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Journal of Orthopaedic Surgery and Research
Published in:

Open Access 01-12-2024 | Research article

Exploring the impact of body mass index on the accuracy of vertebral bone quality in determining bone mineral density in patients undergoing lumbar fusion surgery

Authors: Xuan Zhao, Qijun Wang, Peng Wang, Chao Kong, Shibao Lu

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

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Abstract

Objective

To investigate whether body mass index (BMI) affects the accuracy of vertebral bone quality (VBQ) in determining bone mineral density (BMD) in patients undergoing lumbar fusion surgery.

Methods

In this retrospective study, patients with preoperative noncontrast T1-weighted MRI were included. Restricted Cubic Spline (RCS) was employed to explore the nonlinear relationship between BMI and VBQ. Then patients were stratified according to the threshold of BMI. Pearson correlation analysis and linear regression were used to analyze the correlation between VBQ and the BMD in different groups. Receiver operating characteristic (ROC) analysis to calculate the area under the curve (AUC) was used to assess diagnostic efficacy according to BMI.

Results

A total of 328 patients (201 female and 127 male patients) with a mean age of 68.3 ± 3.3 years were included in the study. Significant nonlinear relationship was observed given the results of RCS. In patients with BMI < 23.8 kg/m2, the correlation coefficient between VBQ and the lowest BMD was − 0.32 and significant distribution difference of VBQ score was observed between osteoporosis and normal as well as osteopenia subgroups. However, in patients with BMI ≥ 23.8 kg/m2, the correlation coefficient between VBQ and the lowest BMD was − 0.39 and significant distribution difference of VBQ score was observed in all three subgroups. In addition, the ROC analysis revealed that the predictive performance in determining low BMD was superior in patients with BMI ≥ 23.8 kg/m2 (AUC 0.80 vs. AUC 0.66, p = 0.034).

