我国汉族人腰椎骨密度与相邻椎间盘退变的相关性研究  

The association between lumbar spine bone mineral density and lumbar disc degeneration:a study in Han Chinese

作　　者：潘健将[1] 童翔[1] 韩咏梅[2] 陈建[1] 封志云[1] 刘源昊 王跃[1] 

机构地区：[1]浙江大学医学院附属第一医院骨科脊柱实验室,浙江杭州310003 [2]浙江大学医学院附属邵逸夫医院体检中心,浙江杭州310016

出　　处：《中国骨质疏松杂志》2016年第12期1556-1560,共5页Chinese Journal of Osteoporosis

基　　金：国家自然科学基金(NSFC 81371995);浙江省医药卫生科技项目资助(2013KYB103)

摘　　要：目的研究并探讨腰椎骨密度和相邻椎间盘退变之间的相关关系。方法回顾性选取同时有腰椎磁共振和DXA腰椎骨密度检查的男性人群224例、女性人群288例。Pfirrmann法评估腰椎间盘退变程度,多因素回归统计分析腰椎骨密度与年龄、体重指数以及腰椎间盘退变的相关性。结果男性人群年龄显著小于女性人群(P<0.01),而男性人群体重指数大于女性人群(P<0.01);男性人群各节段腰椎骨密度均大于女性人群(P<0.01),女性人群各节段腰椎间盘退变程度均大于男性人群(P<0.01);下腰椎(L3、L4)的腰椎骨密度和腰椎间盘退变程度均比上腰椎高(L1、L2)。男性人群中,下腰椎L4椎体骨密度与相邻的L4/5椎间盘退变程度呈正性相关(Coef.=0.04,P<0.05);女性人群中,下腰椎L3和L4椎体骨密度分别与相邻的L3/4、L4/5椎间盘退变程度呈正性相关(Coef.=0.04,P<0.01);其余椎体骨密度与相邻椎间盘退变均未见统计学相关性。结论下腰椎椎体骨密度越大,相邻的椎间盘退变越严重。相对较高的腰椎骨密度可能是腰椎间盘退变的危险因素。Objective To determine the association between lumbar spine bone mineral density（BMD） and lumbar disc generation（DD） in Han Chinese. Methods From January 2012 to July 2015,224 males and 288 females were recruited into the present study,through three approaches. Each subject had lumbar spine magnetic resonance（MR） study and dual energy x-ray absorptiometry（DXA） lumbar spine BMD measurement. Pfirrmann score system was used to evaluate the degree of DD in the lumbar spine. Multiple variable regression analyses were used to determine the associations between vertebral BMD and DD,adjusting for age and body mass index（BMI）. Results Male subjects were younger than female subjects（P〈0. 01）,but had greater BMI（P〈0. 01）. Male subjects had less severe disc degeneration than female subjects（P〈0. 01）,but had greater vertebral BMD（P〈0. 01）. In male subjects,greater BMD at L4 was significantly associated with greater degree of degeneration in the adjacent intervertebral disc L4/5（Coef. = 0. 04,P〈0. 05）,after controlling for age and BMI. In female subjects,greater BMD at L3 and L4 was significantly associated with greater degree of degeneration in the adjacent intervertebral disc L3/4 and L4/5（Coef.= 0. 04 for both,P〈0. 01 for both）,after controlling for age and BMI. This association was not observed in other lumbar regions（L1-L3 for males and L1-L2 for females）. Conclusion Greater vertebral BMD is associated with greater DD in the lower lumbar region. Relatively greater vertebral BMD is a risk factor for lumbar disc degeneration.

关 键 词：腰椎 骨密度 椎间盘退变 汉族 

分 类 号：R681[医药卫生—骨科学]