Abstract：
OBJECTIVE: The bone strain index (BSI) is a marker of bone deformation based on a finite element analysis inferred from dual X-ray absorptiometry (DXA) scans, that has been proposed as a predictor of fractures in osteoporosis (i.e., higher BSI indicates a lower bone\'s resistance to loads with consequent higher risk of fractures). We aimed to investigate the association between lumbar BSI and vertebral fractures (VFs) in acromegaly.
METHODS: Twenty-three patients with acromegaly (13 males, mean age 58 years; three with active disease) were evaluated for morphometric VFs, trabecular bone score (TBS), bone mineral density (BMD) and BSI at lumbar spine, the latter being corrected for the kyphosis as measured by low-dose X-ray imaging system (EOS®-2D/3D).
RESULTS: Lumbar BSI was significantly higher in patients with VFs as compared to those without fractures (2.90 ± 1.46 vs. 1.78 ± 0.33, p = 0.041). BSI was inversely associated with TBS (rho -0.44; p = 0.034), without significant associations with BMD (p = 0.151), age (p = 0.500), BMI (p = 0.957), serum IGF-I (p = 0.889), duration of active disease (p = 0.434) and sex (p = 0.563).
CONCLUSIONS: Lumbar BSI corrected for kyphosis could be proposed as integrated parameter of spine arthropathy and osteopathy in acromegaly helping the clinicians in identifying patients with skeletal fragility possibly predisposed to VFs.
METHODS: Twenty-three patients with acromegaly (13 males, mean age 58 years; three with active disease) were evaluated for morphometric VFs, trabecular bone score (TBS), bone mineral density (BMD) and BSI at lumbar spine, the latter being corrected for the kyphosis as measured by low-dose X-ray imaging system (EOS®-2D/3D).
RESULTS: Lumbar BSI was significantly higher in patients with VFs as compared to those without fractures (2.90 ± 1.46 vs. 1.78 ± 0.33, p = 0.041). BSI was inversely associated with TBS (rho -0.44; p = 0.034), without significant associations with BMD (p = 0.151), age (p = 0.500), BMI (p = 0.957), serum IGF-I (p = 0.889), duration of active disease (p = 0.434) and sex (p = 0.563).
CONCLUSIONS: Lumbar BSI corrected for kyphosis could be proposed as integrated parameter of spine arthropathy and osteopathy in acromegaly helping the clinicians in identifying patients with skeletal fragility possibly predisposed to VFs.
摘要：
目的：骨应变指数（BSI）是根据从双X射线吸收法（DXA）扫描推断的有限元分析得出的骨变形的标记，已被提议作为骨质疏松症骨折的预测因子(即，较高的BSI表明骨骼对载荷的抵抗力较低，因此骨折的风险较高）。我们旨在研究肢端肥大症中腰椎BSI与椎骨骨折（VFs）之间的关系。
方法：23例肢端肥大症患者（13例男性，平均年龄58岁；三名患有活动性疾病)进行了形态计量学VF评估，骨小梁评分(TBS),腰椎骨密度（BMD）和BSI，如通过低剂量X射线成像系统(EOS®-2D/3D)测量的,后者针对后凸进行校正。
结果：与无骨折患者相比，有VFs患者的腰椎BSI明显更高（2.90±1.46vs.1.78±0.33，p=0.041）。BSI与TBS呈负相关（rho-0.44；p=0.034），与BMD无显著关联（p=0.151），年龄（p=0.500），BMI（p=0.957），血清IGF-I（p=0.889），活动性疾病持续时间(p=0.434)和性别(p=0.563)。
结论：经脊柱后凸矫正的腰椎BSI可作为肢端肥大症的脊柱关节病和骨病的综合参数，帮助临床医生识别可能易患VFs的骨骼脆性患者。
方法：23例肢端肥大症患者（13例男性，平均年龄58岁；三名患有活动性疾病)进行了形态计量学VF评估，骨小梁评分(TBS),腰椎骨密度（BMD）和BSI，如通过低剂量X射线成像系统(EOS®-2D/3D)测量的,后者针对后凸进行校正。
结果：与无骨折患者相比，有VFs患者的腰椎BSI明显更高（2.90±1.46vs.1.78±0.33，p=0.041）。BSI与TBS呈负相关（rho-0.44；p=0.034），与BMD无显著关联（p=0.151），年龄（p=0.500），BMI（p=0.957），血清IGF-I（p=0.889），活动性疾病持续时间(p=0.434)和性别(p=0.563)。
结论：经脊柱后凸矫正的腰椎BSI可作为肢端肥大症的脊柱关节病和骨病的综合参数，帮助临床医生识别可能易患VFs的骨骼脆性患者。
