Hormone replacement therapy improves distal radius bone structure by endocortical mineral deposition.
Hormone replacement therapy improves distal radius bone structure by endocortical mineral deposition.
复制标题
激素替代疗法通过皮质内矿物质沉积改善远端桡骨结构。
DOI：
10.1139/y03-096
复制
发表时间：
2003
影响因子：
2.1
通讯作者：
J. Adachi
中科院分区：
文献类型：
--
作者：
M. Muller;C. Webber;J. Adachi
激素替代疗法（HRT）产生一个小的增加骨矿物质密度（BMD）时，测量双能X线吸收（DXA）。骨折风险的相应降低更令人印象深刻，这意味着其他因素，有助于骨强度被HRT有利地修改。我们调查，使用外周定量计算机断层扫描（pQCT），HRT产生的变化在皮质骨和骨小梁之间的矿物质分布和HRT产生的变化在骨小梁的表观结构，表示为平均孔面积和表观连接。对21名开始HRT的绝经后妇女和32名对照妇女进行了为期2年的随访，每6个月进行一次桡骨远端pQCT测量。HRT防止了对照组中观察到的总骨量丢失（p < 0.02）。HRT也在研究的前6个月内产生了明显的骨小梁质量的快速损失（p < 0.02），以及相关的明显连接性的快速损失（p = 0.034）。平均孔面积也有所增加，但未达到统计学显著程度。外源性雌激素明显填充靠近皮质内表面的小骨髓孔，使得pQCT定义的骨小梁和皮质骨之间的边界向有利于皮质骨的方向移动。骨小梁结构指数受到不利影响，因为中央、互连不良的骨小梁（骨髓空间大于平均值）构成剩余骨小梁的较大部分。这项研究表明，HRT导致的骨折风险的改善是由骨的净皮质内吸收的逆转来解释的。
Hormone replacement therapy (HRT) produces a small increase in bone mineral density (BMD) when measured by dual energy X-ray absorptiometry (DXA). The corresponding decrease in fracture risk is more impressive, implying that other factors that contribute to bone strength are favourably modified by HRT. We investigated, using peripheral quantitated computed tomography (pQCT), the changes produced by HRT in both the distribution of mineral between cortical and trabecular bone and the changes produced by HRT in the apparent structure of trabecular bone, expressed as average hole area and apparent connectivity. Twenty-one postmenopausal women starting HRT and 32 control women were followed for 2 years, with distal radius pQCT measurements every 6 months. HRT prevented the loss of total bone mass seen in controls (p < 0.02). HRT also produced an apparent rapid loss of trabecular bone mass within the first 6 months of the study (p < 0.02), with an associated rapid loss in the apparent connectivity (p = 0.034). Average hole area also increased but not to a statistically significant extent. Exogenous estrogen apparently fills small marrow pores close to the endocortical surface, such that the pQCT-defined boundary between trabecular and cortical bone is shifted in favour of cortical bone. Trabecular bone structure indices are adversely affected, as the central, poorly interconnected trabecular bone with greater than average marrow spaces constitutes a greater fraction of the remaining trabecular bone. This study suggests that the improvements in fracture risk resulting from HRT are explained by a reversal of net endocortical resorption of bone.