江苏大学学报（医学版）2025，Vol.35Issue(3)：245-249,261,6.DOI:10.13312/j.issn.1671-7783.y240186
骨密度和椎旁肌内脂肪浸润程度对骨量异常人群发生椎体自发压缩性骨折的预测价值
The predictive value of bone mineral density and paraspinal muscle fat infiltration for spontaneous vertebral compression fractures in individuals with abnormal bone mass
摘要
Abstract
Objective:To investigate the body composition factors associated with the occurrence of spontaneous vertebral compression fractures(SVCF)in individuals with low bone mass or osteoporosis.Methods:A retrospective analysis was conducted on 144 individuals with low bone mass or osteoporosis who underwent non-contrast chest-abdomen CT and received QCT-based bone mineral density measurement and body composition analysis,including 72 cases in the vertebral fractures group and 72 cases in the non-vertebral fracture group.There was no significant differences in age and sex between the two groups.QCT-assessed parameters included bone mineral density(BMD),vertebral cross-sectional area(CSA),paraspinal muscle CSA,total abdominal fat CSA,visceral fat CSA,and paraspinal intramuscular fat CSA.Differences in various indicators between groups were compared.Multivariate logistic regression was used to identify independent risk factors for SVCF.ROC curve analysis and the DeLong test were applied to evaluate diagnostic performance.Partial correlation analysis was used to assess the correlation between variables and the degree of fracture compression.Results:Compared to the non-vertebral fracture group,patients in the vertebral fracture group had significantly increased paraspinal intramuscular fat CSA and fat infiltration,and significantly decreased BMD(P<0.05).Multivariate logistic regression revealed that BMD(OR=0.62,P<0.001)and paraspinal muscle fat infiltration(OR=1.79,P<0.001)were independent risk factors for SVCF.ROC curve analysis showed that the AUCs for diagnosing SVCF using BMD and paraspinal muscle fat infiltration were 0.71 and 0.68,respectively.The combined diagnostic AUC was 0.86.DeLong tests confirmed that the combined model had significantly higher AUC than either factor alone(all P<0.05).Partial correlation analysis showed that BMD was negatively correlated with the degree of fracture compression(r=-0.72,P<0.001),while paraspinal muscle fat infiltration was positively correlated(r=0.61,P<0.001).Conclusion:Decreased BMD and increased paraspinal muscle fat infiltration significantly elevate the risk of SVCF,and their coexistence exerts an even higher risk.关键词
椎体自发压缩性骨折/骨质疏松/低骨量/定量CT/骨密度/体质成分Key words
spontaneous vertebral compression fracture/osteoporosis/low bone mass/quantitative CT/bone mineral density/body composition分类
临床医学引用本文复制引用
蒋小玥,单秀红,潘冬刚,刘博文,陆思远,唐志洋..骨密度和椎旁肌内脂肪浸润程度对骨量异常人群发生椎体自发压缩性骨折的预测价值[J].江苏大学学报（医学版）,2025,35(3):245-249,261,6.基金项目
镇江健康与生命科学重点实验室专项项目(GZsYS202302) （GZsYS202302）
江苏大学附属人民医院科研基金项目(Y2021011-S,Y2022024) （Y2021011-S,Y2022024）
