Quantitative computed tomography of the lumbar spine, not dual X-ray absorptiometry, is an independent predictor of prevalent vertebral fractures in postmenopausal women with osteopenia receiving long-term glucocorticoid and hormone-replacement therapy
Quantitative computed tomography of the lumbar spine, not dual X-ray absorptiometry, is an independent predictor of prevalent vertebral fractures in postmenopausal women with osteopenia receiving long-term glucocorticoid and hormone-replacement therapy
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DOI：
10.1002/art.10277
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发表时间：
2002-05-01
影响因子：
--
通讯作者：
Lane, NE
中科院分区：
文献类型：
--
作者：
Rehman, Q;Lang, T;Lane, NE
Objective.在一组患有糖皮质激素诱导的骨质疏松症的绝经后妇女中，确定哪种骨矿物质密度（BMD）测量方法预测椎骨骨折。我们招募了114名受试者参加这项研究。双能X线骨密度仪（DXA）显示所有患者腰椎或髋部骨质减少，并接受长期糖皮质激素和激素替代治疗（HRT）。对所有受试者进行腰椎、髋关节（和亚区）和前臂（和亚区）DXA BMD测量，脊柱和髋关节（n = 59）定量计算机断层扫描（QCT），以及胸腰椎X线片，以评估普遍的椎体骨折。通过形态测量学确定的椎体骨折患病率要求椎体高度损失大于或等于20%（或大于或等于4 mm）。通过问卷调查获得人口统计学信息。多元回归和分类回归树（CART）分析用于评估椎体骨折的预测因素。百分之二十六的研究对象有普遍的骨折。腰椎、全髋和髋亚区的骨密度（通过QCT测量），但只有腰椎和全髋的骨密度（通过DXA测量）与椎骨骨折的发生率显著相关。然而，只有腰椎骨密度测量的QCT是一个重要的预测椎体骨折。CART分析显示，
Objective. To determine which measurement of bone mineral density (BMD) predicts vertebral fractures in a cohort of postmenopausal women with glueocorticoid-induced osteoporosis.Methods. We recruited 114 subjects into the study. All had osteopenia of the lumbar spine or hip, as demonstrated by dual x-ray absorptiometry (DXA), and were receiving long-term glucocorticoids and hormone replacement therapy (HRT). Measurements of BMD by DXA of the lumbar spine, hip (and subregions), and forearm (and subregions), quantitative computed tomography (QCT) of the spine and hip (n = 59), and radiographs of the thoracolumbar spine were performed on all subjects to assess prevalent vertebral fractures. Vertebral fracture prevalence, as determined by morphometry, required a greater than or equal to20% (or greater than or equal to4-mm) loss of vertebral body height. Demographic information was obtained by questionnaire. Multiple regression and classification and regression trees (CART) analyses were used to assess predictors of vertebral fracture.Results. Twenty-six percent of the study subjects had prevalent fractures. BMD of the lumbar spine, total hip and hip subregions, as measured by QCT, but only the lumbar spine and total hip, as measured by DXA, were significantly associated with prevalent vertebral fractures. However, only lumbar spine BMD as measured by QCT was a significant predictor of vertebral fractures. CART analysis showed that a BMD value