■多项研究表明,腹部计算机断层扫描(CT)测得的骨骼肌指数(SMI)与骨折风险评估工具(FRAX)估计的骨矿物质密度(BMD)和骨折风险密切相关。尽管一些研究报道,在胸部CT图像上测量的第12胸椎(T12)水平的SMI可用于诊断肌肉减少症,令人遗憾的是,没有研究调查T12水平的SMI与BMD或骨折风险之间的关系.因此,在这项研究中,我们进一步调查了T12水平的SMI与FRAX估计的BMD和骨折风险之间的关系.
■本研究共纳入349名受试者。身高1∶1倾向评分匹配(PSM)后,体重,高血压,糖尿病,高脂血症,高尿酸血症,体重指数(BMI),年龄,和性别,最终纳入162名受试者。SMI,BMD,并获得162名参与者的FRAX评分。SMI和BMD之间的相关性,以及SMI和FRAX,使用Spearman等级相关进行评估。此外,通过受试者工作特征(ROC)曲线分析评价各指标预测骨质疏松的有效性.
■腰椎(L1-4)的BMD与SMI具有很强的相关性(r=0.416,p<0.001),而股骨颈(FN)的BMD也与SMI相关(r=0.307,p<0.001)。SMI与FRAX显著相关,在FN没有和有BMD,对于严重的骨质疏松性骨折(分别为r=-0.416,p<0.001和r=-0.431,p<0.001)和髋部骨折(分别为r=-0.357,p<0.001和r=-0.311,p<0.001)。此外,非骨质疏松组的SMI显著高于骨质疏松组(p<0.001)。SMI有效地预测骨质疏松症,曲线下面积为0.834(95%置信区间0.771-0.897,p<0.001)。
■基于第12胸椎CT图像的SMI可以有效地诊断骨质疏松症并预测骨折风险。因此,SMI可以二次利用胸部CT筛查易发生骨质疏松和骨折的人群,及时进行医疗干预。
UNASSIGNED: Multiple studies have shown that skeletal muscle index (SMI) measured on abdominal computed tomography (CT) is strongly associated with bone mineral density (BMD) and fracture risk as estimated by the fracture risk assessment tool (FRAX). Although some studies have reported that SMI at the level of the 12th thoracic vertebra (T12) measured on chest CT images can be used to diagnose sarcopenia, it is regrettable that no studies have investigated the relationship between SMI at T12 level and BMD or fracture risk. Therefore, we further investigated the relationship between SMI at T12 level and FRAX-estimated BMD and fracture risk in this study.
UNASSIGNED: A total of 349 subjects were included in this study. After 1∶1 propensity score matching (PSM) on height, weight, hypertension, diabetes, hyperlipidemia, hyperuricemia, body mass index (BMI), age, and gender, 162 subjects were finally included. The SMI, BMD, and FRAX score of the 162 participants were obtained. The correlation between SMI and BMD, as well as SMI and FRAX, was assessed using Spearman rank correlation. Additionally, the effectiveness of each index in predicting osteoporosis was evaluated through the receiver operating characteristic (ROC) curve analysis.
UNASSIGNED: The BMD of the lumbar spine (L1-4) demonstrated a strong correlation with SMI (r = 0.416, p < 0.001), while the BMD of the femoral neck (FN) also exhibited a correlation with SMI (r = 0.307, p < 0.001). SMI was significantly correlated with FRAX, both without and with BMD at the FN, for major osteoporotic fractures (r = -0.416, p < 0.001, and r = -0.431, p < 0.001, respectively) and hip fractures (r = -0.357, p < 0.001, and r = -0.311, p < 0.001, respectively). Moreover, the SMI of the non-osteoporosis group was significantly higher than that of the osteoporosis group (p < 0.001). SMI effectively predicts osteoporosis, with an area under the curve of 0.834 (95% confidence interval 0.771-0.897, p < 0.001).
UNASSIGNED: SMI based on CT images of the 12th thoracic vertebrae can effectively diagnose osteoporosis and predict fracture risk. Therefore, SMI can make secondary use of chest CT to screen people who are prone to osteoporosis and fracture, and carry out timely medical intervention.