Single-Slice Hounsfield Unit (HU) Value of the Chinese Proximal Humerus on Routine Chest CT: A Study on Opportunistically Screening for Low Bone Density / Valor de Unidad Hounsfield (HU) de Corte Único del Húmero Proximal Chino en una Tomografía Computarizada de Tórax de Rutina: Un Estudio sobre la Detección Oportunista de Baja Densidad Ósea

SUMMARY: A Study on Relationship between Single-Slice Hounsfield Unit(HU) value of the Chinese proximal humerus and Bone Mineral Density(BMD) Using Routine Chest CT and Dual-energy X-ray Absorptiometry(DEXA) was performed. Data were collected from 240 individuals who underwent DEXA and routine chest CT scans (including full images of the proximal humerus) on the same day at 967 Hospitals between January 2019 and December 2021. The method of measuring single-slice HU values of the proximal humerus on routine chest CT scans exhibited high reliability and repeatability (intraclass correlation coefficient > 0.961, P < 0.001). A strong positive correlation was observed between single-slice HU values of the proximal humerus and DEXA results, with the 20-mm HU value demonstrating the highest correlation. Across different BMI groups, the Area Under Curve (AUC) for the 20-mm HU value was consistently the largest (AUC=0.701- 0.813, P< 0.05). Therefore, the 20-mm HU value can be considered a reliable reference for the opportunistic screening of low BMD, with reference values of -4HU for underweight individuals, -13HU for normal weight individuals, -7HU for overweight individuals, and -16HU for obese individuals. Values below these thresholds indicate a risk of low BMD. This study enriches the Chinese BMD data and offers a swift and effective approach for opportunistically screening low BMD.

Se realizó un estudio sobre la relación entre el valor de la Unidad Hounsfield (HU) de corte único del húmero proximal chino y la densidad mineral ósea (DMO) mediante TC de tórax de rutina y absorciometría de rayos X de energía dual (DEXA). Se recopilaron datos de 240 personas que se sometieron a DEXA y tomografías computarizadas de rutina de tórax (incluidas imágenes completas del húmero proximal) el mismo día en 967 hospitales entre enero de 2019 y diciembre de 2021. El método para medir los valores de HU de un solo corte del húmero proximal en las tomografías computarizadas de tórax mostraron alta confiabilidad y repetibilidad (coeficiente de correlación intraclase > 0,961, P < 0,001). Se observó una fuerte correlación positiva entre los valores de HU de un solo corte del húmero proximal y los resultados de DEXA, demostrando el valor de HU de 20 mm la correlación más alta. En diferentes grupos de IMC, el área bajo la curva (AUC) para el valor HU de 20 mm fue consistentemente el más grande (AUC = 0,701-0,813, P <0,05). Por lo tanto, el valor de HU de 20 mm puede considerarse una referencia fiable para el cribado oportunista de DMO baja, con valores de referencia de -4 HU para personas con bajo peso, -13 HU para personas con peso normal, -7 HU para personas con sobrepeso y -16 HU para personas obesas. Los valores por debajo de estos umbrales indican un riesgo de DMO baja. Este estudio es un aporte para los datos chinos sobre la DMO y ofrece un enfoque rápido y eficaz para detectar de forma oportunista la DMO baja.

Actividad física, maduración biológica y salud ósea en función de la condición socioeconómica en escolares colombianos / Physical Activity, Biological Maturation and Bone Health as a Function of the Socio-Economic Status in Colombian Schools / Atividade física, maturação biológica e saúde óssea como função do status socioeconômico em escolas colombianas

Resumen Introducción: diversos estudios describen los diferentes beneficios de la práctica de actividad física en niños y adolescentes; su déficit en estos grupos etarios, provoca un aumento concomitante de alteraciones cardiovasculares y metabólicas. Objetivo: analizar los patrones de actividad física, la maduración biológica y el contenido mineral óseo en escolares colombianos entre 8 y 16 años de edad en función del estrato socioeconómico al que pertenecen. Materiales y métodos: estudio de enfoque cuantitativo, descriptivo, transversal con alcance correlacional el cual incluyó una muestra representativa para escolares colombianos entre 8-16 años de edad a los cuales se les valoró el nivel de actividad física a través del PAQ-C, igualmente, se evaluaron diferentes medidas antropométricas y de manera indirecta se determinó la velocidad pico de crecimiento (VPC) y la densidad mineral ósea (DMO). Resultados: se evaluaron un total de 2147 escolares de los cuales el 56,7 % pertenecían a instituciones educativas del sistema público, se encontraron asociaciones estadísticamente significativas entre el sexo y el estrato socioeconómico con el nivel de actividad física (p<0,005) y las demás variables de estudio. Conclusión: se puede concluir que la actividad física, la maduración biológica y la salud ósea guardan estrecha relación con la condición socioeconómica en escolares colombianos lo que permite establecer diagnósticos tempranos y toma de decisiones frente a programas y estrategias educativas y de salud pública.

Abstract Introduction: Several studies describe the different benefits of physical activity in children and adolescents. Indeed, when a deficit of physical activity is evident in these age groups, there is a concomitant increase in metabolic and metabolic disorders. Objective: to analyze the patterns of physical activity, biological maturation and bone mineral content in Colombian schoolchildren between 8 and 16 years of age according to the socioeconomic status to which they belong. Materials and methods: A quantitative, descriptive, cross-sectional study with a correlational scope, which included a representative sample of Colombian schoolchildren between 8 and 16 years of age, who were assessed for their level of physical activity through the PAQ-C, also, different anthropometric measurements are evaluated and indirectly the peak growth velocity (PSV) and bone mineral density (BMD) are prolonged. Results: a total of 2147 schoolchildren were evaluated, of which 56.7% belonged to educational institutions of the public system, statistically significant associations were found between sex and socioeconomic status with the level of physical activity and the other study variables. Conclusion: It can be concluded that physical activity, biological maturation and bone health are closely related to socioeconomic status in Colombian schoolchildren, which allows early diagnoses and decision-making regarding educational and public health programs and strategies.

