Assessment of Bone and Muscle Measurements by Peripheral Quantitative Computed Tomography in Geriatric Patients
Assessment of Bone and Muscle Measurements by Peripheral Quantitative Computed Tomography in Geriatric Patients
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DOI：
10.1016/j.jocd.2018.10.002
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发表时间：
2020-10-01
影响因子：
2.5
通讯作者：
Schmidmaier, R.
中科院分区：
文献类型：
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作者：
Drey, M.;Henkel, M.;Schmidmaier, R.
骨骼和肌肉质量的损失会增加骨质疏松性骨折的风险。双能 X 射线吸收测定法 (DXA) 会随着年龄的增长而失去敏感性。本研究的目的是评估骨质疏松症老年队列中外周定量计算机断层扫描 (pQCT) 的骨骼和肌肉测量结果。 168 名 65 岁及以上患者 (76.3 +/- 6.5) 的骨矿物质密度和肌肉面积通过 pQCT 测量前臂远端，此外还进行了骨质疏松症评估，包括病史、血液测试和腰椎和髋部 DXA。既往骨折分为轻微和严重骨质疏松性骨折。使用逻辑回归来显示骨矿物质密度和肌肉面积与主要骨折的关联。 54.8% 的参与者至少有一处严重骨折。 pQCT 测量的骨矿物质密度和肌肉面积与这些骨折显着相关（总骨矿物质密度和小梁骨矿物质密度 OR 2.243 和 2.195，p < 0.01；肌肉面积 OR 2.378，p < 0.05），而 DXA 骨矿物质密度显示没有显着相关性。在调整年龄、性别、体重指数、体力活动和其他因素后，这些关联仍然存在。在 75 岁患者的所有模型中，只有肌肉面积与严重骨折显着相关（OR 5.354，p < 0.05）。在老年患者骨折关联方面，使用 pQCT 测量骨矿物质密度和肌肉面积似乎比 DXA 更有优势。测量肌肉面积还可以提供有用的信息来估计骨肌减少症的存在。
The loss of bone and muscle mass increases the risk of osteoporotic fractures. Dual energy X-ray absorptiometry (DXA) loses sensitivity in older age. The purpose of this study was to evaluate bone and muscle measurements of peripheral quantitative computed tomography (pQCT) in a geriatric cohort with osteoporosis. Bone mineral density and muscle area of 168 patients aged 65 years and older (76.3 +/- 6.5) were measured with pQCT at distal forearm additionally to an osteoporosis assessment consisting of anamnesis, blood test and DXA of lumbar spine and hip. Prior fractures were categorized in minor and major osteoporotic fractures. Logistic regression was used to show the association of bone mineral density and muscle area with major fractures. 54.8% of the participants had at least one major fracture. Bone mineral density measured with pQCT and muscle area were significantly associated with these fractures (total and trabecular bone mineral density OR 2.243 and 2.195, p < 0.01; muscle area OR 2.378, p < 0.05), whereas DXA bone mineral density showed no significant association. These associations remained after adjustment for age, sex, BMI, physical activity and other factors. In all models for patients 75 years only muscle area was significantly associated (OR 5.354, p < 0.05) with major fractures. Measurement of bone mineral density and muscle area with pQCT seems to have advantage over DXA in fracture association in geriatric patients. Measuring muscle area also adds useful information to estimate the presence of osteosarcopenia.