Thoracic vertebral bone mineral density measured by quantitative computed tomography is associated with fracture risk in lung cancer screening populations: a prospective cohort study

作者：Wenzhen Jiang, Jinchao Huang, Nan Wu, Jiaxin Liu, Jing Liang, Shixia Li, Zhaoxiang Ye, Jing Wang · 发表于：Frontiers in Endocrinology · 年份：2025 · DOI：10.3389/fendo.2025.1672551 · 被引用次数：2 · 研究领域：Bone health and osteoporosis research、Radiation Dose and Imaging、Medical Imaging Techniques and Applications

Background Chest low-dose computed tomography (LDCT) is extensively utilized for lung cancer screening, offering a concurrent opportunity to assess thoracic vertebral bone mineral density (BMD) using quantitative computed tomography (QCT). Nonetheless, the value of thoracic BMD (TBMD) in estimating the risk of fractures within this population remains underexplored. Purpose We sought to assess the association between fractures and QCT-based TBMD derived from chest LDCT in a lung cancer screening population. Materials and methods A prospective study was conducted involving 546 adults aged 40 to 74 years who were enrolled in a lung cancer screening program between 2017 and 2021. TBMD and lumbar BMD (LBMD) were assessed from chest LDCT scans using QCT. Self-reported incident fractures were recorded over a 3-year period, and vertebral fractures (VFs) were evaluated on follow-up CT. Binary logistic regression models and area under the curve (AUC) analyses were utilized to develop and compare the models incorporating TBMD, LBMD, and FRAX for estimating fracture risk. Results Out of the total participants, 323 individuals (59.2%) were found to have VFs, while 16 individuals (2.9%) reported experiencing incident fractures over a period of three years. In unadjusted logistic regression analyses, TBMD was associated with CT-detected VFs (OR = 0.955; 95% CI: 0.947 - 0.963). After adjusting for age and current smoking, TBMD remained associated with CT-detected VFs (OR = 0.953; 95% CI: 0.9...