目的:关于骨小梁评分(TBS)及其相关因素的人群特异性规范信息有限。这里,我们提供了亚裔印度人的TBS规范及其与血清25-羟基维生素D[25(OH)D]和完整甲状旁腺激素(iPTH)的关系。
方法:TBS,骨矿物质密度(BMD),在923名健康的亚洲印度人(年龄20-60岁)中,使用双能X线骨密度仪评估了椎骨骨折(VFs)。血清25(OH)D,iPTH,T4/TSH,,测量糖化血红蛋白(HbA1c),并使用多变量线性回归评估与TBS的相关性.任何部位BMDZ评分≤-2.0或≥2.0的受试者,VFs,TSH>10.0或<0.05µIU/ml,排除血糖>11.1mmol/L或HbA1c>8.0%的亚裔-印度标准.
结果:在744名健康的亚裔印度人中产生了TBS规范(M:F,389:385)。为“正常”生成的截止值,\'部分降级\',和“降级的”TBS分别>1.305、1.204-1.305和<1.204。女性的平均TBS低于男性(p<.001)。亚洲-印度和现有规范之间的TBS类别一致性为75%。特异性(97.8vs.77.9%,p<.001)和诊断准确性(97.8%与78.4%,p<.001)的TBS检测骨质疏松症与亚洲-印度规范相比更高。与亚洲-印度规范相比,“部分降解的”TBS诊断骨质减少的敏感性也更高。在多变量回归中,性别,身体质量指数(BMI),BMD-L1-L4,血清PTH,每日膳食热量摄入和钙摄入与TBS相关.尽管25(OH)D与PTH呈负相关,25(OH)D与TBS无关。
结论:这项研究为亚裔印度人的TBS提供了具有性别差异的规范。年龄的增加和较高的BMI与较低的TBS相关。TBS与循环PTH和/或25(OH)D的关联需要在进一步研究中确认。
OBJECTIVE: There is limited information on population-specific norms of trabecular-bone-score (TBS) and its associated factors. Here, we provide norms of TBS in Asian-Indians and its relationship with serum 25-hydroxyvitamin D [25(OH)D] and intact-parathyroid hormone (iPTH).
METHODS: TBS, bone-mineral-density (BMD), and vertebral-fractures (VFs) were assessed using dual-energy X-ray absorptiometry in 923 healthy Asian-Indians (aged 20-60 years). Serum 25(OH)D, iPTH, T4/TSH,, glycosylated-haemoglobin (HbA1c) were measured and associations with TBS assessed using multivariable linear regression. Subjects with BMD Z-score ≤ -2.0 or ≥2.0 at any sites, VFs, TSH > 10.0 or <0.05 µIU/ml, blood-glucose >11.1 mmol/L or HbA1c > 8.0% were excluded for generating Asian-Indian norms.
RESULTS: TBS norms were generated in 744 healthy Asian-Indians (M:F,389:385). The cut-offs generated for \'normal\', \'partially-degraded\', and \'degraded\' TBS were >1.305, 1.204-1.305 and <1.204, respectively. Mean TBS was lower in females than males (p < .001). There was 75% congruency in TBS categories between Asian-Indian and existing norms. Specificity (97.8 vs. 77.9%, p < .001) and diagnostic-accuracy (97.8% vs. 78.4%, p < .001) of TBS to detect osteoporosis were higher with Asian-Indian norms. The sensitivity of \'partially-degraded\' TBS to diagnose osteopenia was also higher with Asian-Indian norms. In multivariable regression, gender, body-mass-index (BMI), BMD-L1-L4, serum
PTH, daily dietary-calorie intake and calcium intake were associated with TBS. Though 25(OH)D inversely correlated with
PTH, 25(OH)D was not associated with TBS.
CONCLUSIONS: This study provides norms for TBS in Asian-Indians with gender-specific differences. Increasing age and higher BMI were associated with lower TBS. Associations of TBS with circulating
PTH and/or 25(OH)D need confirmation in further studies.