Resumo Introdução: Vários estudos descrevem os diferentes benefícios da prática de atividade física em crianças e adolescentes. De fato, quando um déficit de atividade física é evidenciado nessas faixas etárias, ocorre um aumento concomitante de distúrbios cardiovasculares e metabólicos. Objetivo: analisar os padrões de atividade física, maturação biológica e conteúdo mineral ósseo em escolares colombianos entre 8 e 16 anos de idade de acordo com o status socioeconômico ao qual pertencem. Materiais e métodos: Um estudo quantitativo, descritivo, transversal com escopo correlacional, que incluiu uma amostra representativa de escolares colombianos entre 8 e 16 anos de idade, que foram avaliados quanto ao seu nível de atividade física por meio do PAQ-C, além disso, diferentes medidas antropométricas são avaliadas e, indiretamente, a velocidade máxima de crescimento (PSV) e a densidade mineral óssea (DMO) são prolongadas. Resultados: Um total de 2147 escolares foram avaliados, dos quais 56,7% pertenciam a instituições educacionais do sistema público, foram encontradas associações estatisticamente significativas entre sexo e status socioeconômico com o nível de atividade física e as outras variáveis do estudo. Conclusão: Pode-se concluir que a atividade física, a maturação biológica e a saúde óssea estão intimamente relacionadas ao status socioeconômico em escolares colombianos, o que permite diagnósticos precoces e tomada de decisões em relação a programas e estratégias educacionais e de saúde pública.

Study on Body Composition of Patients with Diabetes Mellitus by Dual-Energy X-Ray Absorptiometry: A Morphological Study / Estudio sobre la Composición Corporal de Pacientes con Diabetes Mellitus Mediante Absorciometría de Rayos X de Energía Dual: Un Estudio Morfológico

SUMMARY: Diabetes is a form of endocrine disease. Dual-energy X-ray Absorptiometry (DXA) provides a detailed view of the body composition to find out what makes people with diabetes different from those with other diseases. We scanned 371 patients with DXA to analyze their body composition parameters. Three hundreds and seventy one patients (178 women/193 men), who with different diseases, with a mean±SD Body Mass Index (BMI) of 25.32±8.3 kg/m2 were included. The body composition of 371 patients was assessed. Bone Mineral Density (BMD), Fat Weight, Lean Weight, waist-to-hip ratio, Lean Mass Index (LMI), Fat Mass Index (FMI), the relationship between Fat percentage and BMI were analyzed. The 371 patients included 156 diabetics and 215 non-diabetics. Non-diabetic patients also included 5 obesity patients, 9 patients with fatty liver, 39 patients with hypertension, 22 patients with hyperlipidemia, 18 patients with cardiovascular disease, 11 patients with chest and lung disease, 4 patients with chronic disease, 14 patients with brain disease and 93 patients with other diseases. Among 156 diabetic patients, 129 had VAT > 100 cm2 and 27 had VAT ≤100 cm2. The lean weight (LW) of male diabetic patients was significantly higher than that of female diabetic patients. The fat weight (FW) of female patients with diabetes was significantly higher than that of male patients. The waist-hip ratio (WHR) was 1.37 ± 0.25 in male diabetic patients and 1.18 ± 0.21 in female diabetic patients. Among the 215 non-diabetic patients, the obese and fatty liver patients, which the weight (WT) (obesity: 83.87 ± 8.34 kg fat liver: 85.64±28.60 kg), FW (obesity: 28.56 ± 4.18 kg fat liver: 28.61 ± 10.79 kg), LW (obesity: 52.62 ± 9.64 kg fat liver: 54.29±17.58 kg), BMI (obesity: 28.76 ± 1.88 kg/m2 fat liver: 29.10 ± 5.95 kg/m2), was much higher than other patients. Diabetes patients had less fat mass than non- diabetic patients; the difference was around 2 kg. BMI is also a modest number. BMD doesn't differ all that much. Non-diabetic patients with fatty liver obesity and cardiovascular disease had higher fat mass and BMI than patients with other illnesses. Body composition can provide precise information on the makeup of different body areas, but further in-depth exams are required to ascertain the body's endocrine profile.

La diabetes es una enfermedad endocrina. La absorciometría de rayos X de energía dual (DXA) proporciona una vista detallada de la composición corporal para descubrir qué diferencia a las personas con diabetes de aquellas con otras enfermedades. Escaneamos a 371 pacientes con DXA para analizar sus parámetros de composición corporal. Se incluyeron 371 pacientes (178 mujeres/193 hombres), con diferentes enfermedades, con un Índice de Masa Corporal (IMC) medio ± DE de 25,32 ± 8,3 kg/m2. Se evaluó la composición corporal de 371 pacientes. Se analizaron la densidad mineral ósea (DMO), el peso graso, el peso magro, la relación cintura-cadera, el índice de masa magra (LMI), el índice de masa grasa (FMI), y la relación entre el porcentaje de grasa y el IMC. De los 371 pacientes 156 eran diabéticos y 215 no diabéticos. Los pacientes no diabéticos también incluyeron 5 con obesidad, 9 con hígado graso, 39 con hipertensión, 22 con hiperlipidemia, 18 con enfermedad cardiovascular, 11 con enfermedad torácica y pulmonar, 4 con enfermedad crónica, 14 con enfermedad cerebral y 93 pacientes con otras enfermedades. Entre los 156 pacientes diabéticos, 129 tenían un IVA > 100 cm2 y 27 tenían un IVA ≤100 cm2. El peso magro (PV) de los hombres diabéticos fue significativamente mayor que el de las mujeres diabéticas. El peso graso (FW) de las mujeres diabéticas fue significativamente mayor que el de los hombres diabéticos. El índice cintura-cadera (ICC) fue de 1,37 ± 0,25 en hombres diabéticos y de 1,18 ± 0,21 en mujeres diabéticas. Entre los 215 pacientes no diabéticos, los pacientes obesos y con hígado graso, cuyo peso (WT) (obesidad: 83,87 ± 8,34 kg hígado graso: 85,64 ± 28,60 kg), FW (obesidad: 28,56 ± 4,18 kg hígado graso: 28,61 ± 10,79 kg), PV (obesidad: 52,62 ± 9,64 kg, hígado graso: 54,29 ± 17,58 kg), IMC (obesidad: 28,76 ± 1,88 kg/m2, hígado graso: 29,10 ± 5,95 kg/m2), fue mucho mayor que otros pacientes. Los pacientes diabéticos tenían menos masa grasa que los pacientes no diabéticos; la diferencia fue de alrededor de 2 kg. La DMO no difiere mucho. Los pacientes no diabéticos con obesidad debido al hígado graso y enfermedades cardiovasculares tenían mayor masa grasa e IMC que los pacientes con otras enfermedades. La composición corporal puede proporcionar información precisa sobre la composición de diferentes áreas del cuerpo, pero se requieren exámenes más profundos para determinar el perfil endocrino del cuerpo.

