Journal of Clinical Densitometry最新文献_第7页

Correlation of Lean Mass Measurements Between a Novel Whole-body X-ray Bone Densitometer (iNSiGHT C510) and Magnetic Resonance Imaging: A Single-center Comparative study 新型全身x线骨密度仪（iNSiGHT C510）与磁共振成像之间瘦质量测量的相关性：单中心比较研究

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-03-26 DOI: 10.1016/j.jocd.2025.101585

Yong-Chan Ha , Shinjune Kim , Jun-Il Yoo

Background: Sarcopenia, the age-related loss of muscle mass, increases health risks in older adults. Accurate measurement of skeletal muscle mass is critical for diagnosis. While DEXA is widely used, its extended scan time limits clinical utility. This study evaluates the accuracy of lean mass measurements from the newly developed iNSiGHT C510 X-ray bone densitometer compared to MRI, the gold standard.

Methods: This single-center, open-label clinical trial included 20 adult participants (10 males, 10 females) aged 20–70 years. Participants underwent whole-body scans using the iNSiGHT C510 and MRI. Lean and fat mass measurements were obtained from both devices. Statistical analysis included Bland-Altman plots, intraclass correlation coefficients (ICC), and concordance correlation coefficients (CCC) to assess agreement between the two methods. Linear regression analysis was performed to derive conversion formulas between C510 and MRI measurements.

Results: The study found a very strong correlation between lean mass measurements from the iNSiGHT C510 and MRI, with correlation coefficients (r) of 0.961 for the right side, 0.967 for the left, and 0.963 for combined lean mass. ICC and CCC values for lean mass were also high, indicating strong agreement between the two methods. Fat mass measurements, though moderately correlated, showed larger discrepancies compared to lean mass. The iNSiGHT C510 significantly reduced measurement time by 50 % compared to conventional DEXA scans.

Conclusion: The iNSiGHT C510 demonstrated high accuracy in measuring lean mass compared to MRI, with the added benefit of shorter measurement time, making it a practical tool for sarcopenia diagnosis and monitoring in clinical settings. However, further research with larger sample sizes and long-term assessments is needed to validate its broader clinical utility.

背景：骨骼肌减少症，与年龄相关的肌肉质量损失，增加了老年人的健康风险。准确测量骨骼肌质量对诊断至关重要。虽然DEXA被广泛使用，但其延长的扫描时间限制了临床应用。本研究评估了新开发的iNSiGHT C510 x射线骨密度仪与MRI（金标准）相比的瘦质量测量的准确性。方法：这项单中心、开放标签的临床试验包括20名年龄在20 - 70岁之间的成人受试者（10男10女）。参与者使用iNSiGHT C510和MRI进行全身扫描。从这两种设备中获得了瘦和脂肪质量测量值。统计分析包括Bland-Altman图、类内相关系数（ICC）和一致性相关系数（CCC）来评估两种方法之间的一致性。进行线性回归分析，得出C510与MRI测量值之间的转换公式。结果：研究发现iNSiGHT C510测量的瘦质量与MRI之间存在很强的相关性，右侧的相关系数(r)为0.961，左侧为0.967，综合瘦质量为0.963。瘦质量的ICC和CCC值也很高，表明两种方法之间的一致性很强。脂肪质量测量虽然有一定的相关性，但与瘦质量相比，差异更大。与传统的DEXA扫描相比，iNSiGHT C510显着减少了50%的测量时间。结论：与MRI相比，iNSiGHT C510在测量瘦质量方面具有较高的准确性，并且测量时间更短，使其成为临床诊断和监测肌肉减少症的实用工具。然而，需要更大样本量的进一步研究和长期评估来验证其更广泛的临床应用。

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引用次数: 0

Periprosthetic Bone Mineral Density Change after Total Knee Arthroplasty in Vietnamese Population 越南人口全膝关节置换术后假体周围骨矿物质密度的变化

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-03-22 DOI: 10.1016/j.jocd.2025.101583

Hoc Nguyen Van , Khanh Nguyen Manh , Hoang Le Xuan

Objectives: After total knee arthroplasty (TKA), bone structure changes around prosthetics gradually appear. Adverse changes, such as decreased bone mineral density (BMD) and bone remodeling, can lead to joint loosening, affecting surgical outcomes. The study aims to detect BMD changes in the bone around the artificial knee early after TKA.

Methods: We performed a prospectively descriptive study on 54 patients who were operated at Viet Duc University Hospital from 4/2017 to 4/2019. Bone density was measured using dual-energy X-ray absorptiometry (DEXA) at the seventh days, 3,6,12, and 24 months post-surgery.

