腰椎骨密度影响因素的多元线性回归与ROC曲线分析  

Multiple linear regression and ROC curve analysis of the factors of lumbar spine bone mineral density

作　　者：张晓东[1] 赵银霞[1] 胡少勇[1] 郝帅[1] 严杰文[1] 张灵艳[1] 赵静[1] 李绍林[1] 

机构地区：[1]南方医科大学第三附属医院医学影像科广东省骨科研究院骨关节医学影像研究所,广州510630

出　　处：《中华医学杂志》2015年第33期2677-2680,共4页National Medical Journal of China

摘　　要：目的 分析腰椎骨密度与年龄、性别、身高、体质量、体质指数（BMI）、腰围、臀围、骨髓脂肪比（FF％）及腹部脂肪含量的相关性,探讨影响腰椎骨密度的关键因素.方法 2014年4月至2015年4月南方医科大学第三附属医院72名研究对象纳入研究,于1.5 TMR采用单体素点分辨波谱法（PRESS）对腰3椎体（L3）进行波谱采集,计算FF％;同时行腰椎64排CT检查,用定量CT（QCT）分析软件计算L3骨密度（BMD）及相应层面腹部皮下脂肪（SAT）与内脏脂肪（VAT）.SPSS 19.0软件进行统计学分析.结果 多元线性回归分析示年龄、骨髓FF％与BMD关系密切（P＜0.05）,性别、身高、体质量、BMI、腰围、臀围、SAT及VAT与BMD均无关（均P＞0.05）;年龄、FF％与BMD呈负相关（r值分别为-0.830、-0.521,P＜0.05）;ROC曲线分析示年龄58.5岁为最佳临界值,其预测骨质疏松的敏感度为81.8％、特异度为86.9％;骨髓FF％为52.8％为最佳临界值,其预测骨质疏松的敏感度为90.9％,特异度为55.7％.结论 腰椎骨密度与性别、身高、体质量、BMI、腰围、臀围、腹部皮下脂肪及内脏脂肪无明显相关性,与年龄、骨髓FF％呈明显负相关,其中年龄是关键影响因素.Objective To investigate the correlation between the lumbar vertebra bone mineral density（BMD） and age,gender,height,weight,body mass index,waistline,hipline,bone marrow and abdomen fat,and to explore the key factor affecting the BMD.Methods A total of 72 cases were randomly recruited.All the subjects underwent a spectroscopic examination of the third lumber vertebra with singlevoxel method in 1.5T MR.Lipid fractions （FF%） were measured.Quantitative CT were also performed to get the BMD of L3 and the corresponding abdomen subcutaneous adipose tissue （SAT） and visceral adipose tissue （VAT）.The statistical analysis were performed by SPSS 19.0.Results Multiple linear regression showed except the age and FF% showed significant difference （P 〈 O.05）,the gender,height,weight,BMI,waistline,hipline,SAT and VAT showed no significant difference （P 〉 0.05）.The correlation of age and FF% with BMD was statistically negatively significant （r =-0.830,-0.521,P 〈0.05）.The ROC curve analysis showed that the sensitivety and specificity of predicting osteoporosiswere 81.8% and 86.9%,with a threshold of 58.5 years old.And it showed that the sensitivety and specificity of predicting osteoporosis were 90.9% and 55.7%,with a threshold of 52.8% for FF%.Conclusion The lumbar vertebra BMD was significantly and negatively correlated with age and bone marrow FF%,but it was not significantly correlated with gender,height,weight,BMI,waistline,hipline,SAT and VAT.And age was the critical factor.

关 键 词：骨质疏松 磁共振波谱学 体层摄影术 

分 类 号：R580[医药卫生—内分泌]