胸部CT椎体HU值在2型糖尿病骨质疏松症机会性筛查中的价值  

HU value of chest CT vertebral body in the opportunistic screening of type 2 diabetes mellitus osteoporosis

作　　者：王力平 连天星 胡永荣 杨红胜[1] 曾智谋[1] 刘浩 屈波 Wang Liping;Lian Tianxing;Hu Yongrong;Yang Hongsheng;Zeng Zhimou;Liu Hao;Qu Bo(Department of Orthopedics,First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,Sichuan Province,China)

机构地区：[1]成都医学院第一附属医院骨科,四川省成都市610500

出　　处：《中国组织工程研究》2024年第6期950-954,共5页Chinese Journal of Tissue Engineering Research

基　　金：四川省科技厅项目(21ZDYF3033),项目负责人:屈波;四川省中医药管理局科学技术研究专项课题(2020LC0037),项目负责人:屈波;成都医学院校基金(CYZ19-23),项目负责人:曾智谋;2021年研究生创新基金(YCX2021-28),项目负责人:王力平。

摘　　要：背景:有研究表明基于腰椎CT的HU(hounsfield units)值可以筛查骨质疏松症,而目前因肺部感染就诊的患者增加,肺部感染合并2型糖尿病的患者也随之增加,增加了胸部CT的使用率。目的:探讨胸部CT检查中L_1椎体HU值在2型糖尿病骨质疏松症筛查中的作用。方法:回顾性分析2020年6月至2022年6月成都医学院第一附属医院收治的244例2型糖尿病患者的临床资料。利用双能X射线骨密度仪获得骨密度T值,按WHO的骨质疏松症诊断标准,将研究对象分为非骨质疏松组(n=120)及骨质疏松组(n=124),比较两组患者一般情况、骨密度T值及胸部CT检查中L_(1)椎体的HU值,分析HU值与各部位T值的关系并评估2型糖尿病骨质疏松症的准确性。结果与结论:(1)两组患者性别、年龄、体质量指数、糖化血红蛋白、平均血糖、钙、磷、2型糖尿病患病时间、高血压病史、高脂血症病史之间对比差异无显著性意义(P>0.05);(2)HU值与最低T值呈正相关(r=0.619,P<0.01),与髋部T值呈正相关(r=0.584,P<0.01),与股骨颈T值呈正相关(r=0.641,P<0.01);当HU值取98时,其预测2型糖尿病骨质疏松症具有良好的准确性,敏感性为70.8%;(3)提示基于胸部CT检查的L_1椎体HU值对2型糖尿病患者的骨质疏松症筛查具有良好的价值,可作为2型糖尿病骨质疏松症一种机会性、无成本的补充筛查方法。BACKGROUND:Some studies have shown that the hounsfield units(HU)value based on lumbar CT can be used to screen osteoporosis.At present,the number of patients with pulmonary infection has increased;the number of patients with pulmonary infection and type 2 diabetes is also increasing,which increases the utilization rate of chest CT.OBJECTIVE:To investigate the role of lumbar 1 vertebral body HU value based on chest CT in the screening of type 2 diabetes mellitus osteoporosis.METHODS:The clinical data of 244 patients with type 2 diabetes mellitus treated in the First Affiliated Hospital of Chengdu Medical College from June 2020 to June 2022 were analyzed retrospectively.The bone mineral density was obtained by dual-energy X-ray absorptiometry.According to WHO’s diagnostic criteria for osteoporosis,the subjects were divided into the non-osteoporosis group(n=120)and the osteoporosis group(n=124).The general condition,T value and HU value of lumbar 1 vertebra in chest CT were compared,and the relationship between the HU value and T value of each position was analyzed and the accuracy of type 2 diabetes mellitus osteoporosis was evaluated.RESULTS AND CONCLUSION:(1)There was no significant difference in sex,age,body mass index,glycosylated hemoglobin,mean blood glucose,calcium(Ca),phosphorus(P),time of type 2 diabetes mellitus,history of hypertension and history of hyperlipidemia between the two groups(P>0.05).(2)The HU value was positively correlated with the lowest T value of the hip(r=0.619,P<0.01);the HU value was positively correlated with the hip T value(r=0.584,P<0.01),and the HU value was positively correlated with the femoral neck T value(r=0.641,P<0.01).When the HU value was 98,the prediction of type 2 diabetes mellitus osteoporosis had good accuracy,and the sensitivity was 70.8%.(3)It is concluded that the HU value of the lumbar 1 vertebra based on chest CT examination is of good value for osteoporosis screening in patients with type 2 diabetes mellitus,and may be an opportunistic and cost-free supplementar

关 键 词：胸部CT检查 HU值 2型糖尿病 骨质疏松症 骨密度 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R445