三分之一桡骨骨密度测量在骨质疏松症诊断中的应用:与股骨和腰椎骨密度的比较分析。

IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Libyan Journal of Medicine Pub Date : 2025-12-01 Epub Date: 2025-05-17 DOI:10.1080/19932820.2025.2506877
Monder Lafi, Hamzah Amin, Muhammed Aqib Khan, Marwan Bukhari
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引用次数: 0

摘要

骨质疏松症的定义是BMD低于年轻成人参考人群≤2.5 SD。骨质疏松症的标准双能x线吸收仪(DXA)扫描涉及股骨颈和腰椎,但替代部位如三分之一半径(1/3 R)只有在这些部位无法到达时才使用。本研究评估了1/3 R、股骨颈和腰椎的骨密度之间的相关性和一致性水平,以评估其诊断价值。研究人员分析了英格兰西北部43,801名DXA扫描患者的数据。其中437例接受了1/3 R扫描。对进行和未进行前臂扫描的患者进行人口统计学比较。主要分析包括在1/3 R、腰椎和双侧股骨区域扫描的患者(n = 183)。Spearman的相关性评估了骨密度的关系,Cohen的kappa分析了骨质疏松症的分类一致性,Bland-Altman图评估了测量偏差。该队列的平均年龄为65.7岁(SD 12.9),其中83.3%为女性,41.2%报告骨折。接受1/3 R扫描的患者(n = 437)年龄较大,体重较重,体重指数(BMI)较高。相关分析显示,1/3 R与股骨/腰椎骨密度之间仅有中度相关性(R = 0.29 ~ 0.36, p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
One-third Radius bone mineral density measurement utility in the diagnosis of osteoporosis: a comparative analysis with femoral and lumbar spine bone mineral density.

Osteoporosis is defined by a BMD ≤ 2.5 SD below the young adult reference population. Standard dual-energy X-ray absorptiometry (DXA) scans for osteoporosis involve the femoral neck and lumbar spine, but alternative sites like the one-third radius (1/3 R) are only used when these sites are inaccessible. This study assessed the correlation and level of agreement between BMD at the 1/3 R, femoral neck, and lumbar spine to evaluate its diagnostic utility. Data from 43,801 patients referred for DXA scans in northwest England were analysed. Of these, 437 underwent 1/3 R scans. Demographic comparisons between patients with and without forearm scans were conducted. The primary analysis included patients with scans at the 1/3 R, lumbar spine, and bilateral femoral regions;(n = 183). Spearman's correlation assessed BMD relationships, Cohen's kappa analysed osteoporosis classification agreement, and Bland-Altman plots evaluated measurement bias. The cohort had a mean age of 65.7 years (SD 12.9), with 83.3% female and 41.2% reporting fractures. Patients who underwent 1/3 R scans (n = 437) were older, heavier, and had a higher body mass index (BMI). Correlation analysis showed only moderate associations between 1/3 R and femoral/lumbar spine BMD ;(r = 0.29 to 0.36, p < 0.001). Cohen's kappa demonstrated only slight agreement for 1/3 R, femoral neck and lumbar spine T-scores (κ = 0.14-0.29). Bland-Altman analysis revealed that 1/3 R scans systematically underestimated BMD relative to femoral and lumbar sites, with mean biases of -0.7 for femoral sites and -1.53 for lumbar spine. The 1/3 R BMD showed poor agreement and systematic underestimation compared to central sites, limiting its reliability for osteoporosis diagnosis. Future research should explore alternative peripheral weight-bearing sites and novel diagnostic technologies to assess BMD where central sites cannot be scanned.

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来源期刊
Libyan Journal of Medicine
Libyan Journal of Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
4.20%
发文量
20
审稿时长
>12 weeks
期刊介绍: Libyan Journal of Medicine (LJM) is a peer-reviewed, Open Access, international medical journal aiming to promote heath and health education by publishing high-quality medical research in the different disciplines of medicine. LJM was founded in 2006 by a group of enthusiastic Libyan medical scientists who looked at the contribution of Libyan publications to the international medical literature and saw that a publication outlet was missing. To fill this gap they launched LJM as a tool for transferring current medical knowledge to and from colleagues in developing countries, particularly African countries, as well as internationally.The journal is still led by a group of Libyan physicians inside and outside Libya, but it also enjoys support and recognition from the international medical community.
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