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Objective:To establish the normal reference value of lumbar bone mineral density (BMD) under quantitative CT (QCT) in Chinese healthy adult females and to explore the regional differences.Methods:Total of 35 431 healthy women who met the inclusion criteria of Chinese health quantitative CT big data program were selected in this study. The BMD of the central plane of L 1 and L 2 vertebrae was measured by Mindways′s QCT system, and the mean value was taken. One-way analysis of variance was used to compare the BMD differences of lumbar vertebrae in women of different ages and regions. The subjects were grouped by an age interval of 10 years, and the level of BMD in different regions of the same age group were compaired. Results:The peak BMD of Chinese healthy adult women appeared in the age group of 20-29 years (Northeast China(183.01±24.58) mg/cm 3, North China (188.93±24.80) mg/cm 3, East China (187.54±27.71) mg/cm 3, South China (186.22±33.72) mg/cm 3, Central China (176.33±24.91) mg/cm 3, Southwest China(182.25±28.00) mg/cm 3), and then it decreased with age. The level of BMD in different regions decreased with the age. Before the age of 70 years, BMD in Central and Southwest China was always at a low level((176.23±24.91) to (90.38±28.12) mg/cm 3, 182.25±28.00 to (88.55±25.68) mg/cm 3), lower than those in Northeast China ((183.01±24.58) to (99.69±27.85) mg/cm 3), North China ((188.93±24.80) to (95.89±26.12) mg/cm 3), East China ((187.54±27.71) to (95.65±27.86) mg/cm 3). After 70 years of age, BMD tended to be the same in different regions ( P>0.05). The BMD values in Central China and Southwest China were similar in the age group of 40-60 years ( P>0.05). The BMD values in the health adult femles in the age group of 60 years in different regions of Chinawere all lower than those of bone mass abnormality (all P<0.05). The detection rate of osteoporosis in females over 50 years was the highest in Southwest China (25.65%) and it was the lowest in North China (17.30%). Conclusions:This study establishes reference values of BMD under QCT in healthy Chinese women, which can be used as a reference basis for identifying women with low BMD who are at risk of osteoporosis. The BMD value is the lowest in Southwest China and the highest in South China.
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Objective:To describe the baseline characteristics of the subjects enrolled in the China Quantitative CT (QCT) big data program in 2018—2019.Methods:Based on baseline data from the Chinese health big data project from January 2018 to December 2019 from the eligible enrolled population, measurements of bone mineral density (BMD) and visceral adipose tissue (VAT) were performed using Mindways′ QCT Pro Model 4 system. The baseline data of age, gender, regional distribution, height, weight, abdominal circumference, blood pressure, blood routine and blood biochemical tests were analyzed. And the single factor analysis of variance (ANOVA) was used to check the age related trend of BMD and VAT in both genders.Results:After screening the inclusion exclusion criteria and outliers of the main indicators, 86 113 people were enrolled in the project. The enrollment rate was 92.47%, including 35 431 (41.1%) women and 50 682 (58.9%) men, and the ratio of men to women was 1.43. The mean age was (50.3±12.7) years in all the subjects, and it was (50.2±12.8) years and (50.4±12.5) years in men and women, respectively, and there was no statistical difference between the two genders ( P>0.05). Total of 43 833 people were enrolled in east China, it was the largest group by region (50.90%), it was followed by central China (16 434 people, 19.08%), and the number of people enrolled in Northeast China was the lowest (2 914 people, 3.38%). The rate of completing of health information indicators related to the main outcome of the study were all above 70%, and there were significant differences between men and women (all P<0.05). The mean BMD was (139.33±46.76) mg/cm 3 in women, (135.90±36.48) mg/cm 3 in men, which showed a decreasing trend with age in both gender (both P<0.001); the mean intra-abdominal fat area was (116.39±56.23) cm 2 in women, (191.67±77.07) cm 2 in men, and there was an increasing trend with age in both men and women (both P<0.001). Conclusions:There are gender differences in BMD and VAT measured by QCT with different age tendency, and there are gender differences in health information index. Regional factors should also be taken into account for regional differences in the inclusion of data.
