Persons with traumatic spinal cord injury (SCI) have severe bone loss below the level of lesion with the distal femur (DF) and proximal tibia (PT) being the skeletal regions having the highest risk of fracture. While a reference areal bone mineral density (aBMD) database is available at the total hip (TH) using the combined National Health and Nutrition Examination Survey (NHANES) III study and General Electric (GE) combined (GE/NHANES) to calculate T-score (T-score_GE/NHANES), no such reference database exists for aBMD of the DF, and PT. The primary objectives of this study were (1) to create a reference dataset of young-healthy able-bodied (YHAB) persons to calculate T-score (T-score_YHAB) values at the DF and PT, (2) to explore the impact of time since injury (TSI) on relative bone loss in the DF and PT regions using the two computation models to determine T-score values, and (3) to determine agreement between T-score values for a cohort of persons with SCI using the (T-score_YHAB) and (T-score_GE/NHANES) reference datasets. A cross-sectional prospective data collection study. A Department of Veterans Affairs Medical Center and a Private Rehabilitation Hospital. A normative reference aBMD database at the DF and PT was collected in 32 male and 32 female Caucasian YHAB participants (n=64) and then applied to calculate T-score values at the DF and PT in 105 SCI participants from a historical cohort. The SCI participants were then grouped based on TSI epochs (E-I: TSI < 1y, E-II: TSI 1–5y, E-III: TSI 6–10y, E-IV: TSI 11–20y, E-V: TSI > 20y). N/A. The knee and hip aBMD values were obtained by dual energy X-ray absorptiometry (GE Lunar iDXA) using standard clinical software for proximal femur orthopedic knee software applications. There were no significant differences in mean aBMD values across the four YHAB age subgroups (21–25, 26–30, 31–35, and 36–40 yr of age) at the TH, DF, and PT; mean aBMD values were higher in men compared to the women at all skeletal regions of interest. Using the mean YHAB aBMD values to calculate T-score values at each TSI epoch for persons with SCI, T-score values decreased as a function of TSI, and they continued to decline for 11–20 yr. Moderate kappa agreement was noted between the YHAB and the GE/NHANES reference datasets for the T-score cutoff criteria accepted to diagnose osteoporosis (i.e., SD <-2.5). A homogeneous reference dataset of YHAB aBMD values at the DF and PT was applied to calculate T-score values in persons with chronic SCI. There was a moderate level of agreement at the TH between the YHAB and GE/NHANES reference datasets when applying the conventional T-score cutoff value for the diagnosis of osteoporosis.

患有创伤性脊髓损伤(SCI) 的人在病变水平以下有严重的骨丢失，股骨远端 (DF) 和胫骨近端 (PT) 是骨折风险最高的骨骼区域。虽然使用联合国家健康和营养检查调查 (NHANES) III 研究和通用电气 (GE) 联合 (GE/NHANES) 来计算 T-分数（T 分数_GE/NHANES），对于 DF 和 PT 的 aBMD，不存在这样的参考数据库。本研究的主要目标是 (1) 创建一个年轻健康健全 (YHAB) 人的参考数据集，以计算 T 分数 (T-score_YHAB) DF 和 PT 的值，(2) 使用两种计算模型来探索受伤后时间 (TSI) 对 DF 和 PT 区域相对骨丢失的影响，以确定 T 分数值，以及 (3) 确定使用（T-score _YHAB）和（T-score _{GE/NHANES ）}的一组 SCI 患者的 T-score 值之间的一致性) 参考数据集。一项横断面前瞻性数据收集研究。退伍军人事务部医疗中心和私人康复医院。在 32 名男性和 32 名女性高加索 YHAB 参与者（n = 64）中收集了 DF 和 PT 的规范参考 aBMD 数据库，然后用于计算来自历史队列的 105 名 SCI 参与者的 DF 和 PT 的 T 分数值。然后根据 TSI 时期对 SCI 参与者进行分组（EI：TSI < 1y，E-II：TSI 1-5y，E-III：TSI 6-10y，E-IV：TSI 11-20y，EV：TSI > 20y） . 不适用。膝关节和髋关节 aBMD 值通过双能 X 线骨密度仪 (GE Lunar iDXA) 使用标准的股骨近端临床软件获得骨科膝关节软件应用程序。TH、DF 和 PT 四个 YHAB 年龄亚组（21-25、26-30、31-35 和 36-40 岁）的平均 aBMD 值没有显着差异；在所有感兴趣的骨骼区域，男性的平均 aBMD 值均高于女性。使用平均 YHAB aBMD 值来计算 SCI 患者在每个 TSI 时期的 T 分值，T 分值随着 TSI 下降，并且持续下降 11-20 年。在 YHAB 和 GE/NHANES 参考数据集之间注意到了中度 kappa 一致性，用于诊断骨质疏松症的 T 分数截止标准（即 SD <-2.5）。应用 DF 和 PT 的 YHAB aBMD 值的同质参考数据集来计算慢性 SCI 患者的 T 分数值。