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A Comparative Study of Bone Tissue Morphology and Bone Turnover Markers in Different Stages of Kümmell's Disease
Journal of Clinical Densitometry ( IF 2.5 ) Pub Date : 2022-03-09 , DOI: 10.1016/j.jocd.2022.02.002
Zhichao Li 1 , Jingcai Xue 1 , Jianwen Dong 1 , Jianmin Sun 2 , Lei Wang 1 , Yun Zhang 3
Affiliation  

Although the incidence of Kümmell's disease (KD) has increased significantly in recent years, its pathological mechanism is still unclear. The aim of this study is to investigate the histomorphological characteristics and the kinetics of bone turnover markers following KD. This study involves 82 patients with KD, and fasting blood samples were collected to detect the serum concentration of bone turnover markers. A transpedicular bone biopsy was performed to collect bone biopsy specimens during vertebroplasty surgery. According to Li's staging system for KD, all cases were divided into 3 stages. Comparisons of the 3 stages and their kinetics were conducted. 19 (23.2%) patients were classified as Stage I, 39 (47.5%) as Stage II, 24 (29.2%) as Stage III. Bone histomorphological analysis showed that the ratios of WBV and FV reached a peak value (14.23 ± 0.62 and 54.63% ± 3.52%; p = 0.001 and 0.001) at Stage I. The ratios of NBV remained low (4.81% ± 2.61%) in Stage I, but reached a peak value (18.50% ± 2.77%; p = 0.001) in Stage III. Bone metabolism index level showed that the serum concentration of OST and β-CTX continued to rise after fracture, reaching a peak value of (38.15 ± 3.84 and 1.31 ± 0.16 ng/Ml; p = 0.073 and 0.026), while PINP reached its valley value (48.57 ± 7.25 ng/Ml; p = 0.069) in Stage III. A significant and negative correlation was found between the ratio of β-CTX and EBV/TV (p= 0.0194, r = -0.2037), and FV/TV (p= 0.0001, r = -0.5368). At the same time, β-CTX had a positive significant correlation with the NBV/TV (p= 0.0001, r = 0.6218). Bone histomorphometric analysis and bone turnover markers showed that KD has a possibility of healing in the early stage.



中文翻译:

Kümmell 病不同阶段骨组织形态学和骨转换标志物的比较研究

尽管近年库默尔病(Kümmell's disease,KD)的发病率明显上升,但其病理机制仍不清楚。本研究的目的是研究 KD 后骨转换标志物的组织形态学特征和动力学。本研究纳入82例KD患者,采集空腹血样本检测骨转换标志物的血清浓度。在椎体成形术期间进行经椎弓根骨活检以收集骨活检标本。根据李氏KD分期系统,所有病例均分为3期。对 3 个阶段及其动力学进行了比较。19 名 (23.2%) 患者被分类为I 期,39 名 (47.5%II 期, 24 (29.2%) 为 III 期。骨组织形态学分析表明,WBV 和 FV 的比率在阶段 I 达到峰值(14.23 ± 0.62 和 54.63% ± 3.52%; p  = 0.001 和 0.001)。NBV 的比率在第 I 阶段仍然很低(4.81% ± 2.61%)第一阶段,但在第三阶段达到峰值(18.50% ± 2.77%; p  = 0.001)。骨代谢指标水平显示,骨折后 OST 和 β-CTX 的血清浓度持续升高,达到峰值(38.15 ± 3.84 和 1.31 ± 0.16 ng/Ml;p  = 0.073 和 0.026),而 PINP 达到谷值 (48.57 ± 7.25 ng/Ml; p  = 0.069)。在 β-CTX 和 EBV/TV 的比率之间发现了显着的负相关 ( p = 0.0194,r  = -0.2037)和 FV/TV(p = 0.0001,r  = -0.5368)。同时,β-CTX与NBV/TV呈显着正相关(p =0.0001,r  =0.6218)。骨组织形态学分析和骨转换标志物显示KD有早期愈合的可能。

更新日期:2022-03-09
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