Objective: To explore bone mass changes in patients with SAPHO syndrome, utilizing bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and vertebral bone quality (VBQ) scores measured by MRI. Methods: Thirty-six patients with SAPHO syndrome at Peking Union Medical College Hospital from February 2014 to February 2024 were retrospectively collected with 36 age- and gender-matched healthy controls. DXA assessed BMD, corresponding T-score and Z-score of the lumbar spine (LS), femoral neck (FN), total hip (TH), and trabecular bone score (TBS). LS MRI T₁-weighted imaging (T₁WI) measured the VBQ scores. Correlations between BMD, TBS, and VBQ scores were analyzed using Pearson correlation. The predictive efficacy of VBQ scores for low bone mass and impaired bone microarchitecture in patients with SAPHO syndrome was assessed using receiver operating characteristic (ROC) curves, with the area under the curve (AUC), optimal diagnostic cut-off values, sensitivity, and specificity documented. Results: The mean age of patients with SAPHO syndrome was (44.8±9.5) years, with 8 (22.2%) males. There were 36 subjects in the control group with a mean age of (44.8±9.5) years and 8(22.2%) males. Compared to the controls, the case group had lower FN BMD, TH BMD, corresponding T-score and Z-score, TBS, and higher VBQ scores (all P<0.05). Compared to the controls, female patients in the case group had lower LS BMD, FN BMD, TH BMD, corresponding T-score and Z-score, TBS, and higher VBQ scores (all P<0.05), whereas only male patients in the case group had higher VBQ scores (P=0.028). Ten cases (27.8%) in the case group had low bone mass and 19 cases (52.8%) had impaired bone microarchitecture, higher than the 3 cases (8.3%) and 9 cases (25.0%) in controls respectively (both P<0.05). VBQ scores in the case group were negatively correlated with FN BMD, FN T-score, TH BMD, TH T-score, and TBS (r=-0.375, -0.391, -0.368, -0.361, and -0.389, respectively, all P<0.05). The AUCs of VBQ scores for predicting ROC curves of low bone mass and impaired bone microarchitecture in patients with SAPHO syndrome were 0.796 (95%CI: 0.649-0.944) and 0.694 (95%CI: 0.521-0.866), with a sensitivity of 100.0% and 47.4%, and a specificity of 53.9% and 88.2%, respectively. Conclusions: Patients with SAPHO syndrome present with low bone mass and impaired bone microarchitecture. VBQ score has a high sensitivity for predicting low bone mass and a high specificity for predicting impaired bone microarchitectural in patients with SAPHO syndrome.

目的： 基于双能X线（DXA）测量的骨密度（BMD）和MRI测量的椎体骨质量（VBQ）评分探讨SAPHO综合征患者的骨量变化。 方法： 回顾性收集2014年2月至2024年2月于北京协和医院就诊的36例SAPHO综合征患者为病例组，以年龄及性别匹配的36名健康体检者为对照组。基于DXA评估腰椎、股骨颈和全髋的BMD、相应T值、Z值和骨小梁分数（TBS）。腰椎MRI T₁加权成像（T₁WI）测量VBQ评分。使用Pearson相关分析考察BMD、TBS与VBQ评分的相关性。通过受试者工作特征（ROC）曲线分析VBQ评分预测SAPHO综合征患者发生低骨量及骨微结构受损的效能，计算曲线下面积（AUC）、最佳诊断界值、灵敏度及特异度。 结果： 病例组年龄（44.8±9.5）岁，男8例（22.2%）；对照组36名，年龄（44.8±9.5）岁，男8名（22.2%）。病例组股骨颈BMD、全髋BMD、相应T值及Z值、TBS均低于对照组，VBQ评分高于对照组（均PPP=0.028）。病例组10例（27.8%）为低骨量，19例（52.8%）为骨微结构受损，均高于对照组的3例（8.3%）低骨量和9例（25.0%）骨微结构受损（均Pr分别为-0.375、-0.391、-0.368、-0.361和-0.389，均PCI：0.649~0.944）和0.694（95%CI：0.521~0.866），灵敏度分别为100.0%和47.4%，特异度分别为53.9%和88.2%。 结论： SAPHO综合征患者可出现低骨量及骨微结构损伤。VBQ评分预测SAPHO综合征患者低骨量具有较高的灵敏度，预测骨微结构损伤具有较高的特异度。