Young adults with cystic fibrosis have altered trabecular microstructure by ITS-based morphological analysis.
Young adults with cystic fibrosis have altered trabecular microstructure by ITS-based morphological analysis.
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通过基于 ITS 的形态学分析，患有囊性纤维化的年轻人改变了小梁的微观结构。
DOI：
10.1007/s00198-016-3557-z
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Finkelstein,JS
中科院分区：
文献类型：
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作者：
Putman,MS;Greenblatt,LB;Sicilian,L;Uluer,A;Lapey,A;Sawicki,G;Gordon,CM;Bouxsein,ML;Finkelstein,JS
囊性纤维症患者的骨小梁微结构受损，骨小梁轴向排列改变，骨小梁之间的连通性降低，这可能是导致骨强度降低和骨折风险增加的原因之一。基于个体骨小梁分割(ITS)的高分辨率外周定量计算机断层扫描(HR-pQCT)图像的形态分析将骨小梁分割成不同排列和连通性的板状和杆状，这是骨小梁强度的重要决定因素。我们试图确定在CF患者中是否存在其变量的变化，并可能有助于解释他们骨折风险的增加。方法30名年龄在18-40岁的CF患者接受了髋关节和脊柱的DXA扫描和桡骨和胫骨的HR-pQCT扫描，并通过ITS进一步评估了小梁的微结构。这些患者与60名年龄(±2岁)、种族和性别匹配的健康对照组进行了比较。结果CF患者的骨板体积分数、厚度、密度以及板-板和板-棒的连接性降低，骨小梁的轴向排列在桡骨和胫骨都较低(p<； 均为0.05)。在半径方面，对BMI的调整消除了大部分这些差异。然而，在胫骨，仅调整体重指数以及调整体重指数和骨密度后，钢板体积分数和数量、轴向排列的骨小梁和板-板连接性仍然显著减少(p<； 均为0.05)。结论年轻的CF患者的骨小梁形态和轴向排列的骨小梁形态受损，骨小梁之间的连通性降低。它的分析提供了关于骨完整性的独特信息，这些骨小梁缺陷可能有助于解释骨密度和/或传统骨微结构测量未考虑的成人CF骨折风险增加的原因。
SummaryYoung adults with cystic fibrosis have compromised plate-like trabecular microstructure, altered axial alignment of trabeculae, and reduced connectivity between trabeculae that may contribute to the reduced bone strength and increased fracture risk observed in this patient population.IntroductionThe risk of fracture is increased in patients with cystic fibrosis (CF). Individual trabecular segmentation (ITS)-based morphological analysis of high-resolution peripheral quantitative computed tomography (HR-pQCT) images segments trabecular bone into individual plates and rods of different alignment and connectivity, which are important determinants of trabecular bone strength. We sought to determine whether alterations in ITS variables are present in patients with CF and may help explain their increased fracture risk.MethodsThirty patients with CF ages 18–40 years underwent DXA scans of the hip and spine and HR-pQCT scans of the radius and tibia with further assessment of trabecular microstructure by ITS. These CF patients were compared with 60 healthy controls matched for age (±2 years), race, and gender.ResultsPlate volume fraction, thickness, and density as well as plate-plate and plate-rod connectivity were reduced, and axial alignment of trabeculae was lower in subjects with CF at both the radius and the tibia (p< 0.05 for all). At the radius, adjustment for BMI eliminated most of these differences. At the tibia, however, reductions in plate volume fraction and number, axially aligned trabeculae, and plate-plate connectivity remained significant after adjustment for BMI alone and for BMI and aBMD (p< 0.05 for all).ConclusionsYoung adults with CF have compromised plate-like and axially aligned trabecular morphology and reduced connectivity between trabeculae. ITS analysis provides unique information about bone integrity, and these trabecular deficits may help explain the increased fracture risk in adults with CF not accounted for by BMD and/or traditional bone microarchitecture measurements.