Conclusions

In this study, significant nonlinear relationship between BMI and VBQ was observed. Compared with patients with BMI < 23.8 kg/m2, VBQ has better discrimination between higher BMI (≥ 23.8 kg/m2) patients with low BMD and those with normal bone density.
Literature
1.
Rinonapoli G, Pace V, Ruggiero C et al. Obesity and bone: a complex relationship. Int J Mol Sci. 2021; 22(24).
2.
Lopez-Gomez JJ, Perez-Castrillon JL, Garcia de Santos I et al. Influence of obesity on bone turnover markers and fracture risk in Postmenopausal Women. Nutrients. 2022; 14(8).
3.
4.
Ding Y, Chen J-Y, Yang J-C, et al. Disc degeneration contributes to the denser bone in the subendplate but not in the vertebral body in patients with lumbar spinal stenosis or disc herniation. Spine J. 2023;23(1):64–71.CrossRefPubMed
5.
Moser M, Adl Amini D, Albertini Sanchez L, et al. The reciprocal relationship between lumbar intervertebral disk degeneration and the MRI-based vertebral bone quality score. Spine. 2024;49(17):1227–34.CrossRefPubMed
6.
Pu X, Wang X, Ran L, et al. Comparison of predictive performance for cage subsidence between CT-based Hounsfield units and MRI-based vertebral bone quality score following oblique lumbar interbody fusion. Eur Radiol. 2023;33(12):8637–44.CrossRefPubMed
7.
Wang L, Deng Q, Wang B, et al. Comparison of the predictive values of MRI-based vertebral bone quality scores for the determination of osteoporosis in different diseases. Eur Spine J. 2024;33(4):1504–10.CrossRefPubMed
8.
Chen Q, Ai Y, Huang Y, et al. MRI-based Endplate Bone Quality score independently predicts cage subsidence following transforaminal lumbar interbody fusion. Spine J. 2023;23(11):1652–8.CrossRefPubMed
9.
Wang Y, Wang F, Tong T et al. Sex differences in the accuracy of vertebral bone quality score assessing bone density in patients undergoing lumbar spinal fusion. J Neurosurgery: Spine. 2023; 1–7.
10.
Zhang B, Zhou L-P, Zhang X-L, et al. Which Indicator among lumbar vertebral hounsfield unit, vertebral bone quality, or dual-energy X-Ray absorptiometry-measured bone Mineral density is more efficacious in Predicting Thoracolumbar Fragility fractures? Neurospine. 2023;20(4):1193–204.CrossRefPubMedPubMedCentral
11.
Li W, Zhu H, Tian H et al. Combinations of two imaging parameters to improve bone mineral density (BMD) assessment in patients with lumbar degenerative diseases. BMC Musculoskelet Disord. 2023; 24(1).
12.
Li W, Wang F, Chen J, et al. MRI–based vertebral bone quality score is a comprehensive index reflecting the quality of bone and paravertebral muscle. Spine J. 2024;24(3):472–8.CrossRefPubMed
13.
Liu D, Kadri A, Hernando D, et al. MRI-based vertebral bone quality score: relationship with age and reproducibility. Osteoporos Int. 2023;34(12):2077–86.CrossRefPubMed
14.
Aynaszyan S, Devia LG, Udoeyo IF, et al. Patient physiology influences the MRI-based vertebral bone quality score. Spine J. 2022;22(11):1866–74.CrossRefPubMed
15.
Zheng R, Byberg L, Larsson SC, et al. Prior loss of body mass index, low body mass index, and central obesity independently contribute to higher rates of fractures in elderly women and men. J Bone Min Res. 2021;36(7):1288–99.CrossRef
16.
Kang DH, Guo LF, Guo T, et al. Association of body composition with bone mineral density in northern Chinese men by different criteria for obesity. J Endocrinol Invest. 2015;38(3):323–31.CrossRefPubMed
17.
Zhang Y, Pu J. The Saturation Effect of Obesity on Bone Mineral Density for Older People: The NHANES 2017–2020. Front Endocrinol (Lausanne). 2022; 13(883862).
18.
Ehresman J, Pennington Z, Schilling A, et al. Novel MRI-based score for assessment of bone density in operative spine patients. Spine J. 2020;20(4):556–62.CrossRefPubMed
19.
Courtois EC, Davidson I, Ohnmeiss DD et al. Evaluating alternatives to dual-energy x-ray absorptiometry for assessing bone quality in patients undergoing spine surgery. J Neurosurgery: Spine. 2023; 1–8.
20.
Shen J, Nielson CM, Marshall LM, et al. The Association between BMI and QCT-Derived proximal hip structure and strength in older men: a cross-sectional study. J Bone Min Res. 2015;30(7):1301–8.CrossRef
21.
Hammoud E, Toumi H, Jacob C, et al. Does the severity of obesity influence bone Mineral density values in Premenopausal women? J Clin Densitom. 2021;24(2):225–32.CrossRefPubMed
22.
Gomez-Ambrosi J, Rodriguez A, Catalan V, et al. The bone-adipose axis in obesity and weight loss. Obes Surg. 2008;18(9):1134–43.CrossRefPubMed
23.
Faienza MF, D’Amato G, Chiarito M et al. Mechanisms Involved in Childhood Obesity-Related Bone Fragility. Front Endocrinol (Lausanne). 2019; 10(269).
24.
Khan AU, Qu R, Fan T, et al. A glance on the role of actin in osteogenic and adipogenic differentiation of mesenchymal stem cells. Stem Cell Res Ther. 2020;11(1):283.CrossRefPubMedPubMedCentral
25.
Gandham A, Zengin A, Bonham MP et al. Incidence and predictors of fractures in older adults with and without obesity defined by body mass index versus body fat percentage. Bone. 2020; 140(115546).
26.
Savvidis C, Tournis S, Dede AD. Obesity and bone metabolism. Horm (Athens). 2018;17(2):205–17.CrossRef
27.
Özmen E, Biçer O, Meriç E, et al. Vertebral bone quality score for opportunistic osteoporosis screening: a correlation and optimal threshold analysis. Eur Spine J. 2023;32(11):3906–11.CrossRefPubMed
28.
Salzmann SN, Okano I, Jones C, et al. Preoperative MRI-based vertebral bone quality (VBQ) score assessment in patients undergoing lumbar spinal fusion. Spine J. 2022;22(8):1301–8.CrossRefPubMed
Metadata
Title
Exploring the impact of body mass index on the accuracy of vertebral bone quality in determining bone mineral density in patients undergoing lumbar fusion surgery
Authors
Xuan Zhao
Qijun Wang
Peng Wang
Chao Kong
Shibao Lu
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-024-05195-9

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