Influence factors of bone mineral density and its correlation with insulin resistance in obese children in Qianjiang area / 公共卫生与预防医学

Objective To explore the influencing factors of bone mineral density (BMD) in obese children in Qianjiang area and analyze the correlation between BMD and insulin resistance. Methods The data on pediatric cases from the outpatient department of Jianghan Oilfield General Hospital in Qianjiang from January 2018 to December 2022 were collected. A total of 183 obese children who met the inclusion and exclusion criteria were included in the study and selected in the observation group. A total of 352 children undergoing physical examination during the same period were selected as the control group. Results The body mass, waist circumference, waist to hip ratio, and BMI of obese children were significantly higher than those of the control group (P<0.001). Biochemical indexes including FBG, FINS, Home-IR, ALP, and LDL-C in obese children were significantly higher than those in the control group (P<0.05), while bone mineral density, Ca, P, sOC and HDL-C were significantly lower than those in the control group (P<0.001). The bone mineral density of obese children was significantly correlated with their exercise intensity, sunshine exposure duration, sitting time, intake of milk and dairy products, intake of sweets, supplementation of trace elements, BMI, Home-IR, and sex (all P<0.05). BMI, Home-IR, sex, exercise intensity, and sunshine exposure length were independent risk factors affecting bone mineral density of obese children (all P<0.05). Bone mineral density was negatively correlated with BMI and Home-IR (P=0.028 and0.017, respectively), and positive correlation with exercise intensity and sunlight exposure (P=0.033). Conclusion BMD of obese children in Qianjiang area is affected by gender, body mass index, diet, vitamin intake, and physical activity, and is negatively correlated with insulin resistance. Home-IR can be used as a reference for screening BMD of obese children.

Clinical risk factors for chronic complications in patients with type 2 diabetes and their correlation with bone mineral density and 1,25-dihydroxyvitamin D3 / 公共卫生与预防医学

Objective To analyze the clinical risk factors for chronic complications in patients with type 2 diabetes and their correlation with bone mineral density and 1,25-dihydroxyvitamin D3. Methods A total of 163 patients with type 2 diabetes mellitus were selected as research subjects and were divided into complication group and non-complication group according to the presence or absence of chronic complications. The independent related factors for chronic complications in patients with type 2 diabetes mellitus were analyzed. Spearman rank correlation analysis was used to evaluate the correlation between bone mineral density, 1,25-dihydroxyvitamin D3 and chronic complications. Results Among the 326 patients with type 2 diabetes mellitus, 202 developed chronic complications (61.96%), including 71 cases of cardiovascular disease, 59 cases of neuropathy, 33 cases of renal lesion, and 28 cases of retinopathy. There were statistically significant differences in the duration of diabetes mellitus, fasting blood glucose, systolic blood pressure, glycosylated hemoglobin, triglyceride, low density lipoprotein cholesterol, serum creatinine, bone mineral density, and 1,25-dihydroxyvitamin D3 between the complication group and the non-complication group (P<0.05). Logistic multivariate regression analysis showed that the duration of diabetes mellitus, systolic blood pressure, glycosylated hemoglobin, ow density lipoprotein cholesterol, serum creatinine, bone mineral density, and 1,25-dihydroxyvitamin D3 were all independent related factors for the occurrence of chronic complications in patients with type 2 diabetes mellitus (P<0.05). Spearman correlation analysis showed that bone mineral density and 1,25-dihydroxyvitamin D3 were negatively correlated with chronic complications (P<0.05). Conclusion Bone mineral density and 1,25-dihydroxyvitamin D3 in patients with type 2 diabetes mellitus are closely related to chronic complications.

Effects of microRNA-103a-3p on osteoporosis through tumor protein 53-regulated inhibitor of apoptosis 1/P53 / 解剖学报

Objective To investigate the efeects of microRNA(miR)-103a-3p regulates tumor protein 53-regulated inhibitor of apoptosis 1(TRIAP1)on osteoblast differentiation and bone mass in ovariectomized mice.Methods MC3T3-E1 cells were divided into normal group,miR-103a-3p-NC group,miR-103a-3p mimic group,miR-103a-3p mimic+TRIAP1-NC group,miR-103a-3p mimic+TRIAP1 mimic group.mRNA expression of miR-103a-3p,TRIAP1,P53 were detected by Real-time PCR;Cell proliferation and apoptosis were detected by MTT test and flow cytometry;cytoskeleton and mineralization of cells were detected by F-actin immunofluorescence staining and alizarin staining;alkaline phosphatase(ALP)activity was detected by ELISA.24 female mice were divided into sham group,osteoporosis(OP)group,miR-103a-3p antagonist-NC group,miR-103a-3p antagonist group(six in each group),extract bilateral ovaries to establish an OP model,sham group mice only isolated fat around ovarian tissue.mRNA expression of miR-103a-3p,TRIAP1,P53,ALP,osteocalcin(OCN),osteopontin(OPN)of bone tissue were detected;microCT detect bone mineral density(BMD),bone mineral content(BMC);haematoxylin eosin staining was used to observe pathological changes of bone tissue.Results After miR-103a-3p mimic was transfected into cells,the miR-103a-3p and P53 expression increased,TRIAP1 expression decreased,cell proliferation decreased,apoptosis increased,F-actin expression decreased,the number of calcium nodules decreased,and ALP enzyme activity decreased(P<0.01);however,after TRIAP1 mimic was additionally transfected into cells,the above result caused by miR-103a-3p mimics were significantly reversed(P<0.01).In OP group,the miR-103a-3p and P53 expression in bone tissue increased,the TRIAP1,ALP,OCN and OPN expression decreased,BMD and BMC were decreased,and bone tissue construct was damaged(P<0.05);in miR-103a-3p antagonist group,the miR-103a-3p and P53 expression in bone tissue decreased,TRIAP1,ALP,OCN,OPN expression increased,BMD and BMC increased,and bone tissue construct was improved(P<0.05).Conclusion MiRNA-103a-3p mediate TRIAP1/P53 to inhibit proliferation and mineralization of osteoblast,while miR-103a-3p antagonistic treatment reduce bone loss in OP mice.