Results: The BMD in the medial metaphyseal region of interest decreased by 10.36 %, 11.5 %, 11.88 %, and 12.13 % at 3, 6, 12, and 24 months respectively, compared to 7 days post-surgery. The lateral metaphyseal region of interest decreased by 6.09 %, 6.47 %, 6.97 %, and 7.1 % and the tibial diaphyseal region of interest decreased by 3.75 %, 4.66 %, 5.91 %, and 5.8 % over the same follow-up periods. The BMD in the femoral condyle region of interest decreased by 8.15 %, 8.62 %, 9.24 %, and 10.65 % compared to the corresponding 7-day period at 3,6,12, and 24 months post-surgery.

Conclusion: The periprosthetic BMD rapidly reduced in the first 3 months, then gradually decreased. After 24 months of follow-up, the BMD in the medial metaphyseal region of interest decreased the most.

目的：全膝关节置换术后，假体周围骨结构的变化逐渐显现。不利的变化，如骨密度（BMD）降低和骨重塑，可导致关节松动，影响手术结果。本研究旨在检测膝关节置换术后早期人工膝关节周围骨的骨密度变化。方法：对2017年4月至2019年4月在越南大学医院手术的54例患者进行前瞻性描述性研究。术后第7天、3、6、12、24个月采用双能x线骨密度仪（DEXA）测量骨密度。结果：与术后7天相比，内侧干骺端感兴趣区骨密度在术后3、6、12和24个月分别下降了10.36 %、11.5 %、11.88 %和12.13 %。在相同的随访期间，外侧干骺端感兴趣区分别减少了6.09 %、6.47 %、6.97 %和7.1 %，胫骨干骺端感兴趣区分别减少了3.75 %、4.66 %、5.91 %和5.8 %。与术后3、6、12和24个月相应的7天时间相比，股骨髁感兴趣区域的BMD分别下降了8.15% %、8.62% %、9.24% %和10.65 %。结论：假体周围骨密度在前3个月迅速下降，随后逐渐下降。随访24个月后，内侧干骺端感兴趣区域的骨密度下降最多。

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引用次数: 0

An Examination of Patient Knowledge and Education in Patients with Osteoporosis, Osteopenia, and Normal Bone Density 骨质疏松症、骨质减少症和正常骨密度患者的知识和教育检查

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-03-19 DOI: 10.1016/j.jocd.2025.101578

Ahdad Ziyar , Alexander Bolufer , Emily Littman , Shazia Beg

Introduction: Osteoporosis represents a preventable and often treatable condition that is responsible for 1.5 million fractures annually in the United States. Proper patient knowledge represents a crucial aspect of disease management and has potential implications in treatment adherence and lifestyle modification. By examining how much patients know about their own diagnosis, their disease knowledge, and what resources they would like to use, we aim to lay the groundwork for developing efficient patient education resources. Methodology: We surveyed 52 individuals and collected data on demographics, bone density test results, disease knowledge, and educational sources both used and preferred. This was done to learn how much patients know about their condition on a fundamental level. Results: 50% of participants diagnosed with osteoporosis correctly self-reported their condition, as did 21.1% diagnosed with osteopenia. Between the normal, osteopenia, and osteoporosis groups there were no significant differences between participants’ scores on the patient knowledge questionnaire. The resources most used by patients were handouts/brochures and internet/personal research, and patients reported a preference for learning directly from their doctor/nurse. Conclusion: Osteoporosis is associated with millions of fragility fractures occurring annually worldwide. Our study showed a consistent level of knowledge across patients with normal bone mineral density, osteopenia, and osteoporosis, suggesting the need for targeted education efforts, particularly for those with severe forms of the disease. We confirmed the invaluable role of medical personnel in teaching patients about bone density loss. It is through efficient learning that patients can be empowered to take charge of their health.

骨质疏松症是一种可预防且通常可治疗的疾病，每年在美国造成150万例骨折。适当的患者知识代表了疾病管理的一个关键方面，并对治疗依从性和生活方式的改变具有潜在的影响。通过检查患者对自己的诊断、疾病知识的了解程度，以及他们想要使用的资源，我们的目标是为开发有效的患者教育资源奠定基础。方法：我们调查了52个人，收集了人口统计学、骨密度测试结果、疾病知识和常用和首选的教育来源的数据。这样做是为了了解患者在基本层面上对自己的病情了解多少。结果：50%被诊断为骨质疏松的参与者正确地自我报告了他们的病情，21.1%被诊断为骨质减少。在正常组、骨质疏松组和骨质疏松组之间，参与者在患者知识问卷上的得分没有显著差异。患者使用最多的资源是讲义/小册子和互联网/个人研究，患者报告更倾向于直接从他们的医生/护士那里学习。结论：骨质疏松症与全球每年发生的数百万例脆性骨折有关。我们的研究显示，正常骨密度、骨质减少和骨质疏松患者的知识水平是一致的，这表明有必要进行有针对性的教育，特别是对那些患有严重疾病的患者。我们证实了医务人员在教导患者骨密度损失方面的宝贵作用。只有通过有效的学习，病人才能掌握自己的健康。

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引用次数: 0

Optimal kidney-tonifying traditional chinese medicines for postmenopausal osteoporosis: A network meta-analysis of randomized controlled trials 最佳补肾中药治疗绝经后骨质疏松症：随机对照试验的网络荟萃分析

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-03-11 DOI: 10.1016/j.jocd.2025.101581

Xin'e Zhong , Liyun Li , Weiliang Wan

Objective: To evaluate the efficacy and safety of different kidney-tonifying Chinese medicines (KTCMs) combined with bisphosphonates (BPs) in postmenopausal osteoporosis (PMOP) patients.

