The Journal of Practical Medicine >

2023 , Vol. 39 >Issue 20: 2643 - 2650

DOI: https://doi.org/10.3969/j.issn.1006-5725.2023.20.016

Clinical Research

Risk factors for osteoporotic vertebral compression fractures in patients with chronic hepatitis B and MRI findings of lumbar paravertebral muscles

  • Kedi CHEN ,
  • Ximing. ZHANG
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  • *.Department of Hepatology，Xiangyang Traditional Chinese Medicine Hospital，Xiangyang 441021，China

Received date: 2023-05-29

  Online published: 2023-11-15

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Abstract

Objective To investigate the risk factors for osteoporotic vertebral compression fractures （OVCFs） in patients with chronic hepatitis B （CHB） and magnetic resonance imaging （MRI） findings of paravertebral muscles in the lumbar spine. Methods Six hundred and twenty-seven patients with CHB from April 2019 to April 2023 were selected. They were divided into OVCFs group （n = 124） and Non-OVCFs group （n = 503） based on T2-weighted MRI. Risk factors for OVCFs were analyzed after propensity score matching. R software was used to create column line plots. A risk stratification system was established by recursive segmentation.Cox model was used to analyze the association between MRI performance and OVCFs. Results The OVCFs group （n = 73） and Non-OVCFs group （n = 73） were balanced at baseline after matching （P > 0.05）. Multifactorial analysis showed that osteocalcin （OST） ［HR = 2.742 （1.653 ~ 4.572）］， β-collagen crosslinking （β-CTX） ［HR = 2.590 （1.984 ~ 3.391）］， type 1 procollagen amino-terminal extension peptide （P1NP） ［HR = 2.291 （1.672 ~ 2.860）］， sagittal Cobb's angle ［HR = 5.143 （3.375 ~ 6.622）］， and kyphosis ［HR = 1.772 （1.491 ~ 2.095）］ were risk factors for OVCFs. Bone mineral density ［HR = 0.682 （0.551 ~ 0.834）］， history of vitamin/calcium supplementation ［HR = 0.671 （0.563 ~ 0.792）］， and history of exercise ［HR = 0.890 （0.674 ~ 0.923）］ were protective factors. AUC = 0.926 （0.854 ~ 0.997） after column line plot validation. The mean error of calibration curve was 0.012. OVCFs were divided into very low risk group （< 105， n = 50）， low risk group （105 ≤ score < 204， n = 52）， medium risk group （204 ≤ score < 341， n = 26） and high risk group （≥ 341， n = 18）. There was an association between net muscle content， fat infiltration area and risk of OVCFs in L3/4， L4/5 erector spinae and multifidus muscles in each subgroup （Ptrend < 0.05）. However， there was no interaction between the subgroups （Pinteraction > 0.05）. Conclusion OST ≥ 15 ng/mL， β-CTX ≥ 0.5 ng/mL， P1NP ≥ 40 ng/mL， sagittal Cobb angle ≥ 55°， bone mineral density < -3.0， kyphosis deformity， not taking vitamin/calcium supplements， and lack of exercise are risk factors for OVCFs in CHB. With increased risk of OVCFs， CHB patients showed degenerative changes in the erector spinae and multifidus muscles at the L3/4 and L4/5 levels.

Key words： chronic hepatitis B; osteoporotic vertebral compression fractures; lumbar paravertebral muscles; magnetic resonance imaging

Cite this article

Kedi CHEN , Ximing. ZHANG . Risk factors for osteoporotic vertebral compression fractures in patients with chronic hepatitis B and MRI findings of lumbar paravertebral muscles[J]. The Journal of Practical Medicine, 2023 , 39(20) : 2643 -2650 . DOI: 10.3969/j.issn.1006-5725.2023.20.016

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