L comprised more patients (50.8%) who required long-term care than Group N (17.8%) (P < 0.001). Group L also comprised more patients with vertebral fractures and knee osteoarthritis than Group N (33.9% vs 19.5% [P = 0.011] and 78% vs 56.4% [P < 0.001], respectively). A Cox proportional hazards model and Kaplan–Meier analysis revealed a significant difference in the need for nursing care between Groups L and N (log-rank test, P < 0.001; hazard ratio, 2.236; 95% confidence interval, 1.451–3.447).

Conclusions

Between 2012 and 2018, 50% of patients with LS3 required nursing care. Therefore, LS3 is a high-risk condition that necessitates interventions. Approaches to vertebral fractures and osteoarthritis of the knee could be key.

目的与 LS0 期（LS0）、LS1 期（LS1）和 LS2 期（LS2）相比，最近确定的 LOCOMOTION 综合征 3 期（LS3）可能意味着需要更多的护理。在日本，LS3 与长期护理之间的关系尚不明确。方法将 2012 年接受肌肉骨骼检查且未被归类为需要长期护理的 531 名患者（女性 314 人，男性 217 人；平均年龄 75 岁）按照 LS 阶段进行分组。L 组包括 LS3 患者，N 组包括 LS0、LS1 和 LS2 患者。我们根据 2013 年至 2018 年的流行病学结果和长期护理要求对这些组别进行了比较。结果59 名患者（11.1%）被诊断为 LS3。L 组中需要长期护理的患者（50.8%）多于 N 组（17.8%）（P < 0.001）。L 组中脊椎骨折和膝关节骨关节炎患者也多于 N 组（分别为 33.9% vs 19.5% [P = 0.011] 和 78% vs 56.4% [P < 0.001]）。Cox比例危险模型和Kaplan-Meier分析显示，L组和N组在护理需求方面存在显著差异（对数秩检验，P <0.001；危险比，2.236；95%置信区间，1.451-3.447）。结论2012年至2018年间，50%的LS3患者需要护理。因此，LS3是一种需要干预的高风险疾病。治疗脊椎骨折和膝关节骨性关节炎的方法可能是关键。

{"title":"Implications of the diagnosis of locomotive syndrome stage 3 for long-term care","authors":"Koichiro Ide , Yu Yamato , Tomohiko Hasegawa , Go Yoshida , Mitsuru Hanada , Tomohiro Banno , Hideyuki Arima , Shin Oe , Tomohiro Yamada , Yuh Watanabe , Kenta Kurosu , Hironobu Hoshino , Haruo Niwa , Daisuke Togawa , Yukihiro Matsuyama","doi":"10.1016/j.afos.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.afos.2024.05.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Locomotive syndrome stage 3 (LS3), which has been established recently, may imply a greater need for care than LS stage 0 (LS0), LS stage 1 (LS1), and LS stage 2 (LS2). The relationship between LS3 and long-term care in Japan is unclear. Therefore, this study aimed to examine this relationship.</p></div><div><h3>Methods</h3><p>A total of 531 patients (314 women and 217 men; mean age, 75 years) who were not classified as requiring long-term care and underwent musculoskeletal examinations in 2012 were grouped according to their LS stage. Group L comprised patients with LS3 and Group N comprised those with LS0, LS1, and LS2. We compared these groups according to their epidemiology results and long-term care requirements from 2013 to 2018.</p></div><div><h3>Results</h3><p>Fifty-nine patients (11.1%) were diagnosed with LS3. Group L comprised more patients (50.8%) who required long-term care than Group N (17.8%) (P < 0.001). Group L also comprised more patients with vertebral fractures and knee osteoarthritis than Group N (33.9% vs 19.5% [P = 0.011] and 78% vs 56.4% [P < 0.001], respectively). A Cox proportional hazards model and Kaplan–Meier analysis revealed a significant difference in the need for nursing care between Groups L and N (log-rank test, P < 0.001; hazard ratio, 2.236; 95% confidence interval, 1.451–3.447).</p></div><div><h3>Conclusions</h3><p>Between 2012 and 2018, 50% of patients with LS3 required nursing care. Therefore, LS3 is a high-risk condition that necessitates interventions. Approaches to vertebral fractures and osteoarthritis of the knee could be key.</p></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405525524000633/pdfft?md5=ea984a478680c6259c3346acd3c75259&pid=1-s2.0-S2405525524000633-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relation of bone mineral density with fat infiltration of paraspinal muscles: The Goutallier classification 骨矿物质密度与脊柱旁肌肉脂肪浸润的关系Goutallier 分类法

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-06-01 DOI: 10.1016/j.afos.2024.04.002

Firuzan Fırat Ozer , Emel Güler

Objectives

Muscle and bone tissue are interrelated throughout their developmental processes via paracrine and endocrine pathways. Osteosarcopenia has emerged with the growing data proving the high rate of simultaneous occurrence of sarcopenia and osteoporosis. We aimed to evaluate the relationship between osteoporosis, and muscle quality by grading the fatty infiltration in paraspinal muscles according to the Goutallier classification in magnetic resonance imaging (MRI).

