INFLUENCE OF DEGENERATIVE JOINT DISEASE ON SPINAL BONE-MINERAL MEASUREMENTS IN POSTMENOPAUSAL WOMEN
INFLUENCE OF DEGENERATIVE JOINT DISEASE ON SPINAL BONE-MINERAL MEASUREMENTS IN POSTMENOPAUSAL WOMEN
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DOI：
10.1007/bf00310253
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发表时间：
1995-09-01
影响因子：
4.2
通讯作者：
GENANT, HK
中科院分区：
文献类型：
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作者：
YU, W;GLUER, CC;GENANT, HK
我们评估了一组绝经后妇女中各种形式的脊柱退行性关节病（DJD）对骨密度（BMD）的影响，这些骨密度是通过定量计算机断层扫描（QCT）和双能X线吸收仪（DXA）测量的。对209名女性（平均年龄62.6 ± 6.7岁）的侧位（T4-L4）和前后位（L1-L4）脊柱X线片进行了骨折和DJD检查。腰椎X线片上DJD结果的严重程度分级为0、1或2，椎体骨赘除外，其分级为0 - 3。椎体骨折被半定量地定义为前、中或后椎体高度降低约20%。所有受试者均采用QCT和DXA（包括后前DXA（PA-DXA）、外侧DXA（L-DXA）和中外侧DXA（mL-DXA））测量BMD。用QCT和mL-DXA测量168例无骨折妇女的BMD，发现DJD与无骨折妇女之间无显著性差异。然而，在DJD改变的女性中，PA-DXA的BMD显著更高，特别是当椎体或小关节处存在骨赘时。DJD对L-DXA BMD的影响较小。对于该测量，仅在椎体骨赘受试者中观察到BMD显著增加。多因素方差分析（MANOVA）显示DJD对QCT和mL-DXA测量的BMD无影响。相反，对于所有女性，PA和L-DXA的BMD受DJD的影响大于骨折状态。卡方检验表明椎体骨折与任何DJD变化之间无显著关系。结论：QCT和mL-DXA在检测DJD患者骨丢失方面优于PA-DXA和L-DXA，且具有上级优势。因此，对于这些患者，通过QCT或mL-DXA进行BMD评估可能是可取的。
We assessed the impact of various forms of spinal degenerative joint disease (DJD) on bone mineral density (BMD) measured by quantitative computed tomography (QCT) and dual X-ray absorptiometry (DXA) in a group of postmenopausal women. Lateral (T4-L4) and AP (L1-L4) spinal radiographs were reviewed for fracture and DJD in 209 women (mean age 62.6 +/- 6.7). The severity of DJD findings was graded as 0, 1, or 2 on the lumbar films, except for vertebral osteophytes which were graded from 0 to 3. Vertebral fractures were defined semiquantitatively as approximately 20% reduction in anterior, middle, or posterior vertebral height. BMD was measured in all subjects by QCT and DXA, including posteroanterior DXA (PA-DXA), lateral DXA (L-DXA) and midlateral DXA (mL-DXA). When BMD was measured by QCT and mL-DXA in the 168 women without fractures, no significant differences were found between women with and those without DJD. However, BMD by PA-DXA was significantly higher in women with DJD changes, particularly when osteophytes were present at the vertebral bodies or facet joints. BMD by L-DXA was less affected by DJD. For this measurement a significant increase in BMD was only noted in subjects with vertebral osteophytes. Multivariate analysis of variance (MANOVA) showed that BMD by QCT and mL-DXA was not affected by DJD. In contrast, for all women, BMD by PA- and L-DXA was affected more by DJD than by fracture status. Chi-square testing demonstrated no significant relationships between vertebral fractures and any of the DJD changes. We conclude that QCT and mL-DXA are superior to PA-DXA and L-DXA in detecting bone loss in patients with DJD. Thus, for these patients, BMD assessment by QCT or mL-DXA may be advisable.