Bone material strength index is associated with prior fracture in men with and without moderate chronic kidney disease
Bone material strength index is associated with prior fracture in men with and without moderate chronic kidney disease
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DOI：
10.1016/j.bone.2020.115241
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发表时间：
2020-04-01
期刊：
影响因子：
4.1
通讯作者：
Pasco, Julie A.
中科院分区：
文献类型：
--
作者：
Holloway-Kew, Kara L.;Rufus-Membere, Pamela;Pasco, Julie A.
背景：慢性肾脏病（CKD）患者骨折的风险较高。骨矿物质密度（BMD）预测CKD患者骨折的能力一直不一致。其他测量方法，如骨小梁评分（TBS）和冲击显微压痕（IMI）可能更有用。这项研究的目的是确定是否TBS或IMI值不同的男性和没有CKD和检查以前的骨折，TBS和IMI values.Methods之间的关联：男性（n = 343，年龄33-96岁）从基隆骨质疏松症研究。使用DXA（Lunar ProdigyPro）测量股骨颈（FNBMD）和腰椎BMD（LSBMD）。根据腰椎扫描（TBS iNsight软件版本2.2）确定TBS。使用OsteoProbe测量IMI值（骨材料强度指数; BMSi）。CKD定义为eGFR < 60 mL/min/1.73m2（n = 53）。根据放射学报告确定了既往低创伤骨折（n = 37）。使用二元逻辑回归检验相关性，调整潜在的混杂因素。结果：男性CKD患者有较高的骨折可能性（调整OR 2.27，95%CI 1.02-5.01）。较高的BMSi与较低的既往骨折可能性相关（1 SD增加的调整OR：0.70; 95%CI 0.51-0.97）。在校正FNBMD（OR 0.68; 95%CI 0.49-0.96）或LSBMD（OR 0.69; 95%CI 0.49-0.95）后，这种相关性持续存在。BMSi和CKD之间未检测到相互作用（p = 0.898）。在两个人群中均未检测到FNBMD、LSBMD或TBS与既往骨折之间的相关性，并且FNBMD、LSBMD或TBS与CKD无相互作用。结论：BMSi与既往骨折相关，但FNBMD、LSBMD和TBS与CKD无关。缺乏相互作用项表明，无论CKD状态如何，BMSi在识别既往骨折可能性方面的表现相似。IMI可用于评估CKD患者的骨折风险。
Background: Patients with chronic kidney disease (CKD) are at high risk for fracture. The ability of bone mineral density (BMD) to predict fractures in CKD patients has been inconsistent. Other measures such as trabecular bone score (TBS) and impact microindentation (IMI) may be more useful in this group. This study aimed to determine if TBS or IMI values differed between men with and without CKD and examine associations between prior fracture, TBS and IMI values.Methods: Men (n = 343, age 33-96 yr) from the Geelong Osteoporosis Study were included. Femoral neck (FNBMD) and lumbar spine BMD (LSBMD) were measured using DXA (Lunar ProdigyPro). TBS was determined from lumbar spine scans (TBS iNsight software Version 2.2). IMI values (bone material strength index; BMSi) were measured using an OsteoProbe. CKD was defined as an eGFR < 60 mL/min/1.73m(2) (n = 53). Prior low trauma fractures (n = 37) were ascertained from radiological reports. Associations were examined using binary logistic regression, adjusting for potential confounders. Interaction terms were tested in all models.Results: Men with CKD tended to have a higher likelihood of prior fracture (adjusted OR 2.27, 95%CI 1.02-5.01). Higher BMSi was associated with a lower likelihood of prior fracture (adjusted OR for 1SD increase: 0.70; 95%CI 0.51-0.97). This association was sustained after adjustment for FNBMD (OR 0.68; 95%CI 0.49-0.96) or LSBMD (OR 0.69; 95%CI 0.49-0.95). No interaction was detected between BMSi and CKD (p = 0.898). No associations were detected between FNBMD, LSBMD or TBS and prior fracture in either population and there were no interactions with CKD for FNBMD, LSBMD or TBS.Conclusions: BMSi was associated with prior fracture in men with and without CKD, however, FNBMD, LSBMD and TBS were not. Lack of an interaction term suggests that BMSi performed similarly in identifying the likelihood of prior fracture, regardless of CKD status. IMI may have clinical utility for assessing fracture risk in patients with CKD.