Methods

Data of postmenopausal patients who underwent MRI for low back pain were analyzed retrospectively. Lumbar spine and femoral neck bone mineral density (BMD) were measured by using dual energy X-ray absorptiometry (DXA). Grade of paraspinal muscle fatty infiltration for each level of lumbar vertebrae including L1-L2, L2-L3, L3-L4, was evaluated separately according to Goutallier classification system.

Results

A total of 91 postmenopausal women were included in the study. The mean age of the study population was 60.5 ± 11. Lumbar vertebrae L1-L4 total T-scores and BMD g/cm² were lower in patients with higher grades of Goutallier classification (P = 0.031 and P = 0.023, respectively). The distribution of the severity of fatty degeneration was significantly higher in the osteoporosis/osteopenia group at all 3 disc levels. No significant correlation was observed between femoral neck BMD and paraspinal muscle fat infiltration.

Conclusions

There is a strong relationship between osteoporosis of the lumbar spine and paraspinal muscle quality, which can be considered as a reflection of osteosarcopenia. The Goutailler classification can be an effective and easy method in the evaluation of muscle quality with MRI.

目的肌肉和骨骼组织通过旁分泌和内分泌途径在整个发育过程中相互关联。随着越来越多的数据证明肌肉疏松症和骨质疏松症的同时发生率很高，骨质疏松症也随之出现。我们的目的是根据磁共振成像（MRI）中的 Goutallier 分类法对脊柱旁肌肉的脂肪浸润进行分级，从而评估骨质疏松症与肌肉质量之间的关系。腰椎和股骨颈的骨矿密度（BMD）通过双能 X 射线吸收仪（DXA）进行测量。根据 Goutallier 分类系统，分别评估了腰椎各层次（包括 L1-L2、L2-L3、L3-L4）脊柱旁肌肉脂肪浸润的等级。Goutallier 分级较高的患者腰椎 L1-L4 总 T 值和 BMD g/cm2 均较低（分别为 P = 0.031 和 P = 0.023）。骨质疏松症/骨质疏松症组在所有三个椎间盘水平上的脂肪变性严重程度分布都明显较高。结论腰椎骨质疏松症与脊柱旁肌肉质量之间存在密切关系，可视为骨质疏松症的一种反映。Goutailler分类法是利用磁共振成像评估肌肉质量的一种有效而简便的方法。

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引用次数: 0

Hip fracture is associated with a reduced risk of type 2 diabetes: A retrospective cohort study 髋部骨折与 2 型糖尿病风险降低有关：一项回顾性队列研究

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2024-06-01 DOI: 10.1016/j.afos.2024.05.002

Suhas Krishnamoorthy , Casey Tze-Lam Tang , Warrington Wen-Qiang Hsu , Gloria Hoi-Yee Li , Chor-Wing Sing , Xiaowen Zhang , Kathryn Choon-Beng Tan , Bernard Man-Yung Cheung , Ian Chi-Kei Wong , Annie Wai-Chee Kung , Ching-Lung Cheung

Objectives

Type 2 diabetes mellitus (T2DM) shares a complex relationship with bone metabolism and few studies investigated the effect of impaired bone health on the risk of T2DM. This study was conducted to investigate the association between hip fractures and the risk of incident T2DM.

Methods

This is a retrospective cohort study using data from the real-world hip fracture cohort. Hong Kong Chinese patients aged ≥ 65 years without T2DM who were admitted to public hospitals due to a fall between 2008 and 2015 were included in the study. Patients who sustained falls with and without hip fractures were matched by propensity score (PS) at a 1:1 ratio. Competing risk regression was used to evaluate the association between hip fracture and incident T2DM, with death being the competing event.

Results

A total of 23,314 hip fracture cases were matched to 23,314 controls. The median follow-up time was 5.09 years. The incidence rate of T2DM was 11.947 and 14.505 per 1000 person-years for the hip fracture and control group respectively. After accounting for the competing risk of death, the hip fracture group had a significantly lower risk of developing T2DM (HR: 0.771, 95% CI: 0.719–0.827). Similar results were observed in all subgroups after stratification by age and sex.

