Peak Bone Mass From Longitudinal Data: Implications for the Prevalence, Pathophysiology, and Diagnosis of Osteoporosis
Peak Bone Mass From Longitudinal Data: Implications for the Prevalence, Pathophysiology, and Diagnosis of Osteoporosis
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DOI：
10.1002/jbmr.95
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发表时间：
2010-09-01
影响因子：
6.2
通讯作者：
Hanley, David A.
中科院分区：
文献类型：
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作者：
Berger, Claudie;Goltzman, David;Hanley, David A.
我们使用加拿大多中心骨质疏松症研究(CAMOS)的纵向数据估计了615名女性和527名男性的峰值骨量(PBM)，年龄在16岁到40岁之间。对个体变化率进行平均，以求出每个基线年龄的平均变化率。PBM的年龄范围被定义为骨密度(BMD)稳定的时期。根据2006年加拿大人口普查数据，通过分层模型对PBM进行估计。腰椎髓核(1.046+/-0.123 g/cm(2))发生在女性33-40岁和男性19-33岁(1.066+/-0.129 g/cm(2))。全髋关节骨密度(0.981+/-0.122 g/cm(2))发生在16~19岁的女性和19~21岁的男性(1.093+/-0.169 g/cm(2))。对加拿大地理变异的分析表明，65岁以上人群的PBM水平和平均BMD水平有时是不一致的，这表明PBM和随后的骨丢失率可能受到不同的遗传和/或环境影响。根据我们纵向估计的PBM值，估计加拿大50岁及以上女性的骨质疏松患病率(T-Score)为12.0%(L-1-L-4)和9.1%(全髋关节)，50岁及以上男性为2.9%(L-1-L-4)和0.9%(全髋关节)。这些都高于使用PBM横断面数据的患病率。综上所述，我们发现，不同性别和骨骼部位获得骨质疏松症的年龄不同，不同的骨质疏松症参考值会导致对骨质疏松症患病率的不同估计。此外，65岁以上的PBM和BMD缺乏一致性提示了不同的PBM和随后的骨丢失的决定因素。(C)2010年美国骨与矿物研究学会。
We estimated peak bone mass (PBM) in 615 women and 527 men aged 16 to 40 years using longitudinal data from the Canadian Multicentre Osteoporosis Study (CaMos). Individual rates of change were averaged to find the mean rate of change for each baseline age. The age range for PBM was defined as the period during which bone mineral density (BMD) was stable. PBM was estimated via hierarchical models, weighted according to 2006 Canadian Census data. Lumbar spine PBM (1.046 +/- 0.123 g/cm(2)) occurred at ages 33 to 40 years in women and at 19 to 33 years in men (1.066 +/- 0.129 g/cm(2)). Total hip PBM (0.981 +/- 0.122 g/cm(2)) occurred at ages 16 to 19 years in women and 19 to 21 years in men (1.093 +/- 0.169 g/cm(2)). Analysis of Canadian geographic variation revealed that the levels of PBM and of mean BMD in those over age 65 sometimes were discordant, suggesting that PBM and subsequent rates of bone loss may be subject to different genetic and/or environmental influences. Based on our longitudinally estimated PBM values, the estimated Canadian prevalences of osteoporosis (T-score < -2.5) were 12.0% (L-1-L-4) and 9.1% (total hip) in women aged 50 years and older and 2.9% (L-1-L-4) and 0.9% (total hip) in men aged 50 years and older. These were higher than prevalences using cross-sectional PBM data. In summary, we found that the age at which PBM is achieved varies by sex and skeletal site, and different reference values for PBM lead to different estimates of the prevalence of osteoporosis. Furthermore, lack of concordance of PBM and BMD over age 65 suggests different determinants of PBM and subsequent bone loss. (C) 2010 American Society for Bone and Mineral Research.