Best Performance Parameters of HR-pQCT to Predict Fragility Fracture: Systematic Review and Meta-Analysis.
Best Performance Parameters of HR-pQCT to Predict Fragility Fracture: Systematic Review and Meta-Analysis.
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DOI：
10.1002/jbmr.4449
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发表时间：
2021-12
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影响因子：
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骨质疏松症是一种全身性骨骼疾病，其特征是低骨量和骨结构退化，可导致脆性骨折。使用骨成像模式准确预测脆性骨折一直是一个重要的问题，但目前诊断骨质疏松症的双能X线吸收测定法（DXA）的金标准不能完全满足这一目的。最新的高分辨率外周定量计算机断层扫描（HR‐pQCT）是一种三维（3D）成像设备，不仅可以测量体积骨密度，还可以以无创方式测量骨微结构，可以提供更好的骨折预测能力。本系统综述和Meta分析旨在研究桡骨远端和/或胫骨远端的哪些HR‐pQCT参数可以最好地预测脆性骨折。由两名独立评审员使用相关关键词在Embase、PubMed和Web of Science中进行了系统性文献检索。纳入了使用HR‐pQCT预测脆性骨折的原始临床研究，并提供了英文全文。从纳入的研究中提取信息以供进一步审查。共纳入25篇文章进行系统综述，16篇文章进行Meta分析。HR-pQCT显示可显著预测偶发性骨折和/或严重骨质疏松性骨折（MOF）。在所有HR-pQCT参数中，我们的Meta分析显示皮质体积骨矿物质密度（Ct.vBMD）、骨小梁厚度（Tb.Th）和刚度是更好的预测因子。同时，HR-pQCT参数表明预测MOF的性能优于预测偶发骨折。在HR-pQCT的两个标准测量部位之间，非承重桡骨远端是比胫骨远端更适合骨折预测的部位。此外，大多数纳入的研究是基于白色的，而很少有研究来自亚洲或南美洲。这些区域应建立其密度数据库并进行相关的预测研究。预计HR-pQCT可广泛用于骨质疏松症的诊断和未来脆性骨折的预测。版权所有© 2021作者。《骨与矿物质研究杂志》由Wiley Periodicals LLC代表美国骨与矿物质研究学会（ASBMR）出版。
Osteoporosis is a systemic skeletal disease characterized by low bone mass and bone structural deterioration that may result in fragility fractures. Use of bone imaging modalities to accurately predict fragility fractures is always an important issue, yet the current gold standard of dual‐energy X‐ray absorptiometry (DXA) for diagnosis of osteoporosis cannot fully satisfy this purpose. The latest high‐resolution peripheral quantitative computed tomography (HR‐pQCT) is a three‐dimensional (3D) imaging device to measure not only volumetric bone density, but also the bone microarchitecture in a noninvasive manner that may provide a better fracture prediction power. This systematic review and meta‐analysis was designed to investigate which HR‐pQCT parameters at the distal radius and/or distal tibia could best predict fragility fractures. A systematic literature search was conducted in Embase, PubMed, and Web of Science with relevant keywords by two independent reviewers. Original clinical studies using HR‐pQCT to predict fragility fractures with available full text in English were included. Information was extracted from the included studies for further review. In total, 25 articles were included for the systematic review, and 16 articles for meta‐analysis. HR‐pQCT was shown to significantly predict incident fractures and/or major osteoporotic fractures (MOFs). Of all the HR‐pQCT parameters, our meta‐analysis revealed that cortical volumetric bone mineral density (Ct.vBMD), trabecular thickness (Tb.Th), and stiffness were better predictors. Meanwhile, HR‐pQCT parameters indicated better performance in predicting MOFs than incident fractures. Between the two standard measurement sites of HR‐pQCT, the non‐weight‐bearing distal radius was a more preferable site than distal tibia for fracture prediction. Furthermore, most of the included studies were white‐based, whereas very few studies were from Asia or South America. These regions should build up their densitometric databases and conduct related prediction studies. It is expected that HR‐pQCT can be used widely for the diagnosis of osteoporosis and prediction of future fragility fractures. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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DOI：
10.1002/jbmr.111
发表时间：
2010-10
期刊：
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
影响因子：
--
作者：
Liu XS;Cohen A;Shane E;Yin PT;Stein EM;Rogers H;Kokolus SL;McMahon DJ;Lappe JM;Recker RR;Lang T;Guo XE
通讯作者：
Guo XE
影响因子：
2.8
作者：
Chen H;Zhou X;Fujita H;Onozuka M;Kubo KY
通讯作者：
Kubo KY
影响因子：
6.2
作者：
Melton, L. Joseph, III;Riggs, B. Lawrence;Khosla, Sundeep
通讯作者：
Khosla, Sundeep
影响因子：
4.1
作者：
Edwards, M. H.;Robinson, D. E.;Dennison, E. M.
通讯作者：
Dennison, E. M.
影响因子：
6.2
作者：
Boutroy, Stephanie;Van Rietbergen, Bert;Delmas, Pierre D.
通讯作者：
Delmas, Pierre D.