Conclusions

Hip fracture was found to be associated with a reduced risk of T2DM. These findings provide insight into the topic of bone and glucose metabolism and prompt further research in evaluating the role of bone health in the management of T2DM.

目的2型糖尿病（T2DM）与骨代谢有着复杂的关系，很少有研究调查骨健康受损对T2DM风险的影响。本研究旨在调查髋部骨折与T2DM发病风险之间的关系。方法这是一项回顾性队列研究，使用的数据来自真实世界髋部骨折队列。研究纳入了2008年至2015年期间因跌倒而入住公立医院的年龄≥65岁、无T2DM的香港华人患者。根据倾向得分（PS），按1:1的比例对有髋部骨折和无髋部骨折的跌倒患者进行配对。研究采用竞争风险回归法评估髋部骨折与T2DM发病之间的关系，死亡为竞争事件。中位随访时间为 5.09 年。髋部骨折组和对照组的 T2DM 发病率分别为每千人年 11.947 例和 14.505 例。考虑到死亡的竞争风险，髋部骨折组患 T2DM 的风险明显较低（HR：0.771，95% CI：0.719-0.827）。按年龄和性别分层后，在所有亚组中也观察到了类似的结果。这些发现使人们对骨与糖代谢这一主题有了更深入的了解，并促使人们进一步研究评估骨健康在 T2DM 管理中的作用。

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引用次数: 0

Discordance between dual-energy X-ray absorptiometry bone mineral density and spinal computed tomography texture analysis: An investigation into low correlation rates 双能 X 射线吸收测量法骨矿物质密度与脊柱计算机断层扫描纹理分析之间的不一致：低相关率调查

IF 2

Osteoporosis and Sarcopenia

Pub Date : 2024-03-01 DOI: 10.1016/j.afos.2024.01.002

Min Woo Kim, Young Min Noh, Jung Wook Huh, Han Eol Seo, Dong Ha Lee

Objectives

This research delves into the application of texture analysis in spine computed tomography (CT) scans and its correlation with bone mineral density (BMD), as determined by dual-energy X-ray absorptiometry (DXA). It specifically addresses the discordance between the 2 measurements, suggesting that certain spinal-specific factors may contribute to this discrepancy.

Methods

The study involved 405 cases from a single institution collected between May 6, 2012 and June 30, 2021. Each case underwent a spinal CT scan and a DXA scan. BMD values at the lumbar region (T12 to S1) and total hip were recorded. Texture features from axial cuts of T12 to S1 vertebrae were extracted using gray-level co-occurrence matrices, and a regression model was constructed to predict the BMD values.

Results

The correlation between CT texture analysis results and BMD from DXA was moderate, with a correlation coefficient ranging between 0.4 and 0.5. This discordance was examined in light of factors unique to the spine region, such as abdominal obesity, aortic calcification, and lumbar degenerative changes, which could potentially affect BMD measurements.

Conclusions

Emerging from this study is a novel insight into the discordance between spinal CT texture analysis and DXA-derived BMD measurements, highlighting the unique influence of spinal attributes. This revelation calls into question the exclusive reliance on DXA scans for BMD assessment, particularly in scenarios where DXA scanning may not be feasible or accurate.

目的本研究探讨了纹理分析在脊柱计算机断层扫描（CT）中的应用及其与双能 X 射线吸收测量法（DXA）测定的骨矿物质密度（BMD）之间的相关性。该研究特别探讨了这两种测量结果之间的不一致，并指出某些脊柱特异性因素可能会导致这种差异。方法该研究涉及一家机构的 405 个病例，收集时间为 2012 年 5 月 6 日至 2021 年 6 月 30 日。每个病例都接受了脊柱 CT 扫描和 DXA 扫描。记录了腰部（T12 至 S1）和全髋部的 BMD 值。使用灰度级共现矩阵从 T12 至 S1 椎体的轴向切面提取纹理特征，并构建回归模型来预测 BMD 值。结果 CT 纹理分析结果与 DXA BMD 之间的相关性适中，相关系数在 0.4 和 0.5 之间。本研究对脊柱 CT 纹理分析与 DXA 导出的 BMD 测量值之间的不一致性进行了研究，并根据脊柱区域的独特因素（如腹部肥胖、主动脉钙化和腰椎退行性病变）对这种不一致性进行了分析，这些因素可能会影响 BMD 测量值。这一发现使人们对完全依赖 DXA 扫描进行 BMD 评估提出了质疑，尤其是在 DXA 扫描可能不可行或不准确的情况下。

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引用次数: 0