Correlation between Bone Density at Different Hip Positions with Muscle Parameters and Physical Performance in Middle-aged and Elderly People in Kunming Area / 昆明医科大学学报

Objective To investigate the correlation between bone mineral density(BMD)at different hip positions with muscle parameters and physical performance in middle-aged and elderly people in Kunming area.Methods 531 middle-aged and elderly volunteers were recruited from the Radiology Department of the First People's Hospital of Yunnan Province from May 2021 to April 2022.All study subjects completed the five-times-sit-to-stand test(FTSST)and hip quantitative CT(QCT)examinations.Volunteers'total hip(TH),femoral neck(FN),and intertrochanteric(IT)BMD were measured by using QCT PRO workstation and using OsiriX software to measure the area and density of their gluteus maximus muscle,gluteus medius,and minimus muscle and midthigh muscle.Divide male and female volunteers into positive and negative groups respectively based on FTSST time≥12 seconds or<12 seconds,and analyze the differences in hip BMD between the groups;Also divide male and female volunteers into three groups(50～59 years old,60～69 years old,70 years old and above)at the age of 10,and analyze the correlation between hip BMD and muscle parameters in different age and gender stratification.Control for age and BMI,and then perform partial correlation analysis on the above indicators.Results The BMD of the hip in the female FTSST positive group was lower than that in the negative group(P<0.001),while there was no statistically significant difference between the male groups(P>0.05).After adjusting for age and BMI,among males,FN BMD was positively correlated with gluteus medius and minimus muscle density in the age groups of 50～59 and 60～69(P<0.05),while TH BMD,FN BMD,and IT BMD were strongly positively correlated with gluteus medius and minimus muscle density in the age group over 70(P<0.05).For females,the correlation between hip BMD and muscle density in the age groups of 50～59 and 60～69 was weak,while BMD in all parts of the hip was not correlated with muscle density in the age group over 70(P>0.05).There was a negative correlation between TH BMD,FN BMD,and gluteus medius and minimus muscle area in the age group of 50～59 years old for males(P<0.05),while there was a significant negative correlation between TH BMD,IT BMD,and gluteus maximus area in the age group of 70 years old and above for females(P<0.05).Conclusion The BMD of various parts of the hip in the female FTSST positive group is lower than that in the negative group.The density of the gluteus medius and minimus muscle can to some extent serve as a predictive indicator of femoral neck bone strength in middle-aged and elderly men in Kunming area.

Effectiveness research of opportunistic screening for osteoporosis based on chest CT and deep convolutional neural network / 实用放射学杂志

Objective To analyze the feasibility and efficacy of a deep convolutional neural network(DCNN)model based on chest CT images to evaluate bone mineral density(BMD).Methods A total of 1 048 health check subjects'2 096 central level images of lumbar 1 and 2 vertebral bodies were used for experiments and analysis in this retrospective study.According to the results of quanti-tative computed tomography(QCT)BMD measurement,the subjects were divided into three categories:normal,osteopenia,osteopo-rosis(OP).Herein,a DCNN segmentation model was constructed based on chest CT images[training set(n=1 096),tuning set(n=200),and test set(n=800)],the segmentation performance was evaluated using the Dice similarity coefficient(DSC)to com-pare the consistency with the manually sketched region of vertebral body.Then,the DCNN classification models 1(fusion feature construction of lumbar 1 and 2 vertebral bodies)and model 2(image feature construction of lumbar 1 alone)was developed based on the training set(n=530).Model performance was compared in a test set(n=418)by the receiver operating characteristic(ROC)curve analysis.Results When the number of images in the training set(n=300)was adopted,the DSC value was 0.950 in the test set.The results showed that the sensitivity,specificity and area under the curve(AUC)of model 1 and model 2 in diagno-sing osteopenia and OP were 0.716,0.960,0.952;0.941,0.948,0.980;0.638,0.954,0.940;0.843,0.959,0.978,respectively.The AUC value of normal model 1 was higher than that of model 2(0.990 vs 0.983,P=0.033),while there was no significant difference in AUC values between osteopenia and OP(P=0.210,0.546).Conclusion A DCNN may have the potential to evaluate bone mass based on chest CT images,which is expected to become an effective tool for OP screening.

Application of quantitative CT-based imaging histology in the diagnosis of osteoporosis / 实用放射学杂志

Objective To investigate the application value of quantitative computed tomography(QCT)-based imaging histology in the diagnosis of clinical osteoporosis.Methods A total of 182 patients who underwent QCT scans of the chest or abdomen were ana-lyzed retrospectively,and the patients were divided into osteoporosis group(56 cases)and non-osteoporosis group(126 cases)accord-ing to the bone mineral density(BMD)values measured by QCT.The cases were randomly divided into training set(110 cases)and validation set(72 cases)at a ratio of 6︰4.The L1-L2 vertebrae were outlined with the region of interest(ROI)and the image features were extracted using ITK-SNAP 3.6.0 and A.K.software.(1)Radiomics score(Rad-score)model was established using maximum relevance minimum redundancy(mRMR)and least absolute shrinkage and selection operator(LASSO)algorithm.(2)The L1 and L2 vertebrae BMD value and T-value from the dual energy X-ray absorptiometry(DXA)examination of the patient were obtained to build the model separately for analysis and for comparison with the Rad-score model.(3)The discriminative ability,clinical applica-tion performance and calibration ability of Rad-score in the training and validation sets were evaluated using receiver operating charac-teristic(ROC)curves,decision curve analysis(DCA)and calibration curves.(4)Data on sensitivity,specificity,accuracy and area under the curve(AUC)were used to compare the predictive ability of DXA and Rad-score.DeLong test was used for comparison of differences between Rad-score and DXA models.Results Four optimal ima-ging histology features were finally selected to create Rad-score model,which confirmed the significant correlation between Rad-score and QCT for the diagnosis of osteoporosis.The calibration curve showed that Rad-score model had a good fit in both the training set and the validation set.The results of the DeLong test showed that the AUC of Rad-score model were greater than those of DXA model.Conclusion The QCT-based imaging histology model has high sen-sitivity,specificity and accuracy,with outstanding advantages and good performance for osteoporosis diagnosis,and is superior to the DXA model.

