Structural and biomechanical basis of racial and sex differences in vertebral fragility in Chinese and Caucasians
Structural and biomechanical basis of racial and sex differences in vertebral fragility in Chinese and Caucasians
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DOI：
10.1016/j.bone.2004.11.016
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发表时间：
2005-06-01
期刊：
影响因子：
4.1
通讯作者：
Seeman, E
中科院分区：
文献类型：
--
作者：
Duan, YB;Wang, XF;Seeman, E
我们对 1868 名年龄在 18 至 93 岁之间的健康中国和白人女性和男性进行了一项横断面研究，以确定椎体 (VB) 脆性的种族和性别差异的结构和生物力学基础。使用双能X射线吸收仪测量第三腰椎的VB骨矿物质含量（BMC）、横截面积（CSA）和体积骨矿物质密度（vBMD）。利用工程原理，我们计算了每单位 CSA 的载荷（应力）、根据 vBMD 估算的 VB 强度以及应力与强度的比率（断裂风险指数，FRI）。与白种人相比，中国年轻女性和男性的 VB 较小，vBMD 较高。在每场比赛中，女性的 VB 均小于男性，但 vBMD 相似。从青年期（约30岁）到老年（约70岁），中国人的VB CSA增加幅度高于白人女性（8.6% vs. 5.8%），而中国人的增加幅度低于白人男性（8.7% vs. 11.8%）。中国女性和白人女性的估计骨膜骨沉积量相似（2.64 克与 2.63 克，峰值 BMC 的 46% 与 40%）。估计的骨内骨丢失量相似（3.94 与 4.05 g 或峰值 BMC 的 68% 与 62%）。由于骨内骨丢失超过骨膜骨增加，VB 中净骨丢失，但这在中国和白人女性中相似（1.30 与 1.42 g 或两者都丢失了峰值 BMC 的 22%）。对于男性来说，中国人获得的骨膜骨比白人少（2.73 vs. 5.05 g 或峰值 BMC 的 34% vs. 56%），骨内骨损失也较少（3.07 vs. 5.49 g 或峰值 BMC 的 38% vs. 61%），因此中国人和白人男性的净骨损失相似（0.34 vs. 0.44 g，均损失了峰值 BMC 的 5%） BMC）。比较性别，中国女性的净骨丢失量高于男性，因为女性的骨内骨丢失量（峰值 BMC 的 68%）高于男性（峰值 BMC 的 38%）；女性和男性的骨膜骨增加相似。在白种人中，女性的净骨丢失量高于男性，因为女性的骨膜骨增加量 (40%) 低于男性 (56%)，骨内骨丢失量相似。与年龄相关的 VB CSA 增加降低了 VB 压力，但 vBMD 降低，因此 FRI 增加；与 25% 的老年中国和白人女性相似，与 5% 的老年中国和白人男性相似，FRI 高于 1。骨骼脆弱的结构基础因种族和性别而异。骨膜并置在决定净骨丢失、几何形状和强度方面的种族和性别差异方面发挥着关键作用。 Crown 版权所有 (c) 2004 由 Elsevier Inc. 出版。保留所有权利。
We conducted a cross-sectional study in 1868 healthy Chinese and Caucasian women and men aged 18 to 93 years to define the structural and biomechanical basis for racial and sex differences in vertebral body (VB) fragility. VB bone mineral content (BMC), cross-sectional area (CSA), and volumetric bone mineral density (vBMD) of the third lumbar vertebrae were measured using dual-energy X-ray absorptiometry. Using engineering principles, we calculated the load per unit CSA (stress), VB strength estimated from vBMD and the ratio of stress to strength (fracture risk index, FRI). Young adult Chinese women and men had a smaller VB with a higher vBMD than their Caucasian counterparts. In each race, women had a smaller VB than men but similar vBMD. From young adulthood (similar to 30 years) to old age (similar to 70 years), VB CSA increased more in Chinese than Caucasian women (8.6% vs. 5.8%) and increased less in Chinese than Caucasian men (8.7% vs. 11.8%). Estimated periosteal bone deposited was similar in Chinese and Caucasian women (2.64 vs. 2.63 g, 46% vs. 40% of peak BMC). Estimated endosteal bone lost was similar (3.94 vs. 4.05 g or 68% vs. 62% of peak BMC). As endosteal bone loss exceeded periosteal bone gain, net bone was lost from the VB, but this was similar in Chinese and Caucasian women (1.30 vs. 1.42 g or both lost 22% of peak BMC). For men, Chinese gained less periosteal bone than Caucasians (2.73 vs. 5.05 g or 34% vs. 56% of peak BMC) and lost less endosteal bone (3.07 vs. 5.49 g or 38% vs. 61% of peak BMC), so net bone loss was similar in Chinese and Caucasian men (0.34 vs. 0.44 g, both lost 5% of peak BMC). Comparing sexes, in Chinese, net bone loss was greater in women than in men because of greater endosteal bone loss in women (68% of peak BMC) than men (38% of peak BMC); periosteal bone gain was similar in women and men. In Caucasians, net bone loss was greater in women than men because periosteal bone gain was less in women (40%) than men (56%), endosteal bone loss was similar. The age-related increase in VB CSA reduced VB stress but vBMD decreased so the FRI increased; similar to 25% of elderly Chinese and Caucasian women and similar to 5% of elderly Chinese and Caucasian men had an FRI above unity. The structural basis of bone fragility differs by race and sex. Periosteal apposition plays a pivotal role in determining racial and sex differences in net bone loss, geometry, and strength. Crown Copyright (c) 2004 Published by Elsevier Inc. All rights reserved.