CHANGES IN BONE-MINERAL DENSITY OF THE PROXIMAL FEMUR AND SPINE WITH AGING - DIFFERENCES BETWEEN THE POST-MENOPAUSAL AND SENILE OSTEOPOROSIS SYNDROMES
CHANGES IN BONE-MINERAL DENSITY OF THE PROXIMAL FEMUR AND SPINE WITH AGING - DIFFERENCES BETWEEN THE POST-MENOPAUSAL AND SENILE OSTEOPOROSIS SYNDROMES
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DOI：
10.1172/jci110667
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发表时间：
1982-01-01
影响因子：
15.9
通讯作者：
MELTON, LJ
中科院分区：
文献类型：
--
作者：
RIGGS, BL;WAHNER, HW;MELTON, LJ
采用双光子吸收法测定了205名正常志愿者（123名女性和82名男性;年龄范围20-92岁）和31名髋部骨折患者（26名女性和5名男性;平均年龄78岁）的股骨近端、腰椎或两者的骨密度（BMD）。对于正常女性，BMD随年龄的回归在每个部位都是负的和线性的;一生中股骨颈的总体下降率为58%，股骨粗隆间区域为53%，腰椎为42%。正常男性的年龄回归也是线性的，股骨颈和股骨粗隆间BMD下降率为女性的2/3，腰椎BMD下降率仅为女性的1/4。这种差异可以解释为什么女性/男性比例为2：1髋部骨折，而8：1椎骨骨折。26名女性髋部骨折患者与性别-年龄校正正常均值的标准差（Z评分）平均值为：股骨颈-0.31（P < 0.05），股骨粗隆间-0.53（P < 0.01），腰椎+0.24（NS）; 5名男性髋部骨折患者的结果相似。相比之下，另外27名年龄在51-65岁的女性，只有非创伤性椎体骨折，腰椎Z评分为-1.92（P < 0.001）。与骨质疏松症是一个单一的年龄相关的实体的观点相反，存在2个不同的综合征建议。绝经后骨质疏松症的一种形式，其特征是过度和不成比例的骨小梁丢失，涉及绝经后早期的一小部分妇女，主要与椎骨骨折有关。另一种形式是老年性骨质疏松症，其特征是皮质骨和骨小梁骨的成比例损失，基本上涉及整个老年妇女人口，在较小程度上涉及老年男子，并与髋部骨折或椎骨骨折或两者有关。
Bone mineral density (BMD) of the proximal femur, lumbar spine, or both was measured by dual photon absorptiometry in 205 normal volunteers (123 women and 82 men; age range 20-92 yr) and in 31 patients with hip fractures (26 women and 5 men; mean age, 78 yr). For normal women, the regression of BMD on age was negative and linear at each site; overall decrease during life was 58% in the femoral neck, 53% in the intertrochanteric region of the femur and 42% in the lumbar spine. For normal men, the age regression was linear also; the rate of decrease in BMD was 2/3 of that in women for femoral neck and intertrochanteric femur but was only 1/4 of that in women for lumbar spine. This difference may explain why the female/male ratio is 2:1 for hip fractures but 8:1 for vertebral fractures. The standard deviation (Z-score) from the sex-specific age-adjusted normal mean in 26 women with hip fracture averaged -0.31 (P < 0.05) for the femoral neck, -0.53 (P < 0.01) for the intertrochanteric femur and +0.24 (NS) for the lumbar spine; results were similar for 5 men with hip fractures. By contrast, for 27 additional women, ages 51-65 yr, with only nontraumatic vertebral fractures, the Z-score was -1.92 (P < 0.001) for the lumbar spine. Contrary to the view that osteoporosis is a single age-related entity, the existence of 2 distinct syndromes is suggested. One form, postmenopausal osteoporosis, is characterize by excessive and disproportionate trabecular bone loss, involves a small subset of women in the early postmenopausal period, and is associated mainly with vertebral fractures. The other form, senile osteoporosis, is characterized by proportionate loss of both cortical and trabecular bone, involves essentially the entire population of aging women and, to a lesser extent, aging men, and is associated with hip fractures or vertebral fractures or both.