Meta-analysis of efficacy and safety of terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures / 中国组织工程研究

OBJECTIVE:To compare the efficacy and safety of terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures through a Meta-analysis. METHODS:By searching PubMed,Cochrane Library,EMbase,CNKI,WanFang and VIP databases,18 randomized controlled studies on terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures were included according to inclusion and exclusion criteria.Endnote X9 software was used to manage the literature and Revman 5.3 software was used to perform a Meta-analysis on the extracted data.The incidences of vertebral fracture,non-vertebral fracture and adverse reaction in postmenopausal osteoporosis patients treated with terlipatide and bisphosphate were analyzed. RESULTS:A total of 18 randomized controlled studies were included,of which 10 were of medium and high quality and 8 were of low quality.Meta-analysis results showed that the fracture incidence in the teriparatide group[risk ratio(RR)=0.56,95%confidence interval(CI):0.48-0.66,P＜0.000 01]was lower than that in the bisphosphonate group,and teriparatide was superior to alendronate in preventing fractures in postmenopausal women with osteoporosis(RR=0.50,95%CI:0.35-0.69,P＜0.000 1)and other bisphosphonates(RR=0.58,95%CI:0.49-0.70,P＜0.000 01).During the follow-up over 18 months,teriparatide was superior to bisphosphonates in preventing fractures in postmenopausal women with osteoporosis(RR=0.56,95%CI:0.48-0.69,P＜0.000 01).In addition,we found that teriparatide was superior to bisphosphonates in preventing vertebral fractures(RR=0.48,95%CI:0.37-0.62,P＜0.000 01)and non-vertebral fractures(RR=0.63,95%CI:0.51-0.78,P＜0.000 1)in postmenopausal women with osteoporosis.Teriparatide was superior to bisphosphonates in increasing lumbar bone density[odds ratio=4.16,95%CI:2.96-5.36,P＜0.000 1)and femoral neck bone density(odds ratio=1.02,95%CI:0.04-2.01,P=0.04).There was no significant difference in adverse reactions between teriparatide and bisphosphonates(RR=0.95,95%CI:0.85,1.06,P=0.37). CONCLUSION:Teriparatide is superior to bisphosphonates in preventing vertebral and non-vertebral fractures in postmenopausal women with osteoporosis,but the safety and adverse drug reactions of teriparatide and bisphosphonates are basically similar.Teriparatide is superior to bisphosphonate in preventing fracture and improving lumbar and femoral neck bone density regardless of short-term(＜18 months)or long-term(≥18 months)use.

Effect of lumbar CT values in the diagnosis of osteoporosis in women patients with lumbar degenerative diseases / 中国组织工程研究

BACKGROUND:Patients with severe lumbar degenerative disease may have their bone mineral density incorrectly raised by dual-energy X-ray absorptiometry.While lumbar cancellous bone Hounsfield unit value can assist dual-energy X-ray absorptiometry in reducing osteoporosis misdiagnosis. OBJECTIVE:To identify osteoporosis in woman patients with lumbar degenerative diseases using lumbar CT scans. METHODS:Bone mineral density test results and lumbar CT data of 192 women patients who were treated at the Department of Spine Surgery,Sixth Affiliated Hospital of Xinjiang Medical University were retrospectively reviewed.All patients were divided into a degeneration group(n=107)and a control group(n=85)according to the criteria of severity of vertebral degeneration as assessed on CT of the lumbar spine.The CT value of axial cancellous bone of L1 vertebral body was measured in the two groups.The T score and bone mineral density of the hip and L2-L4 were recorded.According to previously published studies,osteoporosis was diagnosed at L1 vertebral CT values≤110.The prevalence of osteoporosis diagnosed by dual-energy X-ray absorptiometry and CT values was compared between the two groups. RESULTS AND CONCLUSION:(1)CT values were significantly and positively correlated with T scores and mean bone mineral density of the L2-L4 vertebrae in both groups(P<0.001),while the correlation was higher in the control group.(2)Lumbar T scores and bone mineral density values were significantly higher in the degeneration group than those in the control group(P<0.05)and CT values were significantly lower in the degeneration group than that in the control group(P = 0.001).Hip T scores and bone mineral density were not significantly different in the two groups.(3)The prevalence of osteoporosis diagnosed by CT thresholds was higher in all patients than that diagnosed by T values(51.0%and 42.7%).(4)The prevalence of osteoporosis diagnosed by CT values was as high as 23.6%in the 110 patients diagnosed with non-osteoporosis by dual energy X-ray absorptiometry in both groups,and was higher in the degeneration group than that in the control group(31.7%and 14.0%,respectively).(5)The prevalence of missed osteoporosis was as high as 38.6%(27/70)of non-osteoporosis patients diagnosed by dual-energy X-ray absorptiometry of the lumbar spine in the degeneration group compared to 19.6%(11/56)in the control group.(6)It is concluded that osteoporosis is common in female patients with lumbar degenerative diseases aged≥50 years.Measurement of lumbar cancellous bone CT values may be a useful complementary method for diagnosing osteoporosis in patients with lumbar degenerative diseases,especially in patients with severe degenerative lumbar degenerative diseases where more missed osteoporosis patients can be identified.

HU value of chest CT vertebral body in the opportunistic screening of type 2 diabetes mellitus osteoporosis / 中国组织工程研究

BACKGROUND:Some studies have shown that the hounsfield units(HU)value based on lumbar CT can be used to screen osteoporosis.At present,the number of patients with pulmonary infection has increased;the number of patients with pulmonary infection and type 2 diabetes is also increasing,which increases the utilization rate of chest CT. OBJECTIVE:To investigate the role of lumbar 1 vertebral body HU value based on chest CT in the screening of type 2 diabetes mellitus osteoporosis. METHODS:The clinical data of 244 patients with type 2 diabetes mellitus treated in the First Affiliated Hospital of Chengdu Medical College from June 2020 to June 2022 were analyzed retrospectively.The bone mineral density was obtained by dual-energy X-ray absorptiometry.According to WHO's diagnostic criteria for osteoporosis,the subjects were divided into the non-osteoporosis group(n=120)and the osteoporosis group(n=124).The general condition,T value and HU value of lumbar 1 vertebra in chest CT were compared,and the relationship between the HU value and T value of each position was analyzed and the accuracy of type 2 diabetes mellitus osteoporosis was evaluated. RESULTS AND CONCLUSION:(1)There was no significant difference in sex,age,body mass index,glycosylated hemoglobin,mean blood glucose,calcium(Ca),phosphorus(P),time of type 2 diabetes mellitus,history of hypertension and history of hyperlipidemia between the two groups(P>0.05).(2)The HU value was positively correlated with the lowest T value of the hip(r=0.619,P<0.01);the HU value was positively correlated with the hip T value(r=0.584,P<0.01),and the HU value was positively correlated with the femoral neck T value(r=0.641,P<0.01).When the HU value was 98,the prediction of type 2 diabetes mellitus osteoporosis had good accuracy,and the sensitivity was 70.8%.(3)It is concluded that the HU value of the lumbar 1 vertebra based on chest CT examination is of good value for osteoporosis screening in patients with type 2 diabetes mellitus,and may be an opportunistic and cost-free supplementary screening method for type 2 diabetes mellitus osteoporosis.

