摘要
目的:探讨在低骨量和骨质疏松人群中与椎体自发压缩性骨折(spontaneous vertebral compression fracture, SVCF)发生相关的体质成分。方法:回顾性分析144例经胸腹部CT平扫并接受定量计算机断层扫描(QCT)骨密度检测和体质成分分析的低骨量和骨质疏松人群,其中椎体骨折组72例,非椎体骨折组72例,两组性别和年龄无显著差异。QCT分析的指标包括:骨密度、椎体横截面积(cross-sectional area, CSA)、椎旁肌CSA、总腹部脂肪CSA、内脏脂肪CSA和椎旁肌内脂肪CSA。比较两组间各指标的差异,采用多因素Logistic回归分析SVCF发生的独立影响因素,并通过ROC曲线分析和DeLong检验进行评估,用偏相关分析变量与骨折压缩程度的相关性。结果:与非椎体骨折组相比,椎体骨折组患者的椎旁肌内脂肪CSA和椎旁肌内脂肪浸润程度显著增加,骨密度显著降低(P<0.05)。多因素Logistic回归分析显示骨密度(OR=0.62,P<0.001)和椎旁肌内脂肪浸润程度(OR=1.79,P<0.001)为SVCF的独立影响因素;ROC曲线分析显示,骨密度和椎旁肌内脂肪浸润程度诊断SVCF的ROC曲线下面积(AUC)分别为0.71、0.68,两者联合诊断的AUC为0.86,经DeLong检验,联合检测的AUC明显高于单独检测(P均<0.05);偏相关性分析表明骨密度与骨折压缩程度呈负相关(r=-0.72,P<0.001),椎旁肌内脂肪浸润程度与骨折压缩程度呈正相关(r=0.61,P<0.001)。结论:骨密度降低和椎旁肌内脂肪浸润增加显著提高SVCF风险,两者同时存在风险更高。
Objective:To investigate the body composition factors associated with the occurrence of spontaneous vertebral compression fractures(SVCF)in individuals with low bone mass or osteoporosis.Methods:A retrospective analysis was conducted on 144 individuals with low bone mass or osteoporosis who underwent non-contrast chest-abdomen CT and received QCT-based bone mineral density measurement and body composition analysis,including 72 cases in the vertebral fractures group and 72 cases in the non-vertebral fracture group.There was no significant differences in age and sex between the two groups.QCT-assessed parameters included bone mineral density(BMD),vertebral cross-sectional area(CSA),paraspinal muscle CSA,total abdominal fat CSA,visceral fat CSA,and paraspinal intramuscular fat CSA.Differences in various indicators between groups were compared.Multivariate logistic regression was used to identify independent risk factors for SVCF.ROC curve analysis and the DeLong test were applied to evaluate diagnostic performance.Partial correlation analysis was used to assess the correlation between variables and the degree of fracture compression.Results:Compared to the non-vertebral fracture group,patients in the vertebral fracture group had significantly increased paraspinal intramuscular fat CSA and fat infiltration,and significantly decreased BMD(P<0.05).Multivariate logistic regression revealed that BMD(OR=0.62,P<0.001)and paraspinal muscle fat infiltration(OR=1.79,P<0.001)were independent risk factors for SVCF.ROC curve analysis showed that the AUCs for diagnosing SVCF using BMD and paraspinal muscle fat infiltration were 0.71 and 0.68,respectively.The combined diagnostic AUC was 0.86.DeLong tests confirmed that the combined model had significantly higher AUC than either factor alone(all P<0.05).Partial correlation analysis showed that BMD was negatively correlated with the degree of fracture compression(r=-0.72,P<0.001),while paraspinal muscle fat infiltration was positively correlated(r=0.61,P<0.001).Conclusion:Decreased BMD and increased paraspinal muscle fat infiltration significantly elevate the risk of SVCF,and their coexistence exerts an even higher risk.
作者
蒋小玥
单秀红
潘冬刚
刘博文
陆思远
唐志洋
JIANG Xiaoyue;SHAN Xiuhong;PAN Donggang;LIU Bowen;LU Siyuan;TANG Zhiyang(Department of Radiology,Affiliated People′s Hospital of Jiangsu University,Zhenjiang Jiangsu 212001,China)
出处
《江苏大学学报(医学版)》
2025年第3期245-249,261,共6页
Journal of Jiangsu University:Medicine Edition
基金
镇江健康与生命科学重点实验室专项项目(GZsYS202302)
江苏大学附属人民医院科研基金项目(Y2021011-S,Y2022024)。
关键词
椎体自发压缩性骨折
骨质疏松
低骨量
定量CT
骨密度
体质成分
spontaneous vertebral compression fracture
osteoporosis
low bone mass
quantitative CT
bone mineral density
body composition