Methods: This study included 15 randomized controlled trials (RCTs) involving a total of 1,360 PMOP patients to compare the efficacy and safety of various KTCMs combined with BPs. A systematic search was conducted in eight medical databases (CNKI, PUBMED, Web of Science, Cochrane, EMBASE, Wanfang, VIP, and TCM Online). The inclusion criteria were as follows: (1) participants were postmenopausal women with PMOP; (2) the intervention involved different KTCMs combined with BPs; (3) outcome measures included pain Visual Analog Scale (VAS) scores, lumbar spine bone mineral density (BMD), femoral neck BMD, serum osteocalcin levels, and the incidence of adverse events. A network meta-analysis was performed to integrate data, calculating mean differences (MD) with 95 % confidence intervals (CIs). SUCRA values were used to rank treatment efficacy and assess the relative advantages of different regimens. League tables were used to visually present direct and indirect comparisons of treatments, while funnel plots were used to evaluate publication bias. The quality of the included studies was assessed using the Cochrane risk-of-bias tool.

Results: GSK + BPs and JWEX + BPs were the most effective in pain relief, while GSK + BPs showed the best efficacy in improving lumbar spine and femoral neck BMD. LWDH + BPs demonstrated superior performance in promoting bone metabolism. Safety analysis indicated a low incidence of adverse events, with no statistically significant difference between the experimental and control groups (p > 0.05).

Conclusion: This study suggests that GSK + BPs and JWEX + BPs are the most effective combinations for pain relief and BMD improvement, while LWDH + BPs and GSK + BPs have advantages in promoting bone metabolism. The combination of KTCMs with BPs can effectively improve PMOP with high safety, offering significant clinical value.

目的：评价不同补肾中药联合双磷酸盐（BPs）治疗绝经后骨质疏松症（PMOP）的疗效和安全性。方法：本研究纳入15项随机对照试验（RCTs），共1360例PMOP患者，比较各种中药联合bp的疗效和安全性。系统检索了8个医学数据库（CNKI、PUBMED、Web of Science、Cochrane、EMBASE、万方、VIP、TCM Online）。纳入标准如下：(1)研究对象为绝经后绝经期妇女；(2)不同ktcm联合bp干预；(3)结局指标包括疼痛视觉模拟量表（VAS）评分、腰椎骨密度（BMD）、股骨颈骨密度（BMD）、血清骨钙素水平和不良事件发生率。采用网络荟萃分析整合数据，以95 %置信区间（ci）计算平均差异（MD）。采用SUCRA值对治疗效果进行排序，并评估不同方案的相对优势。排位表用于直观地呈现治疗的直接和间接比较，而漏斗图用于评估发表偏倚。使用Cochrane风险偏倚工具评估纳入研究的质量。结果：GSK + bp和JWEX + bp缓解疼痛的效果最好，GSK + bp改善腰椎和股骨颈骨密度的效果最好。LWDH + bp在促进骨代谢方面表现优异。安全性分析显示，不良事件发生率低，实验组与对照组比较，差异无统计学意义（p >； 0.05）。结论：本研究提示GSK + bp和JWEX + bp是缓解疼痛和改善骨密度最有效的组合，而LWDH + bp和GSK + bp在促进骨代谢方面具有优势。中药联合bp可有效改善PMOP，安全性高，具有重要的临床价值。

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引用次数: 0

DXA and cardiovascular disease in rheumatoid arthritis: A scoping review 类风湿性关节炎的 DXA 与心血管疾病：范围综述

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-03-10 DOI: 10.1016/j.jocd.2025.101582

Mina Ebrahimiarjestan , Miriam O'sullivan , Attracta Brennan , Erjiang E , Bryan Whelan , Lan Yang , Tingyan Wang , Carmel Silke , Ming Yu , Mary Dempsey , John J. Carey

DXA technology is widely available today in many regions of the world. There is a growing realization of the value of DXA not only for osteoporosis management but also for sports medicine, sarcopenia, and the assessment of cardiovascular disease and mortality. Such features may be of particular interest for populations with a greater risk of these outcomes such as those with diabetes mellitus or rheumatoid arthritis. Recent systematic reviews and meta-analyses show DXA can robustly predict fractures, cardiovascular disease, dementia and mortality. Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting multiple organs including synovial joints, bone and other tissues. People suffering from RA have a greater propensity to osteoporotic fracture, cardiovascular disease, infection and premature death, which is well recognised. RA is the only unique disease included in some fracture risk algorithms such as FRAX, and so RA patients are often referred for a DXA scan to evaluate their risk of osteoporosis. We have previously shown vertebral fractures, aortic calcification and cardiovascular disease are prevalent in our RA population, with strong association. In this paper we performed a scoping review of published literature in Medline and Embase to better understand the current status of DXA and cardiovascular disease in RA populations. 822 papers were identified in an initial search of which 7 papers reflecting 2,038 RA patients from 7 different countries were included. Study design included 4 cross-sectional, 2 longitudinal and 1 case-control. All included associations with various cardiovascular measures, while only 1 included clinical events as an outcome. Our results suggest this is an area which remains relatively unexplored but has substantial important clinical potential.

