Trabecular Bone Score as an Indicator for Skeletal Deterioration in Diabetes
Trabecular Bone Score as an Indicator for Skeletal Deterioration in Diabetes
复制标题
DOI：
10.1210/jc.2014-2047
复制
发表时间：
2015-02-01
影响因子：
5.8
通讯作者：
Shin, Chan Soo
中科院分区：
文献类型：
--
作者：
Kim, Jung Hee;Choi, Hyung Jin;Shin, Chan Soo
背景：骨小梁评分 (TBS) 是一种新颖的纹理指数，可评估腰椎双能 X 射线吸收测量图像中的像素灰度变化，并且与独立于骨矿物质密度 (BMD) 的骨微结构相关。目的：我们研究腰椎 TBS 作为糖尿病骨骼恶化的指标。设计和设置： 横断面数据收集自 2009 年至 2010 年正在进行的一项基于社区的前瞻性队列研究的受试者。参与者：我们在 Ansung 队列中纳入了 1229 名年龄超过 50 岁的男性和 1529 名绝经后女性。结果测量：从双能 X 射线骨密度测量图像中获取生化参数、腰椎 TBS 和 BMD 结果：糖尿病男性的腰椎 TBS 低于非糖尿病男性（1.287 +/- 0.005 vs 1.316 +/- 0.003，P < .001），而糖尿病男性的腰椎 BMD 较高（1.135 +/- 0.010 vs 1.088 +/- 0.006 g/cm(2)）。仅在未经调整的模型中，糖尿病女性的腰椎 TBS 低于非糖尿病女性（1.333 +/- 0.004 vs 1.353 +/- 0.003）。然而，年龄小于 65 岁的糖尿病女性 (n = 707) 的 TBS 低于未患糖尿病的女性，即使在调整协变量后也是如此 (P < .001)。糖尿病与男女股骨部位的骨密度均无关。在两性中，TBS 与糖化血红蛋白、空腹血糖、空腹胰岛素和胰岛素抵抗的稳态模型评估呈负相关，但与 β 细胞功能的稳态模型评估无关。结论：腰椎 TBS 与胰岛素抵抗之间的负相关可能使其成为确定高血糖糖尿病患者骨骼恶化的指标。 弹道导弹防御。
Context: Trabecular bone score (TBS) is a novel texture index that evaluates the pixel gray-level variations in lumbar spine dual-energy X-ray absorptiometry images and is related to bone microarchitecture independent of bone mineral density (BMD).Objective: We investigated lumbar spine TBS as an indicator for skeletal deterioration in diabetes.Design and Setting: Cross-sectional data were collected from subjects participating in an ongoing prospective, community-based, cohort study from 2009 to 2010.Participants: We included 1229 men and 1529 postmenopausal women older than 50 years in the Ansung cohort.Outcome Measures: Biochemical parameters, lumbar spine TBS, and BMD from dual-energy X-ray absorptiometry images were measured.Results: Lumbar spine TBS was lower in men with diabetes than in nondiabetic men (1.287 +/- 0.005 vs 1.316 +/- 0.003, P < .001), whereas lumbar spine BMD was higher in men with diabetes (1.135 +/- 0.010 vs 1.088 +/- 0.006 g/cm(2)). Lumbar spine TBS was lower in women with diabetes than in nondiabetic women only in an unadjusted model (1.333 +/- 0.004 vs 1.353 +/- 0.003). However, women younger than 65 years (n = 707) with diabetes had a lower TBS than those without diabetes, even after adjusted for covariates (P < .001). Diabetes was not associated with BMD at femur sites in both genders. TBS was negatively correlated with glycated hemoglobin, fasting plasma glucose, fasting insulin, and homeostasis model assessment for insulin resistance but not with homeostasis model assessment for beta-cell function in both genders.Conclusions: The inverse association between lumbar spine TBS and insulin resistance may make it an indicator for determining skeletal deterioration in diabetic patients who have high BMD.