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Abstract：
OBJECTIVE: We aim to investigate the relations among effective atomic number (Zeff), density, and area of paraspinal muscles, volumetric bone mineral density (vBMD), and acute vertebral fractures (VF) by using spectral base images (SBIs) and routine CT images.
METHODS: A total of 223 patients (52 men and 171 women) with acute lumber VF and 776 subjects (286 men and 390 women) without VF of at least 60 years were enrolled and underwent dual-layer detector CT scans. We quantified the cross-sectional area, density (paraSMD), and Zeff of paraspinal muscles by CT images and SBIs and measured vBMD of the lumbar spine by quantitative CT.
RESULTS: Higher vBMD was associated with lower VF risk in both sexes (adjusted OR, 0.33 and 0.43). After adjusting for age and body mass index, the associations of paraSMD with VF were not significant in men, and in women the association was borderline significant (OR, 0.80; 95% CI, 0.64-1.00). However, higher Zeff of paraspinal muscles was associated with lower VF risk in men (adjusted OR, 0.59; 0.36-0.96) but not in women. The associations of all muscle indexes with VF were not significant after further adjusting for vBMD.
CONCLUSIONS: A higher Zeff of paraspinal muscles is associated with lower VF risk in older men but not in older women. The density, area, and Zeff of paraspinal muscles were not vBMD independent risk factors for acute VF.
CONCLUSIONS: The effective atomic number of paraspinal muscles might be a potential marker for VF risk prediction.
METHODS: A total of 223 patients (52 men and 171 women) with acute lumber VF and 776 subjects (286 men and 390 women) without VF of at least 60 years were enrolled and underwent dual-layer detector CT scans. We quantified the cross-sectional area, density (paraSMD), and Zeff of paraspinal muscles by CT images and SBIs and measured vBMD of the lumbar spine by quantitative CT.
RESULTS: Higher vBMD was associated with lower VF risk in both sexes (adjusted OR, 0.33 and 0.43). After adjusting for age and body mass index, the associations of paraSMD with VF were not significant in men, and in women the association was borderline significant (OR, 0.80; 95% CI, 0.64-1.00). However, higher Zeff of paraspinal muscles was associated with lower VF risk in men (adjusted OR, 0.59; 0.36-0.96) but not in women. The associations of all muscle indexes with VF were not significant after further adjusting for vBMD.
CONCLUSIONS: A higher Zeff of paraspinal muscles is associated with lower VF risk in older men but not in older women. The density, area, and Zeff of paraspinal muscles were not vBMD independent risk factors for acute VF.
CONCLUSIONS: The effective atomic number of paraspinal muscles might be a potential marker for VF risk prediction.
摘要：
目的：研究有效原子序数(Zeff)与密度,和椎旁肌肉区域，体积BMD（vBMD），和急性椎骨骨折（VF），通过使用光谱基础图像（SBIs）和常规CT图像。
方法：共纳入223例急性VF患者（52例男性和171例女性）和776例至少60年无VF患者（286例男性和390例女性），并接受了双层探测器CT扫描。我们量化了横截面积(paraSMA)，通过CT图像和SBI测量椎旁肌肉的密度（paraSMD）和Zeff，并通过定量CT测量腰椎的vBMD。
结果：较高的vBMD与男女较低的VF风险相关（调整后的OR，0.33和0.43）。在调整了年龄和BMI后，ParaSMD与VF的相关性在男性中并不显着，在女性中，该协会是临界显著的(OR，0.80；95%CI，0.64至1.00）。然而,男性椎旁肌Zeff较高与VF风险较低相关(调整后的OR，0.59；0.36至0.96），但不是女性。进一步调整vBMD后，所有肌肉指数与VF的关联均不显着。
结论：椎旁肌Zeff较高与老年男性VF风险较低相关，但与老年女性无关。密度，椎旁肌面积和Zeff不是急性VF的vBMD独立危险因素。
结论：椎旁肌的有效原子序数可能是预测椎体骨折风险的潜在标志。
方法：共纳入223例急性VF患者（52例男性和171例女性）和776例至少60年无VF患者（286例男性和390例女性），并接受了双层探测器CT扫描。我们量化了横截面积(paraSMA)，通过CT图像和SBI测量椎旁肌肉的密度（paraSMD）和Zeff，并通过定量CT测量腰椎的vBMD。
结果：较高的vBMD与男女较低的VF风险相关（调整后的OR，0.33和0.43）。在调整了年龄和BMI后，ParaSMD与VF的相关性在男性中并不显着，在女性中，该协会是临界显著的(OR，0.80；95%CI，0.64至1.00）。然而,男性椎旁肌Zeff较高与VF风险较低相关(调整后的OR，0.59；0.36至0.96），但不是女性。进一步调整vBMD后，所有肌肉指数与VF的关联均不显着。
结论：椎旁肌Zeff较高与老年男性VF风险较低相关，但与老年女性无关。密度，椎旁肌面积和Zeff不是急性VF的vBMD独立危险因素。
结论：椎旁肌的有效原子序数可能是预测椎体骨折风险的潜在标志。