Three-dimensional finite element analysis of the distribution pattern of stress in bone tissues with different characteristics / 中国组织工程研究

BACKGROUND:Less is reported on the influence of cortical bone thickness on displacement and equivalent stress. OBJECTIVE:To analyze the influence of cortical bone thickness on the maximum displacement and equivalent stress at the implant-bone interface through a three-dimensional finite element method,thereby providing some suggestions for oral implantation. METHODS:In this experiment,we selected the cone-shaped CT image data of a patient who was scheduled for mandibular first molar implant restoration.First,we established a mandibular model in Mimics13 software,and then imported it into Solid works 2022 software.According to the related product information,we drew the cone-shaped implant(4.1 mm×10 mm)and the upper prosthesis model.Cortical bone models were obtained according to different cortical bone thicknesses(2.5,2.0,1.5,1.0 mm)and named D1,D2,D3,and D4,respectively.All the models were imported into ANSYS Workbench 2021 software and cross-combined.Finally,we applied vertical and oblique loads to the four groups of models,and analyzed the stress of the models in each group. RESULTS AND CONCLUSION:The peak equivalent stress is lowest in the cancellous bone and highest in the upper prosthesis,that is,at the abutment-implant junction.The peak stress increases with the decrease of cortical bone thickness.The peak stress of the abutment increases with the decrease of cortical bone thickness,and a similar explanation can also be applied to the other implant restoration components.The peak stress in bone tissue and implants increases with the increase of cortical bone thickness.In models D1,D2,D3,the peak stress in implants is higher than that in bone tissue,but the results are reversed in D4.

Relationship between degeneration of paraspinal muscle and refractures in postmenopausal women treated by percutaneous vertebroplasty / 中国组织工程研究

BACKGROUND:There are few studies on the effect of degeneration of paraspinal muscle on osteoporotic vertebral compression refractures treated by percutaneous vertebroplasty in postmenopausal women.This paper intends to reveal the relationship between them. OBJECTIVE:To investigate the relationship between degeneration of paraspinal muscle and osteoporotic vertebral compression refractures in postmenopausal women treated by percutaneous vertebroplasty. METHODS:The medical records of 81 postmenopausal female patients who were admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine from May 2018 to March 2021 for osteoporotic vertebral compression fracture and received percutaneous vertebroplasty were retrospectively analyzed.The patients were divided into an osteoporotic vertebral compression refracture group(n=39)and a control group(n=42)according to whether they had osteoporotic vertebral compression refracture after percutaneous vertebroplasty.General data,vertebral bone mineral density,paravertebral cross-sectional area and mean CT value(Hu)of the two groups were analyzed. RESULTS AND CONCLUSION:(1)Univariate analysis showed that there was no significant difference in age and mean CT value of psoas major between the two groups(P>0.05).The body mass index,vertebral bone mineral density,paravertebral cross-sectional area and the mean CT value of the posterior vertebral muscle group in the control group were significantly higher than those in the osteoporotic vertebral compression refracture group(P<0.05).(2)Multivariate logistic regression analysis showed that low vertebral bone mineral density(OR=0.004,95%CI:0.000-0.555,P<0.05)and low mean CT value of posterior vertebral muscle group(OR=0.940,95%CI:0.894-0.988,P<0.05)were independent risk factors for postmenopausal osteoporotic vertebral compression refracture.(3)It is indicated that degeneration of paraspinal muscle will increase the risk of osteoporotic vertebral compression refractures in patients treated by percutaneous vertebroplasty,especially in postmenopausal women with a low mean CT value of low posterior vertebral muscle group.

Prediction of osteoporotic vertebral compression fracture based on comprehensive index of lumbar vertebral bone strength / 中国组织工程研究

BACKGROUND:Osteoporotic vertebral compression fracture is a common fracture secondary to osteoporosis.At present,there is no effective prediction index and method for osteoporotic vertebral compression fracture. OBJECTIVE:To investigate the predictive effect of the comprehensive index of lumbar vertebral body bone strength on osteoporotic vertebral compression fracture. METHODS:233 patients with osteoporosis were divided into a fracture group and a non-fracture group according to whether a vertebral fracture occurred.The demography,body mass index,vertebral bone mineral density and other details were collected.Lateral X-ray films of the lumbar spine were photographed.The vertebral body width,vertebral body length,sacral slope,pelvic tilt,pelvic incidence,lumbar compressive strength index and the lumbar impact strength index were measured,calculated,and analyzed by univariate and multivariate,and the receiver operating characteristic curve was analyzed.The survival analysis was conducted according to the cut-off value. RESULTS AND CONCLUSION:(1)All patients were followed up for 2-4 years,with an average of 3.1 years.During the follow-up period,99 cases(38 cases of L1 vertebral body,61 cases of L2 vertebral body)had fractures(fracture group),and 134 cases(52 cases of L1 vertebral body,82 cases of L2 vertebral body)had no fractures(non-fracture group).Univariate analysis showed that there was no significant difference in age,sex,height,body mass,body mass index and fracture segment between the two groups(P>0.05).(2)Lumbar compressive strength index and lumbar impact strength index in the fracture group were lower than those in the non-fracture group(P<0.05).Pelvic incidence and pelvic tilt in the fracture group were higher than those in the non-fracture group(P<0.05).(3)Multivariate analysis showed that lumbar compressive strength index,lumbar impact strength index and pelvic tilt were risk factors for osteoporotic vertebral compression fractures(P<0.05).(4)Receiver operating characteristic curve analysis showed that the cutoff values of vertebral bone mineral density,lumbar compressive strength index,lumbar impact strength index,pelvic tilt and pelvic incidence were 0.913 5 g/cm2,1.932,0.903,21.5° and 55°,respectively;areas under the curve were 0.630,0.800,0.911,0.633 and 0.568,respectively.(5)According to the survival analysis(with osteoporotic vertebral compression fracture as the end point),the average survival time of the patients with lumbar impact strength index≥0.903 was significantly longer than that of the patients with lumbar impact strength index<0.903(P<0.05).(6)These findings conclude that the comprehensive index of lumbar vertebral body bone strength is more accurate than the bone mineral density of the vertebral body and spine-pelvis sagittal parameters in predicting osteoporotic vertebral compression fractures,which is helpful for early prevention and treatment of osteoporotic vertebral compression fractures.