目前，DXA技术在世界许多地区得到广泛应用。越来越多的人认识到DXA不仅在骨质疏松症管理方面有价值，而且在运动医学、肌肉减少症、心血管疾病和死亡率评估方面也有价值。这些特征可能对糖尿病或类风湿关节炎等高危人群特别有意义。最近的系统综述和荟萃分析显示，DXA可以可靠地预测骨折、心血管疾病、痴呆和死亡率。类风湿性关节炎（RA）是一种慢性炎症性疾病，影响包括滑膜关节、骨骼和其他组织在内的多个器官。患类风湿性关节炎的人更容易发生骨质疏松性骨折、心血管疾病、感染和过早死亡，这是众所周知的。RA是FRAX等一些骨折风险算法中唯一包含的独特疾病，因此RA患者经常被推荐进行DXA扫描以评估其骨质疏松症的风险。我们之前的研究表明，在我们的RA人群中，椎体骨折、主动脉钙化和心血管疾病普遍存在，并有很强的相关性。在本文中，我们对Medline和Embase上发表的文献进行了范围综述，以更好地了解RA人群中DXA和心血管疾病的现状。在最初的检索中确定了822篇论文，其中7篇论文反映了来自7个不同国家的2038名RA患者。研究设计包括4个横断面、2个纵向和1个病例对照。所有研究都包括与各种心血管指标的关联，而只有1项研究将临床事件作为结果。我们的结果表明，这是一个相对未开发的领域，但具有重要的临床潜力。

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引用次数: 0

The role of trunk region body composition in lumbar spine bone mineral content and density 躯干区域体成分对腰椎骨矿物质含量和密度的影响

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-03-10 DOI: 10.1016/j.jocd.2025.101580

Mohammad Reza Foroutani , Mohammad Reza Salamat , Sakineh Bagherzadeh , Mohammad Keshtkar , Mehri Khoshhali , Mahdi Asgari

Background: The aim of this study was to investigate the differential effects of trunk region body composition—specifically fat mass (FM) and lean mass (LM)—on lumbar spine bone mineral density (BMD) and bone mineral content (BMC), with a focus on variations by gender and menopausal status.

Materials and Methods: We identified 331 adult patients (69 men, 161 premenopausal women, and 101 postmenopausal women) who underwent dual-energy X-ray absorptiometry (DXA) to simultaneously measure trunk body composition and lumbar spine BMD (L₂-L₄). The Pearson correlation coefficient was used to assess the linear relationships between body composition components and lumbar spine BMD and BMC, stratified by gender and menopausal status. Additionally, multiple linear regression analysis with the forward stepwise elimination procedure was applied to find a reasonable subset of predictor variables.

Result: The highest correlation coefficients between body composition and BMD were seen for men and post- and premenopausal individuals in the following areas: pelvic fat mass (r = 0.325; P < 0.01), chest lean mass (r = 0.260; P < 0.01), and total lean mass (r = 0.312; P < 0.01), respectively. Additionally, total lean mass (r = 0.477; P < 0.01), chest lean mass (r = 0.360; P < 0.01), and total lean mass (r = 0.459; P < 0.01) had the strongest correlation coefficients between body composition and BMC. Forward stepwise regression identified age, chest lean mass, and midriff fat mass as predictors of BMC in postmenopausal women; BMI and total lean mass in premenopausal women; and total lean mass in men. For BMD, chest lean mass (postmenopausal), total lean mass (premenopausal), and BMI (men) were significant predictors.

Conclusions: Fat mass does not affect BMD or BMC, while lean mass, strongly predicts bone health. Trunk body composition showed varying relationships with BMD and BMC, making it challenging to pinpoint how lean mass distribution in the chest and midriff specifically impacts bone health.

