The impact of degenerative conditions in the spine on bone mineral density and fracture risk prediction
The impact of degenerative conditions in the spine on bone mineral density and fracture risk prediction
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脊柱退行性病变对骨矿物质密度和骨折风险预测的影响
DOI：
10.1007/bf01626537
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发表时间：
2005
影响因子：
4
通讯作者：
C. Christiansen
中科院分区：
文献类型：
--
作者：
P. V. D. Recke1;M. A. Hansen;K. Overgaard;C. Christiansen
我们研究了脊柱退行性疾病(骨赘和终板硬化)和腰部主动脉钙化对脊柱和前臂骨矿含量/密度(BMC/BMD)的影响，以及对骨折风险预测的影响。对387名年龄68-72岁的健康绝经后妇女的X线片进行了遮盖方式的评估，以了解L2至L4区域是否存在骨赘、终板硬化和主动脉钙化。根据不同的定义评估椎体畸形/骨折。大于3 mm的骨赘和3 mm或更多的骨赘导致脊柱骨量显著增加(12%)(p<；0.001)。终板硬化也有类似的影响(p<；0.001)。在这两种退行性疾病的受试者中，脊柱和前臂的骨密度/骨密度显著高于未受影响的女性(脊柱19%，前臂10%；p<；0.001)。如果没有这两种退行性疾病，骨折女性的脊柱骨密度值显著较低(p<；0.001)，而如果存在退行性疾病，骨折女性和未骨折女性的骨密度值相似。退行性疾病不会改变前臂BMC区分脊椎或周围骨折的能力。建立腰椎骨密度和前臂BMC的受试者工作特征(ROC)曲线(真阳性分数与假阳性分数)，以区分椎体和周围骨折妇女与健康绝经前妇女。没有退行性疾病的女性的ROC曲线始终高于受腰椎骨赘和终板硬化影响的女性(P<；0.001)。总之，骨赘和终板硬化对绝经后老年妇女的脊柱骨量测量有相当大的影响，并影响脊柱扫描鉴别骨质疏松妇女的诊断能力。我们的数据表明，在老年妇女中，除非脊柱在放射学上没有退行性疾病，否则外周测量程序应该被认为是评估骨矿含量/密度的替代方法。
We examined the impact of degenerative conditions in the spine (osteophytosis and endplate sclerosis) and aortic calcification in the lumbar region on bone mineral content/density (BMC/BMD) measured in the spine and forearm by absorptiometry and on fracture risk prediction. The radiographs of 387 healthy postmenopausal women, aged 68–72 years, were assessed in masked fashion for the presence of osteophytosis, endplate sclerosis and aortic calcification in the region from L2 to L4. Vertebral deformities/fractures were assessed by different definitions. Osteophytes larger than 3 mm and in numbers of 3 or more resulted in a significantly (12%) higher spinal bone mass (p<0.001). Endplate sclerosis had a similar effect (p<0.001). In subjects with both degenerative conditions the BMC/BMD in the spine and forearm were significantly higher than in unaffected women (19% in the spine, 10% in the forearm;p<0.001). The spinal BMD values were significantly lower in fractured women if both degenerative conditions were absent (p<0.001), whereas fractured and unfractured women had similar values if degenerative conditions were present. Degenerative conditions did not alter the ability of forearm BMC to discriminate vertebral or peripheral fractures. Receiver operating characteristic (ROC) curves (true positive fraction versus false positive fraction) were generated for BMD of the lumbar spine and BMC of the forearm with regard to the discrimination between women with vertebral and peripheral fractures and healthy premenopausal women. The ROC curves for women without degenerative conditins were consistently above the curves for women affected by osteophytosis and endplate sclerosis in the lumbar spine (p<0.001). In conclusion, osteophytes and endplate sclerosis have a considerable influence on spinal bone mass measurements in elderly postmenopausal women and affect the diagnostic ability of spinal scans to discriminate osteoporotic women. Our data suggest that in elderly women, unless the spine is radiologically clear of degenerative conditions, a peripheral measurement procedure should be considered an alternative for assessment of bone mineral content/ensity.
影响因子：
5
作者：
MELTON, LJ;KAN, SH;RIGGS, BL
通讯作者：
RIGGS, BL