定量超声测定法与双能X线吸收法评估18~40岁成人骨健康的比较分析  

Comparison on Performance of Quantitative Ultrasound and Dual-Energy X-ray Absorptiometry in Evaluating Bone Health of Adults Aged 18-40 Years

作　　者：邝玉娴 程红[2] 郑伊迎 陈伟业 马振新 邹高雍 曾鼎 米杰 刘丽 KUANG Yuxian;CHENG Hong;ZHENG Yiying;CHEN Weiye;MA Zhenxin;ZOU Gaoyong;ZENG Ding;MI Jie;LIU Li(Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China;Department of Epidemiology,Capital Institute of Pediatrics,Beijing 100020,China;Center for Non-Communicable Disease Management,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)

机构地区：[1]广东药科大学公共卫生学院流行病与卫生统计学系,广州510310 [2]首都儿科研究所流行病学研究室,北京100020 [3]国家儿童医学中心首都医科大学附属北京儿童医院儿童慢病管理中心,北京100045

出　　处：《中国医学科学院学报》2023年第5期737-742,共6页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(81874271)。

摘　　要：目的比较定量超声测定法(QUS)与双能X线吸收法(DXA)测量广州市18~40岁成人骨密度的一致性,评估QUS识别低骨量的诊断价值。方法在731名研究对象中,采用DXA测量骨密度(BMD),QUS测量超声传导速度(SOS)。采用Bland-Altman分析评价SOS与BMD Z值的一致性。以BMD Z≤-2.00作为低骨量的诊断标准,绘制QUS的受试者工作特征曲线,并计算曲线下面积(AUC)以及SOS Z值最佳截断值的灵敏度、特异度和正确诊断指数。结果Bland-Altman分析结果显示,男、女性的SOS和BMD Z值的均值差值分别为1.27(-0.94~3.47)和0.93(-1.33~3.18)。男、女性中SOS Z值诊断低骨量的AUC分别为0.734(95%CI=0.380~0.788)、0.679(95%CI=0.625~0.732)。男性中,低骨量的SOS Z值最佳截断值为-0.35,灵敏度、特异度和正确诊断指数分别为64.1%、68.6%和0.327;女性中,低骨量的SOS Z值最佳截断值为-1.14,灵敏度、特异度和正确诊断指数分别为73.9%、54.8%和0.285。结论广州市18~40岁成人中,QUS与DXA诊断骨密度的一致性欠佳,但QUS在识别低骨量上的应用价值尚可。Objective To compare the consistency of quantitative ultrasound(QUS)and dual-energy X-ray absorptiometry(DXA)in measuring bone mineral density(BMD)of adults aged 18-40 years in Guangzhou and evaluate the diagnostic value of QUS for identifying low bone mass.Methods DXA was employed to measure the BMD and QUS to measure the speed of sound(SOS)in 731 participants.The Bland-Altman analysis was performed to evaluate the consistency of Z scores between SOS and BMD.With the BMD Z≤-2.00 as the diagnostic criterion for low bone mass,the receiver operating characteristics curve of QUS was established,and the area under the curve(AUC)and the sensitivity,specificity,and correct diagnostic index for the optimal cut-off of SOS Z score were calculated.Results The results of Bland-Altman analysis showed that the mean differences in the Z scores of SOS and BMD in males and females were 1.27(-0.94 to 3.47)and 0.93(-1.33 to 3.18),respectively.The AUC of SOS Z score in the diagnosis of low bone mass in males and females was 0.734(95%CI=0.380-0.788)and 0.679(95%CI=0.625-0.732),respectively.In males,the optimal cut-off of SOS Z score for low bone mass was-0.35,with the sensitivity,specificity,and correct diagnostic index of 64.1%,68.6%,and 0.327,respectively.In females,the optimal cut-off value of SOS Z scores for low bone mass was-1.14,with the sensitivity,specificity,and correct index of 73.9%,54.8%,and 0.285,respectively.Conclusion QUS and DXA show poor consistency in the diagnosis of BMD in the adults aged 18-40 years in Guangzhou,while QUS demonstrates an acceptable value in identifying low bone mass.

关 键 词：定量超声测定法 双能X线吸收法 超声传导速度 骨密度 低骨量 

分 类 号：R194.3[医药卫生—卫生事业管理]