Bone geometry and skeletal fragility.
Bone geometry and skeletal fragility.
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DOI：
10.1007/s11914-006-0002-9
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发表时间：
2006-06-01
影响因子：
4.3
通讯作者：
Karasik, David
中科院分区：
文献类型：
--
作者：
Bouxsein, Mary L;Karasik, David
尽管低骨密度是骨折最强的风险因素之一，但许多临床研究表明骨密度测量在评估骨折风险和监测治疗反应方面存在局限性。这些观察使人们重新关注影响骨骼脆弱性的更广泛因素，包括骨骼大小，形状和微结构。本文综述了骨几何结构与骨骼脆性之间的关系，重点介绍了骨几何结构对骨强度和骨折风险的影响。它还回顾了骨质疏松症治疗对股骨几何形状影响的最新数据。很明显，骨骼的大小和形状特征强烈影响其生物力学强度，但对于改善骨折风险预测的几何参数尚无共识。髋关节结构分析的最新数据表明，抗吸收和抗代谢治疗改变股骨几何形状，但这一观察结果取决于几个假设，尚未在骨质疏松症治疗受试者中进行测试。目前的知识是有限的，在一定程度上，主要使用二维技术来评估骨几何形状。需要结合三维成像的额外研究来更好地定义骨几何结构和骨骼脆性之间的关系，并建立骨几何结构测量的临床实用性。
Although low bone mineral density is among the strongest risk factors for fracture, a number of clinical studies have demonstrated the limitations of bone mineral density measurements in assessing fracture risk and monitoring the response to therapy. These observations have brought renewed attention to the broader array of factors that influence skeletal fragility, including bone size, shape, and microarchitecture. This article reviews the relationship between bone geometry and skeletal fragility, focusing on the impact of bone geometry on bone strength and fracture risk. It also reviews recent data on the effect of osteoporosis therapies on femoral geometry. It is clear that characteristics of a bone's size and shape strongly influence its biomechanical strength, but there is no consensus as to the geometric parameters that improve prediction of fracture risk. Recent data from hip structure analysis indicate that antiresorptive and anticatabolic treatments alter femoral geometry, but this observation depends on several assumptions that have not been tested in subjects treated with osteoporosis therapies. Current knowledge is limited, in part, by the predominant use of two-dimensional techniques to assess bone geometry. Additional studies that incorporate three-dimensional imaging are needed to better define the relationship between bone geometry and skeletal fragility, and to establish the clinical utility of bone geometry measurements.