Bone structure assessed by HR-pQCT, TBS and DXL in adult patients with different types of osteogenesis imperfecta
Bone structure assessed by HR-pQCT, TBS and DXL in adult patients with different types of osteogenesis imperfecta
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DOI：
10.1007/s00198-015-3156-4
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发表时间：
2015-10-01
影响因子：
4
通讯作者：
Resch, H.
中科院分区：
文献类型：
--
作者：
Kocijan, R.;Muschitz, C.;Resch, H.
通过高分辨率外周定量计算机断层扫描 (HR-pQCT) 对患有轻度、中度和重度成骨不全 (OI) 的成年患者进行骨微结构总结评估。同样，对成骨不全患者的骨小梁评分 (TBS)、双能 X 射线吸收测定法 (DXA) 测定的骨矿物质密度 (BMD) 以及跟骨双 X 射线和激光 (DXL) 进行了评估。成骨不全患者的小梁微观结构和骨密度尤其严重改变。简介 成骨不全患者的特点是骨折风险高，但骨密度不一定低。本研究的主要目的是评估不同类型 OI 不同骨骼部位的骨微结构和 BMD。 方法 对 30 名 OI 患者进行 HR-pQCT（轻度 OI-I，n = 18（41.8 [34.7，55.7] 岁）和中度至重度 OI-III-IV，n = 12（47.6 [35.3，58.4] 岁））和30 名年龄匹配的健康对照。同样，仅对成骨不全患者进行腰椎和髋部的 TBS、DXA 测量的 BMD 以及跟骨的 DXL 测量的 BMD。结果 在桡骨处，小梁参数显着降低，包括 BV/TV（分别为 p = 0.01 和 p < 0.0001）和小梁数量（分别为 p < 0.0001 和 p < 0.0001），并且增加了与对照组相比，OI-I 和 OI-III-IV 中观察到小梁网络的不均匀性（分别为 p < 0.0001 和 p < 0.0001）。在胫骨处也发现了类似的小梁参数结果。 OI-III-IV 的微观结构参数比 OI-I 更差。三个亚组在桡骨处的皮质厚度和皮质孔隙度没有发现显着差异。与对照组相比，OI-I 的胫骨皮质厚度较薄 (p < 0.001)，但 OI-III-IV 则不然。结论 临床 OI-I 和 OI-III-IV 患者的小梁 BMD 和骨小梁微结构发生了严重改变。低 TBS 和 DXL 及其与骨小梁 HR-pQCT 参数的显着关联支持这一结论。
The Summary Bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT) was assessed in adult patients with mild, moderate, and severe osteogenesis imperfecta (OI). The trabecular bone score (TBS), bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), and dual X-ray and laser (DXL) at the calcaneus were likewise assessed in patients with OI. Trabecular microstructure and BMD in particular were severely altered in patients with OI.Introduction OI is characterized by high fracture risk but not necessarily by low BMD. The main purpose of this study was to assess bone microarchitecture and BMD at different skeletal sites in different types of OI.Methods HR-pQCT was performed in 30 patients with OI (mild OI-I, n = 18 (41.8 [34.7, 55.7] years) and moderate to severe OI-III-IV, n = 12 (47.6 [35.3, 58.4] years)) and 30 healthy age-matched controls. TBS, BMD by DXA at the lumbar spine and hip, as well as BMD by DXL at the calcaneus were likewise assessed in patients with OI only.Results At the radius, significantly lower trabecular parameters including BV/TV (p = 0.01 and p < 0.0001, respectively) and trabecular number (p < 0.0001 and p < 0.0001, respectively) as well as an increased inhomogeneity of the trabecular network (p < 0.0001 and p < 0.0001, respectively) were observed in OI-I and OI-III-IV in comparison to the control group. Similar results for trabecular parameters were found at the tibia. Microstructural parameters were worse in OI-III-IV than in OI-I. No significant differences were found in cortical thickness and cortical porosity between the three subgroups at the radius. The cortical thickness of the tibia was thinner in OI-I (p < 0.001), but not OI-III-IV, when compared to controls.Conclusions Trabecular BMD and trabecular bone microstructure in particular are severely altered in patients with clinical OI-I and OI-III-IV. Low TBS and DXL and their significant associations to HR-pQCT parameters of trabecular bone support this conclusion.