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Objective To observe the therapeutic effect of Taoshi Jiangu Decoction for osteoporosis(OP). Methods A total of 120 cases of OP patients were randomly divided into treatment group and control group ,60 cases in each group. Patients in the treatment group were treated with Taoshi Jiangu Decoction orally,and those in the control group were treated with Caltrate D and Alendronate Sodium Tablets orally. Four weeks constituted one treatment course, and the treatment for the two groups covered 3 courses. The therapeutic effect of the two groups was evaluated by the changes of traditional Chinese medicine(TCM)syndrome scores,urine hydroxyproline (U-HYP),serum bone Gla-protein (BGP or osteocalcin),serum alkaline phosphatase (ALP),urine calcium (U-Ca),tartrate resistant acid phosphatase (TRAP), bone mass density(BMD) and quantitative CT(QCT) before and after treatment. Results (1)After treatment, the TCM syndrome scores of the two groups were decreased(P<0.05 compared with those before treatment),and the decrease in the treatment group was superior to that of the control group (P < 0.05). (2)After treatment,the levels of bone formation indexes of ALP and BGP were increased,and the levels of bone resorption indexes of U-HYP,U-Ca and TRAP were decreased in the two groups (P<0.05 compared with those before treatment). The effects of the treatment group were superior to those of the control group,the difference being statistically significant(P < 0.05).(3)After treatment,BMD of lumbar vertebrae 2-4 (L2-L4),neck of femur,Wards triangle and trochanter of femur,and QCT values of left neck of femur were obviously increased in the two groups (P < 0.05 compared with those before treatment). The treatment group showed stronger effect on increasing BMD and QCT values than the control group, the difference being statistically significant (P < 0.05). Conclusion Taoshi Jiangu Decoction can restrain bone absorption , promote bone formation and increase BMD, showing certain therapeutic effect for OP.
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Objective To investigate the reproducibility and accuracy of spinal BMD (bone mineral density) by low mA using adaptive statistic iterative reconstruction based on phantom model.Methods European spine phantom (ESP) was scanned with 5 different tube currents (40,60,80,100 and 120 mA) on the GE Revolution prototype.All data were transferred to the quantitative CT (QCT) PRO workstation for measuring the bone mineral density (BMD).And all data were reconstructed using different adaptive statistical iterative reconstruction veo (ASiR-V) weighting percentages from ASiR-V 0 filtered back projection(FBP) to ASiR-V 100％,at interval of 20％.Quantitative measurements of CT value,noise,and contrast noise ratio (CNR) of L1,L2 and L3 were measured in each group.The singlefactor analysis of variance (ANOVA) was used to compare the bone mineral density values of different mA and ASiR-V weighting percentages.Results Volume CT dose index(CTDIvol) and dose length product (DLP) were positively correlated with tube current(r =1).The BMD of ESP phantoms had no statistically significant differences among the multi-center lumbar spines L1,L2 and L3 at different doses under the same ASiR-V weighting percentages (P ＞ 0.05),as well as at the same dose under different ASiR-V weighting percentages(P ＞ 0.05).The error of bone density accuracy was within 6％.Conclusions Low dosage of 120 kV and 40 mA using ASiR-V without affecting the accuracy of BMD has the potential effect to reduce radiation dose without compromising image quality.
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OBJECTIVE: To assess clinical feasibility of low-attenuation cluster analysis in evaluation of chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: Subjects were 199 current and former cigarette smokers that underwent CT for quantification of COPD and had physiological measurements. Quantitative CT (QCT) measurements included low-attenuation area percent (LAA%) (voxels ≤ −950 Hounsfield unit [HU]), and two-dimensional (2D) and three-dimensional D values of cluster analysis at three different thresholds of CT value (−856, −910, and −950 HU). Correlation coefficients between QCT measurements and physiological indices were calculated. Multivariable analyses for percentage of predicted forced expiratory volume at one second (%FEV1) was performed including sex, age, body mass index, LAA%, and D value had the highest correlation coefficient with %FEV1 as independent variables. These analyses were conducted in subjects including those with mild COPD (global initiative of chronic obstructive lung disease stage = 0–II). RESULTS: LAA% had a higher correlation coefficient (-0.549, p < 0.001) with %FEV1 than D values in subjects while 2D D−910HU (−0.350, p < 0.001) revealed slightly higher correlation coefficient than LAA% (−0.343, p < 0.001) in subjects with mild COPD. Multivariable analyses revealed that LAA% and 2D D value−910HU were significant independent predictors of %FEV1 in subjects and that only 2D D value−910HU revealed a marginal p value (0.05) among independent variables in subjects with mild COPD. CONCLUSION: Low-attenuation cluster analysis provides incremental information regarding physiologic severity of COPD, independent of LAA%, especially with mild COPD.