背景：本研究的目的是探讨躯干区域身体组成（特别是脂肪量（FM）和瘦质量（LM））对腰椎骨密度（BMD）和骨矿物质含量（BMC）的差异影响，重点关注性别和绝经状态的变化。材料和方法：我们确定了331名成年患者（69名男性，161名绝经前女性和101名绝经后女性），他们接受了双能x线吸收仪（DXA），同时测量躯干成分和腰椎骨密度（L2-L4）。使用Pearson相关系数评估身体组成成分与腰椎BMD和BMC之间的线性关系，并按性别和绝经状态分层。此外，采用多元线性回归分析和正向逐步消去程序来寻找合理的预测变量子集。结果：男性、绝经后和绝经前个体的身体成分与骨密度之间的相关系数最高的区域如下：骨盆脂肪量(r = 0.325；P <； 0.01)，胸瘦质量(r = 0.260；P <； 0.01)，总瘦质量(r = 0.312；分别P & lt; 0.01)。此外，总瘦质量(r = 0.477；P <； 0.01)，胸瘦质量(r = 0.360；P <； 0.01)，总瘦体重(r = 0.459；体成分与BMC的相关系数为P <； 0.01)。前向逐步回归发现年龄、胸部瘦质量和腹部脂肪质量是绝经后妇女BMC的预测因素；绝经前妇女的身体质量指数和总瘦体重；以及男性的总瘦体重。对于骨密度，胸瘦质量（绝经后）、总瘦质量（绝经前）和BMI（男性）是显著的预测因子。结论：脂肪量不影响骨密度或BMC，而瘦质量强烈预测骨骼健康。躯干身体组成与骨密度和BMC的关系各不相同，这使得确定胸部和腹部的瘦质量分布如何具体影响骨骼健康变得具有挑战性。

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引用次数: 0

Bioelectrical phase angle and impedance vectors are related to leg hip-femur density and bone geometry parameters in adolescent male soccer players 青少年男性足球运动员的腿部-髋-股骨密度和骨几何参数与生物电相位角和阻抗矢量有关

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-03-09 DOI: 10.1016/j.jocd.2025.101579

Marcus Vinícius de Oliveira Cattem, Josely Correa Koury

Background: Bone geometry parameters are essential for evaluating bone health and fracture risk in soccer players, whose physical demands affect their bone characteristics. However, studies on adolescent soccer players linking raw bioelectrical data to bone data are lacking, in addition to potential discrepancies in phase angle (PhA) values obtained using single-frequency (SF-BIA) and multifrequency (MF-BIA) bioelectrical impedance devices.

Aims: In this cross-sectional study, we aimed to compare raw bioelectrical impedance data (resistance (R), reactance (Xc), and PhA values) obtained using SF-BIA and MF-BIA devices and test the relationships among PhA and bioelectrical impedance vector analysis (BIVA) with bone mineral density (BMD), and leg hip-femur geometry (HF-G) parameters in adolescent male soccer players.

Methods: Raw bioelectrical impedance data were assessed using the SF-BIA and MF-BIA devices at a frequency of 50 kHz. The HF-G parameters were obtained by dual-energy X-ray absorptiometry. BIVA was used to compare bone data considering BMD and HF-G median values.

Results: Overall, 59 adolescent male soccer players participated in this study. Raw SF-BIA data had lower R values (-19.3 %, p < 0.001), but higher Xc (+5.3 %, p < 0.001) and PhA values (+20.3 %, p < 0.001) than when using MF-BIA data. PhA values obtained using SF-BIA (r = 0.27, p = 0.04) or MF-BIA (r = 0.43, p < 0.001) were positively correlated with total hip-femur BMD. Considering BIVA, the ellipses differed for the total BMD (p = 0.0018), neck BMD (p = 0.026), and cross-sectional area (p = 0.024).

Conclusion: The PhA and R values obtained using SF-BIA were higher than those obtained using MF-BIA, possibly because of the technological differences between the devices. However, the MF-BIA data suggests that PhA and BIVA can be used as tools for continuous use to warn of possible imbalances in bone tissue.

背景：足球运动员的身体需求影响其骨骼特征，因此骨几何参数对于评估其骨骼健康和骨折风险至关重要。然而，除了使用单频（SF-BIA）和多频（nf - bia）生物电阻抗装置获得的相位角（PhA）值可能存在差异外，还缺乏将原始生物电数据与骨骼数据联系起来的青少年足球运动员研究。目的：在这项横断面研究中，我们旨在比较使用SF-BIA和MF-BIA装置获得的原始生物电阻抗数据(电阻（R)，电抗（Xc）和PhA值），并测试PhA和生物电阻抗矢量分析（BIVA）与青少年男性足球运动员骨密度（BMD）和腿-髋-股骨几何（HF-G）参数之间的关系。方法：使用SF-BIA和MF-BIA装置在50 kHz频率下评估原始生物电阻抗数据。采用双能x射线吸收法测定HF-G参数。BIVA用于比较考虑BMD和HF-G中位数的骨数据。结果：共有59名青少年男性足球运动员参与本研究。原始SF-BIA数据较低R值(-19.3 % p & lt; 0.001),但高Xc(+ 5.3 % p & lt; 0.001)和PhA值(+ 20.3 % p & lt; 0.001)比使用MF-BIA数据。使用SF-BIA （r = 0.27,p = 0.04）或MF-BIA （r = 0.43,p <； 0.001）获得的PhA值与髋-股骨总骨密度呈正相关。考虑到BIVA，椭圆在总骨密度（p = 0.0018）、颈部骨密度（p = 0.026）和横截面积（p = 0.024）上存在差异。结论：SF-BIA法测得的PhA和R值高于MF-BIA法测得的PhA和R值，可能与两种器械的工艺差异有关。然而，MF-BIA数据表明PhA和BIVA可以作为持续使用的工具来警告骨组织中可能存在的不平衡。

