Diagnostic performance of the vertebral bone quality score for osteoporosis is minimally influenced by lipid parameters in lumbar fusion patients: a retrospective study.

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the influence of lipid parameters on vertebral bone quality (VBQ) scores in patients undergoing lumbar fusion surgery. OVERVIEW OF LITERATURE: The MRI-derived VBQ score is a validated tool for assessing osteoporosis in patients undergoing lumbar fusion surgery. However, the effect of lipid parameters on its diagnostic performance remains unclear. METHODS: Consecutive patients who underwent lumbar fusion surgery over a 3-year period were retrospectively reviewed. Inclusion required the availability of lumbar T-scores, quantitative computed tomography, magnetic resonance imaging (MRI), and laboratory data obtained within a 1-month interval. Patients were stratified according to lipid levels and clinical characteristics. Correlation analysis and receiver operating characteristic (ROC) curve analysis evaluated the impact of lipid parameters on VBQ 1.5T, VBQ 3.0T, and the calibrated VBQ (C-VBQ) scores, which was developed to improve consistency across different MRI field strengths. RESULTS: This study included 294 patients (mean age, 67.1±6.5 years; 57.8% female; 56.8% with hyperlipidemia). Among the lipid parameters evaluated, only high-density lipoprotein cholesterol (HDLC) demonstrated a modest association with VBQ scores. Correlation analysis demonstrated significant positive correlations between HDLC and both VBQ 1.5T (p =0.003) and C-VBQ (p =0.001). After stratification by HDLC levels, C-VBQ differed significantly between normal and abnormal HDLC groups (p =0.046). Significant differences in VBQ 3.0T and C-VBQ across HDLC quintiles persisted even after T-score adjustment (p =0.037 and p =0.003). ROC analysis revealed minimal influence of lipid parameters or hyperlipidemia on VBQ diagnostic performance. CONCLUSIONS: Among lipid parameters, only HDLC was positively associated with VBQ scores; however, this weak association did not significantly compromise the diagnostic performance of VBQ for osteoporosis.