与性别相关的股胫软骨厚度差异的地形:一个匹配的男性-女性配对分析,控制年龄,bmi和身高

N. Spoelder , W. Wirth , T.D. Turmezei , F. Eckstein , D.A. Kessler , J.W. Mackay , M. Karperien , S.C. Mastbergen , M.P. Jansen
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引用次数: 0

摘要

膝关节炎在女性中比男性更常见且进展更快。虽然我们都知道男性的软骨更厚,但目前还不清楚这种差异是天生的性别差异,还是由年龄、体重指数和/或身高等混杂因素造成的。目的:本研究的目的是评估年龄、BMI和身高匹配的无骨关节炎的男性和女性膝关节软骨厚度的区域差异。方法从骨关节炎倡议(OAI)中选择无膝关节OA影像学征象的参与者。根据身高(±1 cm)、年龄(±5岁)和BMI(±2 kg/m²)对男女进行配对,共得到63对男女配对(n = 126;平均年龄57±8岁,体重指数26±4 kg/m²,身高170±5 cm)。右膝3T MRI扫描使用深度学习模型进行处理,以生成股骨外侧和胫骨轮廓以及内部软骨边界的初步自动分割。这些分割是在Stradview中手工细化并转换为3D表面模型。在每个顶点处计算软骨厚度,作为软骨表面到下面骨骼的距离,沿着法向量使用基于模型的反褶积进行测量。使用wxRegSurf将股骨、胫骨内侧和胫骨外侧表面及其相关的厚度图在空间上与标准模板对齐。在MATLAB中使用SurfStat软件包进行统计分析,采用统计参数映射(SPM)和线性混合模型来评估成对的男女差异。p <为显著性;0.05.结果图1显示了男性和女性的平均软骨厚度,以及性别之间的差异。差异图以蓝色为主,表明男性的软骨较厚。在两性中,外侧软骨比内侧软骨厚。滑车整体厚度最大,男性最大3.98 mm,女性最大3.30 mm。在股骨、胫骨内侧和胫骨外侧的特定区域,男性和女性的软骨厚度在统计学上有显著差异(图2)。在股骨的这些区域,男性的软骨较厚,平均厚度为2.77 mm,而女性为2.42 mm,差异为0.36 mm(15%)。在胫骨内侧和外侧这两个具有统计学意义的不同区域,男性的软骨厚度比女性大0.09 mm(4%),分别为2.26 mm比2.17 mm和2.19 mm比2.10 mm。结论:尽管身高、年龄和BMI相似,但男性的股胫软骨比女性厚。在所有三个关节表面上都发现了统计学上显著的差异,其中滑车的差异最大。这些发现强调需要进一步研究股骨胫骨软骨厚度的性别差异,作为女性膝关节OA患病率和严重程度更高的潜在因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
TOPOGRAPHY OF SEX-RELATED FEMOROTIBIAL CARTILAGE THICKNESS DIFFERENCES: A MATCHED MALE-FEMALE PAIR ANALYSIS CONTROLLING FOR AGE, BMI, AND HEIGHT

INTRODUCTION

Knee OA is both more common and progresses faster in women than in men. While it is well known that men exhibit thicker cartilage, it remains unclear whether this difference is inherently sex-based or attributable to confounding factors such as age, BMI, and/or height.

OBJECTIVE

The aim of this study was to evaluate regional differences in knee cartilage thickness between men and women without radiographic OA, who were matched for age, BMI, and height.

METHODS

Participants without radiographic signs of knee OA were selected from the Osteoarthritis Initiative (OAI). Men and women were matched based on height (±1 cm), age (±5 years), and BMI (±2 kg/m²), yielding 63 male-female pairs (n = 126; mean age 57 ± 8 years, BMI 26 ± 4 kg/m², height 170 ± 5 cm). Right knee 3T MRI scans were processed using a deep learning model to generate preliminary automatic segmentations of the outer femoral and tibial contours and the inner cartilage boundaries. These segmentations were manually refined in Stradview and converted into 3D surface models. Cartilage thickness was computed at each vertex as the distance from the cartilage surface to the underlying bone, measured along the normal vector using model-based deconvolution. The femoral, medial tibial, and lateral tibial surfaces and their associated thickness maps were spatially aligned to canonical templates using wxRegSurf. Statistical analyses were performed in MATLAB using the SurfStat package, applying statistical parametric mapping (SPM) with linear mixed models to evaluate paired male-female differences. Significance was set at p < 0.05.

RESULTS

Figure 1 shows the average cartilage thickness in men and women, as well as the differences between sexes. The difference map is predominantly blue, indicating thicker cartilage in men. In both sexes, cartilage was thicker on the lateral side than on the medial side. The trochlea had the greatest thickness overall, with a maximum of 3.98 mm in men and 3.30 mm in women. Statistically significant differences in cartilage thickness between men and women were observed in specific regions of the femur, medial tibia, and lateral tibia (Figure 2). In those regions in the femur, cartilage was thicker in men, with a mean thickness of 2.77 mm compared to 2.42 mm in women, a difference of 0.36 mm (15%). In both the statistically significant different regions of the medial and lateral tibia, cartilage thickness was 0.09 mm (4%) greater in men than in women, with means of 2.26 mm versus 2.17 mm and 2.19 mm versus 2.10 mm, respectively.

CONCLUSION

Despite similar height, age, and BMI, men exhibited thicker femorotibial cartilage than women. Statistically significant differences were found across all three joint surfaces, with the largest difference observed in the trochlea. These findings underscore the need for further research into sex-related differences in femorotibial cartilage thickness as a potential contributor to the greater prevalence and severity of knee OA in women.
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Osteoarthritis imaging
Osteoarthritis imaging Radiology and Imaging
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