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引用次数: 0

The association of hip bone mineral density (BMD) with incident major osteoporotic and hip fractures varies by body mass index 髋部骨密度（BMD）与重大骨质疏松症和髋部骨折的关系因体重指数而异

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-02-18 DOI: 10.1016/j.jocd.2025.101577

John T. Schousboe , Neil Binkley , William D. Leslie

Background: Bone mineral density (BMD) measurement is less precise amongst those with body mass index (BMI) > 30 kg/m². We hypothesized that the association of BMD with incident hip and major osteoporotic fractures (MOF; hip, clinical vertebral, forearm, or humerus) becomes weaker with increasing BMI.

Methodology: Our study population was 75,391 individuals age ≥ 50 years who had a bone density test in the province of Manitoba 1998 to 2018. BMD of the total hip was assessed on GE Lunar densitometers. Incident MOF and hip fractures were ascertained using linked health claims data over a mean (SD) follow-up of 8.6 (5.3) years. The associations of total hip BMD with incident major osteoporotic and hip fractures were estimated with Cox proportional hazards models including an interaction term between BMI category and BMD to test if the association of BMD with incident fractures varies by BMI.

Result: The multivariable adjusted associations of total hip BMD with incident MOF did not vary by BMI (hazard ratio [HR] 1.56, 95 % C.I. 1.30, 1.85 for BMI ≥ 40 kg/m²; HR 1.36, 95 % C.I. 1.17, 1.58 for BMI <18.5 kg/m²; p-value for interaction 0.14). However, the association of total hip BMD with incident hip fracture was stronger for those with BMI ≥ 35 kg/m² (HR 2.16, 95 % C.I. 1.71, 2.74) compared to those with BMI <18.5 kg/m² (HR 1.48, 95 % C.I. 1.19, 1.84, p-value 0.001 for interaction).

Conclusion: The associations of total hip BMD with incident major osteoporotic and hip fracture are as strong for those with very high BMI as for those with normal BMI. However, total hip BMD may have a weaker association with incident hip fracture among underweight individuals. Further studies to confirm and explain this finding are warranted.

背景：骨矿物质密度（BMD）测量在身体质量指数（BMI） >；30 kg / m2。我们假设骨密度与髋部和主要骨质疏松性骨折(MOF；髋部、临床椎体、前臂或肱骨)随着BMI的增加而变弱。方法：我们的研究人群是1998年至2018年在马尼托巴省进行骨密度测试的75,391名年龄≥50岁的个体。采用GE Lunar骨密度仪评估全髋骨密度。MOF和髋部骨折的发生率是通过平均（SD） 8.6（5.3）年随访的相关健康声明数据确定的。采用Cox比例风险模型，包括BMI类别和BMD之间的相互作用项，以检验BMD与骨折事件的相关性是否因BMI而异，评估髋部总骨密度与骨质疏松症和髋部骨折事件的相关性。结果：经多变量调整后的全髋关节骨密度与MOF的相关性不因BMI而变化(风险比[HR] 1.56, 95 % ci . 1.30, 1.85, BMI≥40 kg/m2；HR 1.36, 95 % ci 1.17, 1.58 BMI <18.5 kg/m2；相互作用的p值为0.14)。然而，与BMI≥35 kg/m2 （HR 2.16, 95 % C.I. 1.71, 2.74）的患者相比，BMI≥18.5 kg/m2 （HR 1.48, 95 % C.I. 1.19, 1.84， p值0.001）的患者，髋部总骨密度与髋部骨折的相关性更强。结论：与BMI正常者相比，BMI正常者髋部骨密度与骨质疏松和髋部骨折发生率的相关性同样强。然而，在体重过轻的个体中，髋部骨密度与髋部骨折的相关性较弱。进一步的研究证实和解释这一发现是有必要的。