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Body Mass Index , Cluster Analysis , Forced Expiratory Volume , Pulmonary Disease, Chronic Obstructive , Tobacco ProductsABSTRACT
Objective To investigate the influence of abdominal adipose tissue on insulin resistance and other metabolic indicators in the patients with type 2 diabetes mellitus(T2DM)complicating obesity.Methods Fifty-one patients with newly diagnosed T2DM complicating obesity (T2DM group) and 50 cases of simple obesity(control group) in Jishuitan Hospital were enrolled.The two groups were performed QCT for measuring the total abdominal adipose tissue volume (TAV),subcutaneous adipose tissue volume (SAV),visceral adipose tissue volume (VAV),and then the VAV/SAV ratio was calculated.Meanwhile the waist circumference,body mass index(BMI),blood uric acid (UA),total cholesterol (C H O),triglycerides (TG),high-density lipo protein cholesterol (HDL),low density lipoprotein cholesterol(LDL),homocysteine(HCY),dosage of basal insulin(DBIns),dosage of prandial insulin (DPIns),fasting plasma glucose(FBG),fasting blood insulin (FIns) and HbA1c levels were also measured.The relationship between TAV,SAV and VAV with HOMA-RI and other indicators was investigated.The influence of abdominal adipose tissue on insulin resistance and other metabolic indicators was determined.Results The UA,TG,LDL,FPG and HbA1c levels in the T2DM group were increased compared with the control group(P＜0.05).Compared with the control group,the SAV level in the T2DM group was decreased(P＜0.05),the VAV and VAV/SAV levels were increased(P＜0.05).The multivariate regression analysis showed that VAV was the natural logarithm affecting In (HOMA-RI),UA,CHO,TG,LDL,HCY,DBIns (β=0.399,0.398,0.389,0.447,0.440,0.372,0.307;P＜ 0.05).TAV was the main factor affecting the waist circumference and BMI (β=0.868,0.639;P＜0.05).Conclusion The visceral adipose tissue volume has larger influences on insulin resistance,blood lipids,UA,HCY and DBIns.
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Objective To investigate the influence of abdominal adipose tissue on insulin resistance and other metabolic indicators in the patients with type 2 diabetes mellitus(T2DM)complicating obesity.Methods Fifty-one patients with newly diagnosed T2DM complicating obesity (T2DM group) and 50 cases of simple obesity(control group) in Jishuitan Hospital were enrolled.The two groups were performed QCT for measuring the total abdominal adipose tissue volume (TAV),subcutaneous adipose tissue volume (SAV),visceral adipose tissue volume (VAV),and then the VAV/SAV ratio was calculated.Meanwhile the waist circumference,body mass index(BMI),blood uric acid (UA),total cholesterol (C H O),triglycerides (TG),high-density lipo protein cholesterol (HDL),low density lipoprotein cholesterol(LDL),homocysteine(HCY),dosage of basal insulin(DBIns),dosage of prandial insulin (DPIns),fasting plasma glucose(FBG),fasting blood insulin (FIns) and HbA1c levels were also measured.The relationship between TAV,SAV and VAV with HOMA-RI and other indicators was investigated.The influence of abdominal adipose tissue on insulin resistance and other metabolic indicators was determined.Results The UA,TG,LDL,FPG and HbA1c levels in the T2DM group were increased compared with the control group(P＜0.05).Compared with the control group,the SAV level in the T2DM group was decreased(P＜0.05),the VAV and VAV/SAV levels were increased(P＜0.05).The multivariate regression analysis showed that VAV was the natural logarithm affecting In (HOMA-RI),UA,CHO,TG,LDL,HCY,DBIns (β=0.399,0.398,0.389,0.447,0.440,0.372,0.307;P＜ 0.05).TAV was the main factor affecting the waist circumference and BMI (β=0.868,0.639;P＜0.05).Conclusion The visceral adipose tissue volume has larger influences on insulin resistance,blood lipids,UA,HCY and DBIns.
