Bone Structure at the Distal Radius During Adolescent Growth
Bone Structure at the Distal Radius During Adolescent Growth
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DOI：
10.1359/jbmr.081255
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发表时间：
2009-06-01
影响因子：
6.2
通讯作者：
Khosla, Sundeep
中科院分区：
文献类型：
--
作者：
Kirmani, Salman;Christen, David;Khosla, Sundeep
前臂远端骨折的发生率在青少年生长突增期间达到高峰，但其结构基础尚不清楚。因此，我们在桡骨远端使用高分辨率 pQCT（体素大小，82 μm）研究了健康的 6 至 21 岁女孩 (n = 66) 和男孩 (n = 61)。受试者按骨龄分为五组：I组（青春期前，6-8岁）、II组（青春期早期，9-11岁）、III组（青春期中期，12-14岁）、TV组（青春期后期，15-17岁）和V组（青春期后，18-21岁）。与第一组相比，从青春期后期开始，女孩的小梁参数（骨体积分数、小梁数量和厚度）没有变化，但男孩的小梁参数有所增加。女孩的皮质厚度和密度从青春期前到青春期中期有所下降，但男孩的皮质厚度和密度没有变化，然后在青春期末上升到更高的水平。使用微有限元模型评估的总骨强度在男女骨龄组中呈线性增加，青春期中期后男孩的骨强度高于女孩。皮质骨承受的负荷比例以及皮质骨与小梁骨体积之比在男女青春期中后期均短暂下降，明显的皮质孔隙度在此期间达到峰值。这反映了先前研究中前臂远端骨折的发生率。我们得出的结论是，皮质骨的区域性缺陷可能是青少年前臂骨折高峰的原因。这些缺陷在前臂骨折的儿童中是否更严重或持续到以后的生活值得进一步研究。骨矿工研究杂志 2009；24：1033-1042。 2008年12月29日在线发布；号码：10.1359/JBMR.081255
The incidence of distal forearm fractures peaks during the adolescent growth spurt, but the structural basis for this is unclear. Thus, we studied healthy 6- to 21-yr-old girls (n = 66) and boys (n = 61) using high-resolution pQCT (voxel size, 82 mu m) at the distal radius. Subjects were classified into five groups by bone-age: group I (prepuberty, 6-8 yr), group II (early puberty, 9-11 yr), group III (midpuberty, 12-14 yr), group TV (late puberty, 15-17 yr), and group V (postpuberty, 18-21 yr). Compared with group I, trabecular parameters (bone volume fraction, trabecular number, and thickness) did not change in girls but increased in boys from late puberty onward. Cortical thickness and density decreased from pre- to midpuberty in girls but were unchanged In boys, before rising to higher levels at the end of puberty in both sexes. Total bone strength., assessed using microfinite element models, increased linearly across bone age groups in both sexes, with boys showing greater bone strength than girls after midpuberty. The proportion of load borne by cortical bone, and the ratio of cortical to trabecular bone volume, decreased transiently during mid- to late puberty in both sexes, with apparent cortical porosity peaking during this time. This mirrors the incidence of distal forearm fractures in prior studies. We conclude that regional deficits in cortical bone may underlie the adolescent peak in forearm fractures. Whether these deficits are more severe in children who sustain forearm fractures or persist into later life warrants further study. J Bone Miner Res 2009;24:1033-1042. Published online on December 29, 2008; doi: 10.1359/JBMR.081255