Mendelian randomization study on the association between rheumatoid arthritis and osteoporosis and bone mineral density / 中国组织工程研究

BACKGROUND:Many clinical research observations have indicated a close association between rheumatoid arthritis and osteoporosis as well as bone mineral density(BMD).However,it remains unclear whether there is a causal genetic relationship between rheumatoid arthritis and the development of osteoporosis and alterations of BMD. OBJECTIVE:To assess the potential causal relationship between rheumatoid arthritis and osteoporosis as well as BMD using a two-sample Mendelian randomization approach,provide meaningful insights from a genetic perspective into the underlying mechanisms and offer a reference for early prevention of osteoporosis and improvement in the progression of the disease. METHODS:We conducted a study using data from publicly available genome-wide association studies databases to identify single nucleotide polymorphisms associated with rheumatoid arthritis as instrumental variables(P＜5×10-8).The main outcomes of the study included osteoporosis and BMD at five different sites,including total body BMD,lumbar spine BMD,femoral neck BMD,heel BMD,and forearm BMD.The inverse variance-weighted method was used as the primary analysis method to evaluate causal effects.Weighted median,simple median,weighted mode and MR-Egger regression were used as supplementary analyses.Causal relationships between rheumatoid arthritis and the risk of osteoporosis and BMD were assessed using odds ratios(OR)and 95%confidence intervals(CI).Heterogeneity was assessed using Cochran's Q test and horizontal pleiotropy was evaluated using MR-Egger intercept tests. RESULTS AND CONCLUSION:The inverse variance-weighted analysis demonstrated a positive association between genetically predicted rheumatoid arthritis and osteoporosis(OR=1.123,95%CI:1.077-1.171;P=4.02×10-8).Heterogeneity test(P=0.388)indicated no significant heterogeneity among the single nucleotide polymorphisms.MR-Egger intercept(P=0.571)tests did not detect horizontal pleiotropy,and sensitivity analysis showed no evidence of bias in the study results.There was no causal relationship between rheumatoid arthritis and BMD at the five different sites.The total body BMD(OR=1.000,95%CI:0.988-1.012;P=0.925),lumbar spine BMD(OR=0.999,95%CI:0.982-1.016;P=0.937),femoral neck BMD(OR=1.001,95%CI:0.986-1.016;P=0.866),heel BMD(OR=0.996,95%CI:0.989-1.004;P=0.419),and forearm BMD(OR=1.063,95%CI:0.970-1.031;P=0.996)indicated no significant association.MR-Egger intercept analysis did not detect potential horizontal pleiotropy(total body BMD:P=0.253;lumbar spine BMD:P=0.638;femoral neck BMD:P=0.553;heel BMD:P=0.444;forearm BMD:P=0.079).Rheumatoid arthritis may contribute to the development of osteoporosis through the interaction between chronic inflammation and bone formation,resorption,and absorption.Additionally,the use of glucocorticoids and the presence of autoantibodies(such as anti-citrullinated protein antibody)in patients with rheumatoid arthritis showed associations with osteoporosis.Future research should focus on monitoring systemic inflammatory markers,standardized use of glucocorticoids,and regular screening for osteoporosis risk in patients with rheumatoid arthritis.

Association between obesity and osteoporosis:a two-sample Mendelian randomization analysis / 中国组织工程研究

BACKGROUND:Numerous clinical studies have suggested a close relationship between obesity and osteoporosis,but whether there is a genetic causal effect between obesity and osteoporosis remains unclear. OBJECTIVE:To explore the association between obesity and osteoporosis using summary data from a large-scale genome-wide association study(GWAS)through Mendelian randomization analysis. METHODS:Obesity data were derived from summary statistics of the Genetic Investigation of Anthropometric Traits(GIANT)and the UK Biobank(UKBB).Osteoporosis data were obtained from the Genetic Factors for Osteoporosis(GeFOS)consortium,including two bone density phenotypes:total body bone mineral density(BMD)and heel BMD.The inverse variance-weighted method was the primary analysis,with the Mendelian randomization method based on Egger regression(MR-Egger)and weighted median method as supplementary approaches to calculate the causal association between genetic variations related to obesity and osteoporosis.Sensitivity analyses were conducted to validate the reliability of the results.Heterogeneity was assessed using Cochran's Q test.Horizontal pleiotropy was assessed through the MR-Egger intercept test.Leave-one-out analysis was performed to evaluate the potential influence of single nucleotide polymorphisms on the combined inverse variance-weighted estimates. RESULTS AND CONCLUSION:(1)Impact of obesity on osteoporosis:In addition to body mass index and forearm BMD,body mass index,waist-to-hip ratio,body mass index-adjusted waist-to-hip ratio,and whole-body body mass index,heel BMD,forearm BMD,lumbar spine BMD,and femoral neck BMD were causally related to each other.Further Meta-analysis revealed that obesity increased the risk of BMD(odds ratio=1.07,95%confidence interval:1.03-1.12,P<0.01).(2)Impact of osteoporosis on obesity:Apart from arm BMD and lumbar spine BMD as exposure factors showing causal relationships with obesity,other datasets indicated no causal effect between total body BMD,heel BMD,femoral neck BMD,and obesity.Additional meta-analysis demonstrated that BMD did not increase the risk of obesity(odds rate=0.99,95%confidence interval:0.98-1.01,P<0.01).There is a causal relationship between obesity and osteoporosis,suggesting that obesity may be a risk factor for osteoporosis.However,no causal association is found between osteoporosis and obesity.