{"title":"The association of hip bone mineral density (BMD) with incident major osteoporotic and hip fractures varies by body mass index","authors":"John T. Schousboe , Neil Binkley , William D. Leslie","doi":"10.1016/j.jocd.2025.101577","DOIUrl":"10.1016/j.jocd.2025.101577","url":null,"abstract":"<div><div><em>Background:</em> Bone mineral density (BMD) measurement is less precise amongst those with body mass index (BMI) > 30 kg/m<sup>2</sup>. We hypothesized that the association of BMD with incident hip and major osteoporotic fractures (MOF; hip, clinical vertebral, forearm, or humerus) becomes weaker with increasing BMI.</div><div><em>Methodology:</em> Our study population was 75,391 individuals age ≥ 50 years who had a bone density test in the province of Manitoba 1998 to 2018. BMD of the total hip was assessed on GE Lunar densitometers. Incident MOF and hip fractures were ascertained using linked health claims data over a mean (SD) follow-up of 8.6 (5.3) years. The associations of total hip BMD with incident major osteoporotic and hip fractures were estimated with Cox proportional hazards models including an interaction term between BMI category and BMD to test if the association of BMD with incident fractures varies by BMI.</div><div><em>Result:</em> The multivariable adjusted associations of total hip BMD with incident MOF did not vary by BMI (hazard ratio [HR] 1.56, 95 % C.I. 1.30, 1.85 for BMI ≥ 40 kg/m<sup>2</sup>; HR 1.36, 95 % C.I. 1.17, 1.58 for BMI <18.5 kg/m<sup>2</sup>; p-value for interaction 0.14). However, the association of total hip BMD with incident hip fracture was stronger for those with BMI ≥ 35 kg/m<sup>2</sup> (HR 2.16, 95 % C.I. 1.71, 2.74) compared to those with BMI <18.5 kg/m<sup>2</sup> (HR 1.48, 95 % C.I. 1.19, 1.84, p-value 0.001 for interaction).</div><div><em>Conclusion:</em> The associations of total hip BMD with incident major osteoporotic and hip fracture are as strong for those with very high BMI as for those with normal BMI. However, total hip BMD may have a weaker association with incident hip fracture among underweight individuals. Further studies to confirm and explain this finding are warranted.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 2","pages":"Article 101577"},"PeriodicalIF":1.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial intelligence for opportunistic osteoporosis screening with a Hounsfield Unit in chronic obstructive pulmonary disease patients 人工智能用于慢性阻塞性肺疾病患者霍斯菲尔德单元的机会性骨质疏松症筛查

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-02-13 DOI: 10.1016/j.jocd.2025.101576

Yali Li, Yan Wu

Introduction: To investigate the accuracy of an artificial intelligence (AI) prototype in determining bone mineral density (BMD) in chronic obstructive pulmonary disease (COPD) patients using chest computed tomography (CT) scans.

Methodology: This study involved 1276 health checkups and 1877 COPD patients who underwent chest CT scans from April 2020 to December 2021. Automated identification, segmentation, and Hounsfield Unit (HU) measurement of the thoracic vertebrae were performed using the musculoskeletal module of the AI-Rad Companion Chest CT (Siemens Healthineers, Er langen, Germany). Patients were divided into three groups: normal BMD, osteopenia, and osteoporosis, with quantitative CT (QCT) as the standard for analysis. The correlation between the HU and BMD values from T8 to T12 and T11-T12 vertebrae was analyzed using Linear regression analysis. The diagnostic performance of the HU values from T8 to T12 and T11-T12 vertebrae for osteoporosis was evaluated using the receiver operating characteristic curve.

Results: The HU values strongly correlated with BMD values in health checkups and COPD patients (R²=0.881‒0.936 and 0.863‒0.927, P < 0.001). The Box-and-Whisker plot showed significant differences between HU and BMD values for T11-T12 vertebrae in normal BMD, osteopenia, and osteoporosis groups in two datasets (P < 0.001). The AUC was 0.970-0.982 and 0.944-0.961 in health checkups and COPD patients for detecting osteoporosis, with a sensitivity of 92.27 %‒97.42 % and 79.48 %‒90.24 % and a specificity of 86.35 %‒92.69 % and 82.81 %‒90.94 %. The optimal thresholds were 99.5‒120.5 HU and 104.5‒123.5 HU, respectively.

Conclusions: The AI software achieved high accuracy for automatic opportunistic osteoporosis screening in COPD patients, which may be a complementary method for quickly screening the population at high risk of osteoporosis.

前言：研究人工智能（AI）原型在使用胸部计算机断层扫描（CT）确定慢性阻塞性肺疾病（COPD）患者骨矿物质密度（BMD）的准确性。方法：本研究涉及1276名健康检查和1877名COPD患者，他们在2020年4月至2021年12月期间接受了胸部CT扫描。使用AI-Rad胸部CT的肌肉骨骼模块（Siemens Healthineers, Er langen, Germany）对胸椎进行自动识别、分割和霍斯菲尔德单元（Hounsfield Unit， HU）测量。将患者分为骨密度正常组、骨质减少组和骨质疏松组，以定量CT （QCT）作为分析标准。采用线性回归分析T8 ~ T12和t11 ~ T12椎体HU与BMD值的相关性。采用受试者工作特征曲线评价T8 ~ T12和t11 ~ T12椎体HU值对骨质疏松症的诊断价值。结果：健康体检及COPD患者的HU值与BMD值呈强相关（R2= 0.881-0.936、0.863-0.927，P值 <； 0.001）。盒须图显示，在两个数据集中，骨密度正常组、骨质疏松组和骨质疏松组中，T11-T12椎体的HU值和骨密度值存在显著差异（P <； 0.001）。健康体检及COPD患者骨质疏松检测AUC分别为0.970 ~ 0.982、0.944 ~ 0.961，敏感性分别为92.27 % ~ 97.42 %、79.48 % ~ 90.24 %，特异性分别为86.35 % ~ 92.69 %、82.81 % ~ 90.94 %。最佳阈值分别为99.5 ~ 120.5 HU和104.5 ~ 123.5 HU。结论：AI软件在COPD患者骨质疏松自动机会性筛查中取得了较高的准确率，可作为快速筛查骨质疏松高危人群的一种补充方法。

