Bone marrow lesion volume reduction is not associated with improvement of other periarticular bone measures: data from the Osteoarthritis Initiative.
Bone marrow lesion volume reduction is not associated with improvement of other periarticular bone measures: data from the Osteoarthritis Initiative.
复制标题
DOI：
10.1186/ar4336
复制
发表时间：
2013
影响因子：
4.9
通讯作者：
OAI Investigators Group
中科院分区：
文献类型：
--
作者：
Driban JB;Lo GH;Price L;Pang J;Miller E;Ward RJ;Hunter DJ;Eaton CB;Lynch JA;McAlindon TE;OAI Investigators Group
我们评估了骨髓病变（BML）体积变化与关节周围骨矿物质密度（paBMD）变化以及软骨下硬化之间的相关性，以确定BML变化是否与其他局部骨变化相关。便利样本包括骨关节炎倡议（OAI）的参与者，在24个月和48个月访视时接受负重膝关节后前位X线片和磁共振成像（MRI），在30个月/36个月和48个月访视时接受双能X线吸收测定法（DXA）。对右膝关节进行评估，除非禁忌MRI。我们使用膝关节DXA扫描测量胫骨内侧paBMD和内侧/外侧paBMD比值（M：L paBMD）。对膝关节X线片进行胫骨内侧硬化评分（0 - 3级）。两名评估者使用半自动分割方法确定矢状面脂肪抑制MRI上的BML体积。为了关注仅胫骨内侧BML变化的膝关节，排除了胫骨外侧BML。胫骨内侧BML体积变化分为三组：BML消退（胫骨内侧BML体积变化的最低四分位数）、无至最小变化（中间两个四分位数）和BML进展（最高四分位数）。我们使用比例优势logistic回归模型来评估内侧paBMD或M：L paBMD比值变化的四分位数与BML体积变化之间的相关性。样本（n = 308）包括163例（53%）女性受试者，212例（69%）膝关节影像学骨关节炎，受试者平均年龄为63.8 ± 9.3岁，平均体重指数为29.8 ± 4.7 kg/m2。我们发现胫骨内侧paBMD的增加与BML消退之间存在相关性（OR = 1.7（95%置信区间（CI）= 1.1至2.8）），BML进展的趋势相似（OR = 1.6（95% CI = 1.0至2.6））。我们还检测到M：L paBMD的更大增加与BML消退（OR = 1.6（95% CI = 1.0至2.7））和BML进展（OR = 1.8（95% CI = 1.1至3.0））之间的相关性，尽管BML消退具有临界统计学意义。与无BML变化的膝关节相比，BML进展或消退的膝关节中胫骨内侧硬化进展的频率（n = 14）更高（分别为P = 0.01和P = 0.04）。BML消退和BML进展的特征是同时出现paBMD和硬化增加，这是放射学骨关节炎严重程度增加的特征。至少在24个月内，BML回归并不代表其他关节周围骨测量的改善。
We evaluated the associations between bone marrow lesion (BML) volume change and changes in periarticular bone mineral density (paBMD) as well as subchondral sclerosis to determine whether BML change is associated with other local bone changes. The convenience sample comprised participants in the Osteoarthritis Initiative (OAI) with weight-bearing posterior-anterior knee radiographs and magnetic resonance images (MRIs) at the 24- and 48-month visits and dual-energy x-ray absorptiometry (DXA) at the 30-/36-month and 48-month visits. The right knee was assessed unless contraindicated for MRI. We used knee DXA scans to measure medial tibia paBMD and medial/lateral paBMD ratio (M:L paBMD). Knee radiographs were scored for sclerosis (grades 0 to 3) in the medial tibia. Two raters determined BML volume on sagittal fat-suppressed MRI by using a semiautomated segmentation method. To focus on knees with only medial tibia BML changes, knees with lateral tibial BMLs were excluded. Medial tibial BML volume change was classified into three groups: BML regression (lowest quartile of medial tibial BML volume change), no-to-minimal change (middle two quartiles), and BML progression (highest quartile). We used proportional odds logistic regression models to evaluate the association between quartiles of changes in medial paBMD or M:L paBMD ratio, as outcomes, and BML volume change. The sample (n = 308) included 163 (53%) female subjects, 212 (69%) knees with radiographic osteoarthritis, and participants with a mean age of 63.8 ± 9.3 years and mean body mass index of 29.8 ± 4.7 kg/m2. We found an association between greater increases in medial tibia paBMD and BML regression (OR = 1.7 (95% confidence interval (CI) = 1.1 to 2.8)) and a similar trend for BML progression (OR = 1.6 (95% CI = 1.0 to 2.6]). We also detected associations between greater increase in M:L paBMD and BML regression (OR = 1.6 (95% CI = 1.0 to 2.7]) and BML progression (OR = 1.8 (95% CI = 1.1 to 3.0)), although BML regression had borderline statistical significance. The frequency of sclerosis progression in the medial tibia (n = 14) was greater among knees with BML progression or regression compared with knees without BML change (P = 0.01 and P = 0.04, respectively). BML regression and BML progression are characterized by concurrent increases in paBMD and sclerosis, which are characteristic of increased radiographic osteoarthritis severity. At least during 24 months, BML regression is not representative of improvement in other periarticular bone measures.
登录
查看更多内容
影响因子：
7
作者：
Felson, D. T.;Parkes, M. J.;Hutchinson, C. E.
通讯作者：
Hutchinson, C. E.
影响因子：
4.9
作者：
Driban JB;Price L;Lo GH;Pang J;Hunter DJ;Miller E;Ward RJ;Eaton CB;Lynch JA;McAlindon TE
通讯作者：
McAlindon TE
影响因子：
7
作者：
Kazakia, G. J.;Kuo, D.;Schooler, J.;Siddiqui, S.;Shanbhag, S.;Bernstein, G.;Horvai, A.;Majumdar, S.;Ries, M.;Li, X.
通讯作者：
Li, X.
影响因子：
27.4
作者：
Laslett, Laura Louise;Dore, Dawn A.;Jones, Graeme
通讯作者：
Jones, Graeme
影响因子：
7
作者：
Altman, R. D.;Gold, G. E.
通讯作者：
Gold, G. E.