Relationship between statin drugs and bone density:a drug target-mediated Mendelian randomization study / 中国组织工程研究

BACKGROUND:Observational studies have suggested that statin drugs may have a protective effect on bone density,making them a potential treatment option for osteoporosis. OBJECTIVE:To evaluate the causal relationship between drug target-mediated lipid phenotypes and bone mineral density(BMD)using Mendelian randomization methods. METHODS:We obtained single nucleotide polymorphismsrelated to statin drugs and BMD data from the IEU Open GWAS database.The primary analysis method was the inverse variance weighted method,and we also used weighted median,simple median,weighted mode,and MR-Egger regression.We usedβ values and 95%confidence intervals(CI)to assess the causal relationship between statin drugs and BMD.Additionally,we conducted sensitivity analyses to validate the results,assessed heterogeneity using Cochran's Q test,examined for horizontal pleiotropy using the MR-Egger intercept test,and performed leave-one-out analyses to determine if individual or multiplesingle nucleotide polymorphism influenced the results. RESULTS AND CONCLUSION:There was a significant association between the statin target of action,3-hydroxy-3-methyl glutaryl coenzyme A reductase-mediated low-density lipoprotein cholesterol,and heel bone BMD(β=-0.086,95%CI:-0.117 to-0.055,P=5.42×10-8)and whole-body BMD(β=-0.193,95%CI:-0.288 to-0.098,P=7.35×10-5).The findings of this study support the protective effect of statin drugs on BMD.These findings not only deepen our understanding of the relationship between cholesterol-related genes and bone health but also reveal potential therapeutic targets for improving BMD.

Effect of type 2 diabetes mellitus on bone mineral density in different age groups:a two-sample Mendelian randomization study / 中国组织工程研究

BACKGROUND:Epidemiologic studies have shown a correlation between type 2 diabetes mellitus and bone mineral density,but the causal association between the two and whether it is age-related remains unknown. OBJECTIVE:To study the correlation between type 2 diabetes mellitus and whole body bone mineral density at unspecified age and at all ages based on the Mendelian randomization technique. METHODS:The genome-wide association study(GWAS)data of type 2 diabetes mellitus and bone mineral density at all ages were selected from the IEU GWAS database of the University of Bristol.The exposure data were single nucleotide polymorphisms with significant correlation with type 2 diabetes mellitus as instrumental variables,and bone mineral density at all ages was selected as the outcome variable.Two-sample Mendelian randomization analysis of type 2 diabetes mellitus and bone mineral density was performed using inverse variance weighted method,weighted median estimator,and MR-Egger regression.The βvalue was used to evaluate the causal relationship between type 2 diabetes mellitus and bone mineral density at all ages. RESULTS AND CONCLUSION:A total of 118 single nucleotide polymorphisms were extracted from the GWAS summary data as instrumental variables.The MR-Egger regression results showed that there was no horizontal pleiotropy,but there was heterogeneity.Therefore,this study was based on the inverse variance weighted results.Inverse variance weighted results showed that type 2 diabetes mellitus may be a potential protective factor for bone mineral density and is associated with age:age-unspecified bone mineral density[β=0.038,95%confidence interval(CI):1.01-1.07,P=0.002],bone mineral density over 60 years old(β=0.052,95%CI:1.01-1.09,P=0.027),bone mineral density between 45-60 years old(β=0.049,95%CI:1.01-1.09,P=0.009),bone mineral density between 30-45 years old(β=0.033,95%CI:0.99-1.07,P=0.127).bone mineral density of 15-30 years old(β=0.025,95%CI:0.95-1.10,P=0.506),bone mineral density of 0-15 years old(β=0.006,95%CI:0.96-1.04,P=0.716).Similar results were obtained from the MR-Egger regression and weighted median estimator analyses.These findings indicate that type 2 diabetes mellitus may be one of the protective factors of bone mineral density,and there is a correlation with age.

Risk factors for adjacent vertebral compression fractures after percutaneous vertebroplasty / 中国组织工程研究

BACKGROUND:Percutaneous vertebroplasty is the most widely used method for the treatment of osteoporotic vertebral compression fractures,and most studies have concluded that percutaneous vertebroplasty increases the probability of adjacent vertebral secondary compression fractures in patients with osteoporotic vertebral compression fractures.However,controversy remains regarding the risk factors associated with adjacent vertebral re-fracture caused after percutaneous vertebroplasty. OBJECTIVE:To summarize the influencing factors of adjacent vertebral compression fractures after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures,in order to provide a certain reference for reducing the risk of its occurrence as well as formulating the corresponding treatment plan. METHODS:Using"osteoporosis,fracture,percutaneous vertebroplasty,adjacent vertebral compression fractures,risk factors"as the Chinese search terms,"osteoporosis,osteoporotic vertebral compression fractures,percutaneous vertebroplasty,adjacent vertebral compression fractures,risk factors"as English search terms,computerized searches were conducted on CNKI,Wanfang Medical Network,VIP,PubMed,Springer,ScienceDirect,and Elsevier databases.The search timeframe focuses on January 2018 through September 2023,with the inclusion of a few classic forward literature.The literature was screened by reading the titles and abstracts,and 83 papers were finally included in the review. RESULTS AND CONCLUSION:(1)Osteoporotic vertebral compression fractures are one of the most common complications of osteoporosis,placing elderly patients at a significant risk of disability and death.Percutaneous vertebroplasty is a practical and effective treatment for osteoporotic vertebral compression fractures.(2)With the popularity of percutaneous vertebroplasty,its secondary vertebral compression fractures have gradually increased,with adjacent vertebral compression fractures being the most common.(3)Previous studies have only discussed the effects of factors such as bone mineral density,multiple vertebral fractures,body mass index,age,sex,amount of bone cement,cement leakage,and anti-osteoporosis treatment on secondary compression fractures of adjacent vertebrae after percutaneous vertebroplasty,and summarized the number of vertebral fractures,timing of the operation,surgical approach,cement material,diffuse distribution of bone cement,recovery height of the injured vertebrae,and wearing of a support after surgery,which is not yet comprehensive.The analysis of the specific mechanisms of risk factor-induced adjacent vertebral fractures is relatively rare.(4)The results of the article showed that low bone mineral density,advanced age,perimenopausal women,multiple vertebral fractures,excessive recovery of the height of the injured vertebrae,cement leakage,comorbid underlying diseases,and poor lifestyle habits were the risk factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty,and that maintaining a normal body mass index,early surgery,bilateral percutaneous vertebroplasty,use of a new type of cement material,an appropriate volume of bone cement injection and uniform cement dispersion,regular anti-osteoporosis treatment,and postoperative brace wearing are protective factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty.