肺部相关的风险因素与以前接触烟草但不符合骨质疏松症查标准的个体的低骨矿物质密度相关
Xinxin Du1, S Mehdi Nouraie1, Jiantao Pu2
1Division of Pulmonary Allergy Critical Care and Sleep, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
概括
肺部疾病的前吸烟者通常有低骨密度. 在CT扫描中检测到的肺独立预测低骨密度,这表明肺应该指导骨质疏松症查.
科学领域:
- 肺部医学
- 骨健康
- 放射学
背景情况:
- 低骨矿物质密度 (BMD) 是骨折,生活质量下降和死亡的重要危险因素.
- 曾经吸烟和肺部疾病的个体有较低的骨质量.
- 目前的骨质疏松症查指南通常不包括前吸烟者或患有慢性肺部疾病 (如COPD或肺气) 的个人.
研究的目的:
- 调查目前不符合骨质疏松症查标准的烟草暴露个体的低骨质疏松症的患病率.
- 在该群体中确定与低骨质量相关的肺特异性风险因素.
- 通过CT扫描发现的肺气是否与前吸烟者的低骨质量有关.
主要方法:
- 在一组472名前吸烟者 (≥40岁,≥10包年历史) 中,使用双能量X射线吸收度 (DXA) 测量骨矿物质密度 (BMD).
- 使用修改的骨折风险评估工具 (FRAX) 评估了骨质疏松症查的资格.
- 分析了与肺相关的因素,包括CT确定的肺气,并根据年龄,性别和糖尿病进行了调整,以确定它们与低骨质量相关的因素.
主要成果:
- 在472名参与者中,28%的人不符合标准骨质疏松症查标准.
- 在不符合查标准的患者中,有55%的患者表现出低骨质量.
- 在没有资格进行查的个体中,在胸部CT扫描中发现的肺显著与低的骨质量相关 (调整后OR为2. 1; 95% CI为1. 02,4. 42).
结论:
- 胸部CT扫描检测到的肺是不符合传统骨质疏松症查标准的前吸烟者低骨质量的一个独立预测指标.
- 这些发现支持将肺作为早期骨矿物密度评估标准纳入骨质疏松症查建议.
- 将肺气纳入查方案可以帮助识别可能被忽视的风险人群.
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