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Objective To explore the correlation between the posterior vertebral muscle group aging degeneration and body mass index (BMI) in normal middle-aged and elderly women.Methods One hundred and fifteen women(48-75 years old) were divided into the middle-aged group (＜60 years old) and elderly group (≥60 years old).The muscle area of posterior vertebral muscle group and fat area at lumbar levels L3 were measured by quantitative computed tomography (QCT).The muscle fat infiltration (MFI),e.g.fat area/(muscle area + fat area),was calculated.The differences between the two groups were compared by using independent-samples t test.The correlation and linear regression analysis were used for analyzing the correlations between the muscle area,fat area and MFI with age and BMI.Results The BMI had no statistical difference between the two groups (P＞0.05),while the muscle area of posterior vertebral muscle group,fat area and MFI had statistical difference (t=2.182,-1.997,-2.604,P=0.031,0.048,0.010);the correlation and linear regression analysis showed that controlling the body height,body mass factor and age were positively correlated with the fat area of posterior vertebral muscle group and MFI(r=0.275,0.320,t=2.915,3.445,P=0.004,0.001),while had no obvious correlation with the muscle area(r=-1.109,P =0.270);controlling age factor and BMI were positively correlated with the fat area of posterior vertebral muscle group and MFI(r=0.361,0.307,t=3.945,3.277,P≤0.001),while had no obvious correlation with the muscle area(t=1.653,P=0.101).Conclusion In middle-aged and elderly women,the fat content of posterior vertebral muscle group is increased with the age increase.In evaluating the degeneration,especially greater body mass,the fat content of muscles and their proportion have more significance than the muscle area.
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Objective To explore the age related decline in spine muscle volume and fat content in healthy elderly males . Methods Totally 88 males aged 50-79 years were selected from the patients who underwent quantitative CT (QCT) exam of lum‐bar spine .They were subgrouped by 50- <60 years ,60- <70 years and 70-79 years .The muscle fat area ,skeletal muscular area , muscle fat infiltration (MFI) ,abdominal visceral fat volume and subcutaneous fat volume ,abdominal total fat volume were measured by the QCT software .Statistical analysis was performed using intraclass correlation coefficient ,ANOVA with post hoc Bonferroni correction ,Pearson correlation analysis and multiple regression analysis .Results Compared to other two groups ,subjects in 70-79 years subgroup had highest muscle fat area/MFI and least skeletal muscular mass(P<0 .05) .Age‐dependent correlation was found in muscle fat mass(r=0 .381 ,P<0 .05) and MFI(r=0 .358 ,P=0 .001) ,but no obvious correlation was found between age and skeletal muscular mass .Age was the only factor entered into the all three paravertebral muscle composition regression equations , meaning age may had an important influence on paravertebral muscle degeneration .Conclusion Lumbar paravertebral muscle de‐generation in elderly men is correlated with the aging and MFI ,which may play a important role in the normative age‐related decline of skeletal muscle .
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PURPOSE: The degree of radiation-induced lung fibrosis (RILF) can be measured quantitatively by fibrosis volume (VF) on chest computed tomography (CT) scan. The purpose of this study was to investigate the interobserver and intraobserver variability in CT-based measurement of VF. MATERIALS AND METHODS: We selected 10 non-small cell lung cancer patients developed with RILF after postoperative radiation therapy (PORT) and delineated VF on the follow-up chest CT scanned at more than 6 months after radiotherapy. Three radiation oncologists independently delineated VF to investigate the interobserver variability. Three times of delineation of VF was performed by two radiation oncologists for the analysis of intraobserver variability. We analysed the concordance index (CI) and inter/intraclass correlation coefficient (ICC). RESULTS: The median CI was 0.61 (range, 0.44 to 0.68) for interobserver variability and the median CIs for intraobserver variability were 0.69 (range, 0.65 to 0.79) and 0.61(range, 0.55 to 0.65) by two observers. The ICC for interobserver variability was 0.974 (p < 0.001) and ICCs for intraobserver variability were 0.996 (p < 0.001) and 0.991 (p < 0.001), respectively. CONCLUSION: CT-based measurement of VF with patients who received PORT was a highly consistent and reproducible quantitative method between and within observers.