Accounting for Surgical Confounding Factors Affecting Dual-Energy X-ray Absorptiometry in a Large Clinical Trial.
Accounting for Surgical Confounding Factors Affecting Dual-Energy X-ray Absorptiometry in a Large Clinical Trial.
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DOI：
10.1016/j.jocd.2021.06.002
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
LeBoff MS
中科院分区：
文献类型：
--
作者：
Donlon CM;Chou SH;Yu CY;LeBoff MS
关节置换术是美国最常见的骨科手术之一，随着人口老龄化将继续增加。因此，在进行双能X线吸收法（DXA）测量时，有必要考虑这些和其他混杂因素，如乳房植入体。对771名参与者（男性≥50岁，女性≥55岁）进行全身DXA扫描，以评估骨矿物质密度（BMD）和身体成分（脂肪和瘦体重）。在DXA扫描分析的参与者与内部金属，这些受影响的地区的利益被取代的措施，从未受影响的，对侧，符合国际社会的建议，临床密度测定。使用默认的性别和种族匹配数据库重新计算T评分和Z评分。我们还探讨了乳房植入物对骨密度和身体成分分析的影响。大约13.1%的参与者在基线时有内部金属伪影。用未受影响的对侧替换金属伪影，全身BMD平均降低8.1%（SEM 0.84%; n = 67）。在单侧髋关节置换术（n = 17）和膝关节置换术（n = 20）的参与者中，BMD分别平均下降14.1%（SEM 1.7%）和11.2%（SEM 1.1%）。脂肪和瘦体重没有受到金属伪影的显著影响，因为有和没有金属的值之间的差异在1%以内。两名参与者植入了双侧乳房植入体，在另一项试验中，一名参与者植入了单侧乳房植入体。乳房植入体区域的骨矿物质含量（BMC）是对侧的5.8倍，全身BMC增加了4.7%。金属伪影和乳房植入物可以混淆DXA全身骨骼，但不会混淆脂肪和瘦肉结果。因此，在临床研究中考虑这些因素以检测骨测量的生理相关差异是很重要的。
Joint replacements are among the most common orthopedic procedures performed in the U.S. and will continue to increase with the aging population. It is therefore necessary to account for these and other confounding factors, such as breast implants, when performing dual-energy X-ray absorptiometry (DXA) measurements. Whole-body DXA scans were performed in 771 participants (men ≥50 yr and women ≥55 yr) to assess bone mineral density (BMD) and body composition (fat and lean mass). In the DXA scan analyses of participants with internal metal, these affected regions of interest were replaced with measures from the unaffected, contralateral side, consistent with recommendations of the International Society for Clinical Densitometry. T-scores and Z-scores were recalculated using default sex and ethnicity-matched databases. We also explored effects of breast implants on bone density and body composition analyses. Approximately 13.1% of participants had internal metal artifacts at baseline. Replacing metal artifacts with the unaffected, contralateral side decreased the whole-body BMD by an average of 8.1% (SEM 0.84%; n = 67). In participants with unilateral hip (n = 17) and knee replacements (n = 20), BMD was decreased by an average of 14.1% (SEM 1.7%) and 11.2% (SEM 1.1%), respectively. Fat and lean mass were not significantly affected by metal artifacts, as differences between values with and without metal were within 1%. Two participants had bilateral breast implants, and in a separate trial, one participant had a unilateral breast implant. Bone mineral content (BMC) in the region with the breast implant was 5.8 times higher than the contralateral side, and whole-body BMC was increased by 4.7%. Metal artifacts and breast implants can confound DXA whole-body bone but not fat and lean results. It is therefore important in clinical studies to account for these factors to detect physiologically relevant differences in bone measures.
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DOI：
10.1056/nejmoa1811403
发表时间：
2019-01-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
Manson JE;Cook NR;Lee IM;Christen W;Bassuk SS;Mora S;Gibson H;Albert CM;Gordon D;Copeland T;D'Agostino D;Friedenberg G;Ridge C;Bubes V;Giovannucci EL;Willett WC;Buring JE;VITAL Research Group
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影响因子：
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作者：
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通讯作者：
WILMORE, DW
影响因子：
19.7
作者：
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通讯作者：
Haramati, N
影响因子：
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Morgan, Sarah L.;Prater, Ginnie L.
通讯作者：
Prater, Ginnie L.
影响因子：
2.2
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Manson JE;Bassuk SS;Lee IM;Cook NR;Albert MA;Gordon D;Zaharris E;Macfadyen JG;Danielson E;Lin J;Zhang SM;Buring JE
通讯作者：
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