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引用次数: 0

Bone quality is associated with fragility fracture in patients with hemoglobinopathies 在血红蛋白病患者中，骨质量与脆性骨折有关

IF 1.7 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Clinical Densitometry

Pub Date : 2025-01-21 DOI: 10.1016/j.jocd.2025.101565

Ellen B. Fung , Iman Sarsour , Raquel Manzo , Ashutosh Lal

Background: Low bone mass, defined as a bone mineral density (BMD) Z-score ≤-2.0, is common in adults with thalassemia (Thal) and sickle cell disease (SCD), though disease-specific artifacts may contribute to inaccuracies in BMD assessment. Trabecular bone score (TBS), an indicator of bone quality, is not susceptible to these challenges and may improve fracture risk prediction.

Methods: A retrospective chart review was conducted in patients with Thal or SCD who had at least one spine BMD scan by DXA in the past 10 years. The most recent scan was reanalyzed for bone quality with abnormal defined as TBS <1.2. Fracture prevalence was determined by patient report with medical record validation. Patients were compared to healthy controls who participated in previous research.

Results: Data were abstracted from 126 patients with Thal (31.7 ± 11.9 yrs, 51 % Male), 170 with SCD (24.6 ± 13.5 yrs, 43 % Male), and 64 controls (25.9 ± 8.0 yrs, 17 % Male). Abnormal TBS was more common in Thal (26 %) or SCD (7 %) compared to controls (0 %, p < 0.001). Fracture prevalence was greater in Thal (36 %) compared to SCD (23 %) and controls (16 %, p = 0.005). Fragility fractures were not observed in controls but constituted 21 % of fractures in Thal and 15 % in SCD. After adjusting for age and hypogonadism, low bone mass was associated with an increased fracture prevalence (OR: 1.8, 95 % CI: 1.03, 3.23; p = 0.041), but not with fragility fracture. In contrast, abnormal TBS was strongly associated with fragility fracture after adjustment for age, sex, and BMI (OR: 11.4, 95 % CI: 2.2, 59.1, p = 0.004).

Conclusions: Bone quality by TBS may be a valuable tool in predicting the risk of fragility fractures in young adults with hemoglobinopathies and should be considered when making decisions for anti-resorptive therapy in those with low BMD naive to fracture or where disease-specific artifacts complicate accurate spine assessment by BMD alone.

背景：低骨量，定义为骨矿物质密度（BMD） z评分≤-2.0，在地中海贫血（Thal）和镰状细胞病（SCD）的成人中很常见，尽管疾病特异性的人为因素可能导致BMD评估的不准确性。骨质量指标小梁骨评分（TBS）不容易受到这些挑战的影响，可以改善骨折风险预测。方法：对过去10年中至少进行过一次DXA脊柱骨密度扫描的Thal或SCD患者进行回顾性图表回顾。重新分析最近一次扫描的骨质量，异常定义为TBS <；1.2。骨折发生率由患者报告和医疗记录验证确定。将患者与之前参与研究的健康对照组进行比较。结果:数据抽象从126年患者需要(31.7 ± 11.9岁,男性51 %),170年SCD(24.6 ± 13.5年,43 %男性),和64名对照(25.9 ± 8.0岁,17 %男性)。与对照组（0 %,p <； 0.001）相比，TBS异常在Thal（26 %）或SCD（7 %）中更为常见。与SCD组（23 %）和对照组（16 %,p = 0.005）相比，Thal组（36 %）的骨折发生率更高。在对照组中未观察到脆性骨折，但占Thal骨折的21. %和SCD骨折的15. %。在调整年龄和性腺功能减退后，低骨量与骨折发生率增加相关(OR: 1.8, 95 % CI: 1.03, 3.23；P = 0.041)，但与脆性骨折无关。相反，调整年龄、性别和BMI后，TBS异常与脆性骨折密切相关（OR: 11.4, 95 % CI: 2.2, 59.1, p = 0.004）。结论：TBS的骨质量可能是预测患有血红蛋白病的年轻成人脆性骨折风险的一个有价值的工具，在决定对那些刚发生骨折的低骨密度患者进行抗再吸收治疗时，或者在单纯通过骨密度进行准确的脊柱评估时，应考虑到TBS的骨质量。

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引用次数: 0