股骨颈aBMD和vBMD与骨面积的关系及对诊断骨质疏松的影响  

Relationship of aBMD and vBMD with bone area and their effects on diagnosis of osteoporosis at femoral neck

作　　者：钟如意[1] 廖二元[1] 伍贤平[1] 张红[1] 罗湘杭[1] 张蓉[1] 

机构地区：[1]中南大学湘雅二医院代谢内分泌研究所,长沙410011

出　　处：《中国骨质疏松杂志》2008年第10期718-723,共6页Chinese Journal of Osteoporosis

摘　　要：目的探讨股骨颈的面积骨密度（aBMD）和体积骨密度（vBMD）与骨面积（BA）之间的关系及其对诊断骨质疏松（OP）的影响。方法采用QDR-4500A型扇形束双能X线吸收法骨密度仪,测量5585例年龄5～96岁的女性髋部（股骨近端）股骨颈的BA、骨矿含量（BMC）、aBMD和vBMD。结果股骨颈aBMD和vBMD的峰值BMD（x±s）分别为0.8098±0.1017g/cm^2和0.1747±0.0244g/cm^3,BMC与BA呈显著正相关（r=0.350,P=0.000）,aBMD与BA相关无显著性（r=-0.022,P=0.104）,vBMD与BA呈显著负相关（r=-0.381,P=0.000）。年龄≥40岁（平均52.7±9.58岁）的受试者（n=4012）股骨颈BA按四分位数分成Q1、Q2、Q3和Q4组,各组之间的BMC呈显著性梯次增加,vBMD呈显著性梯次减少,各组之间的aBMD无显著性差异。采用aBMD诊断时,四个组的OP检出率分别为Q1=8.59%、Q2=7.67%、Q3=8.86%和Q4=9.07%,各组之间的差异无显著性意义;采用vBMD诊断OP时,四个组的OP检出率分别为Q1=1.90%、Q2=4.88%、Q3=6.87%和Q4=13.4%,呈显著性梯次增加。在年龄≥40岁的全体受试者,aBMD的OP检出率（8.55%）显著高于vBMD（6.80%）,两者的诊断齐同率为67.1%。结论该研究揭示股骨颈aBMD与骨骼大小不相关,vBMD与骨骼大小呈负相关。aBMD的OP检出率显著高于vBMD。Objective To probe into the relationship of areal bone mineral density （aBMD） and volumetric bone mineral density （vBMD） with bone area （BA） and their effects on diagnosis of osteoporosis（OP）. Methods BA, bone mineral content （BMC）, aBMD and vBMD at the femoral neck were measured by QDR-4500A fan beam Dual-energy X-ray absorptiometry bone densitometer in 5585 females aged 5 to 96 years. Results Peak BMD（x± s） of aBMD and vBMD at the femoral neck were 0.8098 ± 0.1017 g/cm^2 and 0.1747 ± 0.0244 g/cm^3, respectively. There was a significant positive eorelation between BMC and BA （ r = 0.350, P = 0.000）. No significant correlations were found between aBMD and BA （ r = - 0.022, P = 0. 104）. vBMD showed significantly negative correlations with BA （ r = - 0.381, P = 0.000）. The subjects aged more than 40 years （average age 52.7 ±9.58 years） （n = 4012） were grouped into Q1, Q2, Q3 and Q4 group according to BA quartile at the femoral neck. BMC presented an obvious gradient increase among the groups, vBMD showed an obvious gradient decrease. No significant differences were found in the aBMD among the groups. When we use aBMD to diagnose OP, detection rates of OP among these four groups were Q1 = 8.59%, Q2 = 7.67%, Q3 = 8.86% and Q4 = 9.07%, respectively. No significant differences were found among the groups. When we use vBMD to diagnose OP, detection rates of OP among these four groups were Q1 = 1.90%, Q2 = 4.88%, Q3 = 6.87% and Q4 = 13.4%, respectively, showing an obvious gradient increment. Detection rates of OP by aBMD （8.55%） was significantly higher than that by vBMD （6.80%） among all subjects aged more than 40 years. Conclusion This study indicates that aBMD is not correlated with bone size. While vBMD is negatively correlated with bone size.Detection rates of OP by aBMD is significantly higher than that by vBMD.

关 键 词：股骨颈 骨面积 面积骨密度 体积骨密度 骨质疏松 

分 类 号：R816.8[医药卫生—放射医学]