Predictive value of changes in CT value of vertebral body for the efficacy of zoledronate sodium in primary osteoporosis

doi:10.3877/cma.j.issn.2096-0263.2022.05.006

Abstract

Abstract:

Objective

To explore the predictive value of CT value changes of vertebral body for the efficacy of zoledronate sodium in primary osteoporosis (OP).

Methods

152 patients with primary OP who were admitted to the hospital from May 2018 to April 2021 were selected as the research objects. All patients were treated with zoledronic sodium, and the curative effect was calculated 12 months after treatment. Patient clinical data were collected. Logistic regression was used to analyze the factors that affect the efficacy of zoledronate in patients with primary OP. Receiver operating characteristic (ROC) curve was used to analyze the evaluation value of influencing factors on the efficacy of zoledronate in primary OP.

Results

2 patients dropped out. Among the remaining 150 patients, 59 patients had satisfactory curative effects, and 91 patients had poor curative effects of the 152 patients with primary OP. Logistic multivariate regression analysis showed that lumbar vertebral body cancellous bone L1 △CT value (OR=4.084, 95% CI: 1.680, 9.925), 25-hydroxyvitamin D (OR=3.640, 95% CI: 1.498, 8.847) were the influencing factors Independent factors for the efficacy of zoledronate sodium in patients with OP. The ROC curve showed that the AUC of lumbar vertebral cancellous bone L1 △CT value in evaluating the efficacy of primary OP zoledronate was higher than that of 25-hydroxyvitamin D.

Conclusions

Patients with primary OP are at risk of poor efficacy of zoledronate treatment. The changes of vertebral CT value and 25-hydroxyvitamin D level are related to the efficacy of zoledronate in primary OP. OP zoledronate has good efficacy.

Key words: Primary osteoporosis, CT value of vertebral body, Efficacy of zoledronate sodium, Predictive value

Lihui Lei, Feng Li, Guangping Luo, Hong Liu, Qizhang Yang, Tao Wu, Rui Weng. Predictive value of changes in CT value of vertebral body for the efficacy of zoledronate sodium in primary osteoporosis[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2022, 08(05): 285-289.

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References 19

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	因素	疗效不佳者（n=91）	疗效满意者（n=59）	t/χ²值	P值
性别				1.059	0.304
	男性	40（43.96）	31（52.54）
	女性	51（56.04）	28（47.46）
年龄（岁）				0.186	0.666
	≥60	34（37.36）	20（33.90）
	<60	57（62.64）	39（66.10）
体质量指数（kg/m²）				0.040	0.841
	<25	76（83.52）	50（84.75）
	≥25	15（16.48）	9（15.25）
吸烟史		30（32.97）	18（30.51）	0.099	0.753
饮酒史		20（21.98）	11（18.64）	0.243	0.622
TC（mmol/L）		4.70±0.81	4.51±0.62	1.533	0.127
TG（mmol/L）		2.26±0.37	2.31±0.33	0.843	0.401
HDLC（mmol/L）		1.43±0.22	1.46±0.21	0.830	0.408
LDLC（mmol/L）		2.35±0.39	1.99±0.35	5.746	<0.001
骨碱性磷酸酶（U/L）		82.35±12.30	81.21±11.65	0.566	0.572
血钙（mmol/L）		2.19±0.28	2.21±0.32	0.404	0.687
血磷（mmol/L）		1.27±0.21	1.29±0.23	0.549	0.584
25-羟维生素D（ug/l）		19.32±3.24	21.97±3.56	4.706	<0.001
腰椎体L₁△CT值（HU）
骨皮质		1.06±0.17	1.11±0.19	1.680	0.095
骨松质		3.04±0.42	5.09±0.71	22.214	<0.001

	因素	疗效不佳者（n=91）	疗效满意者（n=59）	t/χ²值	P值
性别				1.059	0.304
	男性	40（43.96）	31（52.54）
	女性	51（56.04）	28（47.46）
年龄（岁）				0.186	0.666
	≥60	34（37.36）	20（33.90）
	<60	57（62.64）	39（66.10）
体质量指数（kg/m²）				0.040	0.841
	<25	76（83.52）	50（84.75）
	≥25	15（16.48）	9（15.25）
吸烟史		30（32.97）	18（30.51）	0.099	0.753
饮酒史		20（21.98）	11（18.64）	0.243	0.622
TC（mmol/L）		4.70±0.81	4.51±0.62	1.533	0.127
TG（mmol/L）		2.26±0.37	2.31±0.33	0.843	0.401
HDLC（mmol/L）		1.43±0.22	1.46±0.21	0.830	0.408
LDLC（mmol/L）		2.35±0.39	1.99±0.35	5.746	<0.001
骨碱性磷酸酶（U/L）		82.35±12.30	81.21±11.65	0.566	0.572
血钙（mmol/L）		2.19±0.28	2.21±0.32	0.404	0.687
血磷（mmol/L）		1.27±0.21	1.29±0.23	0.549	0.584
25-羟维生素D（ug/l）		19.32±3.24	21.97±3.56	4.706	<0.001
腰椎体L₁△CT值（HU）
骨皮质		1.06±0.17	1.11±0.19	1.680	0.095
骨松质		3.04±0.42	5.09±0.71	22.214	<0.001

因素	β	SE	Wald χ²	P	OR	95% CI
腰椎体骨松质L₁ △CT值	1.407	0.235	35.847	<0.05	4.084	1.680，9.925
25-羟维生素D	1.292	0.304	18.063	<0.05	3.640	1.498，8.847

因素	β	SE	Wald χ²	P	OR	95% CI
腰椎体骨松质L₁ △CT值	1.407	0.235	35.847	<0.05	4.084	1.680，9.925
25-羟维生素D	1.292	0.304	18.063	<0.05	3.640	1.498，8.847

指标	截断值	AUC	95% CI	灵敏度	特异度
腰椎体骨松质L₁ △CT值	4.08 HU	0.754	0.656，0.852	74.19%	70.00%
25-羟维生素D	20.86 ug/l	0.703	0.565，0.813	78.90%	62.19%

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