PREDICTING VERTEBRAL DEFORMITY USING BONE DENSITOMETRY AT VARIOUS SKELETAL SITES AND CALCANEUS ULTRASOUND
PREDICTING VERTEBRAL DEFORMITY USING BONE DENSITOMETRY AT VARIOUS SKELETAL SITES AND CALCANEUS ULTRASOUND
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DOI：
10.1016/8756-3282(94)00045-x
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发表时间：
1995-03-01
期刊：
影响因子：
4.1
通讯作者：
WASNICH, R
中科院分区：
文献类型：
--
作者：
ROSS, P;HUANG, C;WASNICH, R
我们研究了多个骨骼部位骨密度测量和跟骨超声对评估椎体变形概率的有用性。骨密度（BMD）测量在第二掌骨和中指骨使用放射线吸收法的手X线片，并在腰椎使用双能X线吸收法。使用单能X线吸收法（SXA）测量桡骨远端和桡骨近端，表示为骨矿物质含量（BMC，克/厘米）和BMD（克/平方厘米）。使用SXA（BMD）和宽带超声衰减（BUA）测量跟骨。在本研究的女性中（平均年龄74岁，SD = 5），84名女性发生了新的椎体变形（57例有一个变形，27例有两个或两个以上变形），这些变形是在测量骨密度之前平均9年内通过连续X线片确定的。Logistic回归分析用于计算与密度或超声检查的I-SD差异相对应的变形风险的比值比，并根据年龄进行调整。所有骨测量值均与椎体变形显著相关，比值比（95%置信区间）范围从桡骨近端BMD的1.40（1.10，1.78）至跟骨BMD测量值的1.88（1.45，2.44）。跟骨BUA、跟骨BMD和手部BMD的测量值在与同一模型中的另一测量值同时纳入时通常保持显著性，这表明脊柱或桡骨BMD可能无法提供有关变形风险的更多信息。似乎所有的骨密度和超声测量都提供了关于变形概率的有用信息。这些发现有待于前瞻性研究的证实。
We investigated the usefulness of bone density measurements from multiple skeletal sites and calcaneus ultrasound for evaluating the probability of vertebral deformation. Bone mineral density (BMD) was measured at the second metacarpal and middle phalanges using radiographic absorptiometry of hand radiographs, and at the lumbar spine using dual-energy x-ray absorptiometry. Distal radius and proximal radius were measured using single-energy x-ray absorptiometry (SXA), expressed as bone mineral content (BMC, grams per centimeter), and as BMD (grams per square centimeter). The calcaneus was measured using both SXA (BMD) and broadband ultrasound attenuation (BUA). Among the women in this study (mean age 74, SD = 5), 84 women developed new vertebral deformations (57 cases with one and 27 cases with two or more deformations), which were identified on serial radiographs during an average of 9 years prior to the measurements of bone density. Logistic regression analysis was used to calculate odds ratios for risk of deformation corresponding to a I-SD difference in density or ultrasound, adjusted for age. All bone measurements were significantly associated with vertebral deformation, with odds ratios (95% confidence intervals) ranging from 1.40 (1.10, 1.78) for proximal radius BMD to 1.88 (1.45, 2.44) for calcaneus BMD measurements. Measurements of calcaneal BUA, calcaneal BMD, and hand BMD generally remained significant when included simultaneously with another measurement in the same model, suggesting that spine or radius BMD may not provide much additional information about risk of deformation. It appears that all of the measurements of bone density and ultrasound provide useful information regarding the probability of deformation. These findings await confirmation in a prospective study.