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Abstract：
Bone Strain Index (BSI) is a new dual-energy x-ray absorptiometry (DXA)-based index. We retrospectively evaluated data from 153 postmenopausal women with a history of type 2 diabetes mellitus (T2DM). Lumbar spine and femoral Bone Strain Index (BSI) were sensitive to skeletal impairment in postmenopausal women suffering from T2DM.
OBJECTIVE: Bone Strain Index (BSI) is a new dual-energy X-ray absorptiometry (DXA)-based measurement. We evaluated the performance of BSI in predicting the presence of fragility fractures in type 2 diabetes mellitus (T2DM) postmenopausal women.
METHODS: We retrospectively evaluated data from a case-control study of 153 postmenopausal women with a history of at least 5 years of T2DM (age from 40 to 90 years). For each subject, we assessed the personal or familiar history of previous fragility fractures and menopause age, and we collected data about bone mineral density (BMD), BSI, and Trabecular Bone Score (TBS) measurements. Statistical analysis was performed having as outcome the history of fragility fractures.
RESULTS: Out of a total of 153 subjects, n = 22 (14.4%) presented at least one major fragility fracture. A negative correlation was found between lumbar BSI and lumbar BMD (r = - 0.49, p < 0.001) and between total femur BSI and total femur BMD (r = - 0.49, p < 0.001). A negative correlation was found between femoral neck BSI and femoral neck BMD (r = - 0.22, p < 0.001). Most DXA-based variables were individually able to discriminate between fractured and non-fractured subjects (p < 0.05), and lumbar BSI was the index with the most relative difference between the two populations, followed by femoral BSI.
CONCLUSIONS: Lumbar spine and femoral BSI are sensitive to skeletal impairment in postmenopausal women suffering from T2DM. The use of BSI in conjunction with BMD and TBS can improve fracture risk assessment.
OBJECTIVE: Bone Strain Index (BSI) is a new dual-energy X-ray absorptiometry (DXA)-based measurement. We evaluated the performance of BSI in predicting the presence of fragility fractures in type 2 diabetes mellitus (T2DM) postmenopausal women.
METHODS: We retrospectively evaluated data from a case-control study of 153 postmenopausal women with a history of at least 5 years of T2DM (age from 40 to 90 years). For each subject, we assessed the personal or familiar history of previous fragility fractures and menopause age, and we collected data about bone mineral density (BMD), BSI, and Trabecular Bone Score (TBS) measurements. Statistical analysis was performed having as outcome the history of fragility fractures.
RESULTS: Out of a total of 153 subjects, n = 22 (14.4%) presented at least one major fragility fracture. A negative correlation was found between lumbar BSI and lumbar BMD (r = - 0.49, p < 0.001) and between total femur BSI and total femur BMD (r = - 0.49, p < 0.001). A negative correlation was found between femoral neck BSI and femoral neck BMD (r = - 0.22, p < 0.001). Most DXA-based variables were individually able to discriminate between fractured and non-fractured subjects (p < 0.05), and lumbar BSI was the index with the most relative difference between the two populations, followed by femoral BSI.
CONCLUSIONS: Lumbar spine and femoral BSI are sensitive to skeletal impairment in postmenopausal women suffering from T2DM. The use of BSI in conjunction with BMD and TBS can improve fracture risk assessment.
摘要：
骨应变指数（BSI）是一种基于双能X射线吸收法（DXA）的新指数。我们回顾性评估了153名有2型糖尿病（T2DM）病史的绝经后妇女的数据。腰椎和股骨骨应变指数（BSI）对患有T2DM的绝经后妇女的骨骼损害敏感。
目的：骨应变指数（BSI）是一种基于双能X射线吸收法（DXA）的新型测量方法。我们评估了BSI在预测2型糖尿病（T2DM）绝经后妇女脆性骨折中的表现。
方法：我们回顾性评估了来自153名绝经后妇女的病例对照研究的数据，这些妇女有至少5年的T2DM病史（年龄从40岁到90岁）。对于每个主题，我们评估了个人或熟悉的既往脆性骨折史和绝经年龄，我们收集了骨矿物质密度（BMD）的数据，BSI,和骨小梁评分(TBS)测量。进行统计分析，结果是脆性骨折的病史。
结果：在总共153名受试者中，n=22（14.4％）出现至少一个主要的脆性骨折。腰椎BSI与腰椎BMD呈负相关(r=-0.49,p<0.001),股骨总BSI与股骨总BMD呈负相关(r=-0.49,p<0.001)。股骨颈BSI与股骨颈BMD呈负相关(r=-0.22,p<0.001)。大多数基于DXA的变量分别能够区分骨折和非骨折受试者（p<0.05），腰椎BSI是两个人群之间相对差异最大的指标，其次是股骨BSI。
结论：腰椎和股骨BSI对患有T2DM的绝经后妇女的骨骼损伤敏感。BSI与BMD和TBS联合使用可以改善骨折风险评估。
目的：骨应变指数（BSI）是一种基于双能X射线吸收法（DXA）的新型测量方法。我们评估了BSI在预测2型糖尿病（T2DM）绝经后妇女脆性骨折中的表现。
方法：我们回顾性评估了来自153名绝经后妇女的病例对照研究的数据，这些妇女有至少5年的T2DM病史（年龄从40岁到90岁）。对于每个主题，我们评估了个人或熟悉的既往脆性骨折史和绝经年龄，我们收集了骨矿物质密度（BMD）的数据，BSI,和骨小梁评分(TBS)测量。进行统计分析，结果是脆性骨折的病史。
结果：在总共153名受试者中，n=22（14.4％）出现至少一个主要的脆性骨折。腰椎BSI与腰椎BMD呈负相关(r=-0.49,p<0.001),股骨总BSI与股骨总BMD呈负相关(r=-0.49,p<0.001)。股骨颈BSI与股骨颈BMD呈负相关(r=-0.22,p<0.001)。大多数基于DXA的变量分别能够区分骨折和非骨折受试者（p<0.05），腰椎BSI是两个人群之间相对差异最大的指标，其次是股骨BSI。
结论：腰椎和股骨BSI对患有T2DM的绝经后妇女的骨骼损伤敏感。BSI与BMD和TBS联合使用可以改善骨折风险评估。
