Proximal femoral density and geometry measurements by quantitative computed tomography: Association with hip fracture
Proximal femoral density and geometry measurements by quantitative computed tomography: Association with hip fracture
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DOI：
10.1016/j.bone.2006.06.018
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发表时间：
2007-01-01
期刊：
影响因子：
4.1
通讯作者：
Lang, T.
中科院分区：
文献类型：
--
作者：
Cheng, X.;Li, J.;Lang, T.
简介：通过容积定量计算机断层扫描（vQCT）进行的骨密度和几何结构测量已用于衰老、药物干预和机械卸载的临床研究，但关于这些测量与髋部骨折相关性的信息相对较少。为了解决这个问题，我们进行了一项研究，比较了vQCT参数在中国老年女性髋部骨折与年龄匹配的对照测量。材料与方法：45名髋部骨折女性（平均年龄74.71 ± 5.94）与66名年龄匹配的对照组（平均年龄70.70 ± 4.66）进行了比较。采用vQCT表征股骨近端皮质骨、骨小梁和感兴趣的整体体积中的体积骨矿物质密度。除了感兴趣的体积测量，我们还计算了股骨颈和转子间平面的横截面积、股骨颈轴长、股骨颈弯曲和抗压强度指数以及股骨颈皮质几何形状的测量。为了确定皮质几何测量是否与髋部骨折相关，而不依赖于骨小梁vBMD，我们进行了多变量分析，包括logistic回归模型中的这些参数。结果和结论：所有vQCT测量区分骨折受试者和年龄匹配的对照。骨密度和骨小梁和积分vBMD的体积和面积表示之间的预测强度没有显着差异，显示出相当的判别力，虽然这两种措施更相关的骨折状态比皮质vBMD。我们发现，骨折的受试者有较大的股骨颈横截面积，这与这些患者对较低BNID的适应一致。较大的颈部横截面积导致骨折受试者的弯曲强度指数与对照受试者相当或大于对照受试者。在多变量分析中，股骨颈皮质厚度减少和屈曲比指数与骨折状态相关，与骨小梁vBMD无关。(c)2006年爱思唯尔公司All rights reserved.
Introduction: Bone mineral density and geometry measurements by volumetric quantitative computed tomography (vQCT) have been utilized in clinical research studies of aging, pharmacologic intervention and mechanical unloading, but there is relatively little information about the association of these measures with hip fracture. To address this issue, we have carried out a study comparing vQCT parameters in elderly Chinese women with hip fractures with measurements in age-matched controls. Materials and methods: Forty-five women (mean age 74.71 +/- 5.94) with hip fractures were compared to 66 age-matched control subjects (mean age 70.70 +/- 4.66). vQCT was employed to characterize the volumetric bone mineral density in cortical, trabecular, and integral volumes of interest in the proximal femur. In addition to the volume of interest measurements, we computed the cross-sectional areas of the femoral neck and intertrochanteric planes, the femoral neck axis length, indices of femoral neck bending and compressive strength, and measures of femoral neck cortical geometry. To determine if cortical geometry measures were associated with hip fracture independently of trabecular vBMD, we carried out multi-variate analyses including these parameters in a logistic regression model. Results and conclusions: All vQCT measurements discriminated between fractured subjects and age-matched controls. There was no significant difference in predictive strength between volumetric and areal representations of BMD and trabecular and integral vBMD showed comparable discriminatory power, although both of these measures were more correlated to fracture status than cortical vBMD. We found that fractured subjects had larger femoral neck cross-sectional areas, consistent with adaptation to lower BNID in these osteoporotic subjects. The larger neck cross-sectional areas resulted in bending strength indices in the fractured subjects that were comparable or larger than those of the control subjects. In multi-variate analyses, reduced femoral neck cortical thickness and buckling ratio indices were associated with fracture status independently of trabecular vBMD. (c) 2006 Elsevier Inc. All rights reserved.