Differential effects of menopause and metabolic disease on trabecular and cortical bone assessed by peripheral quantitative computed tomography (pQCT)
Differential effects of menopause and metabolic disease on trabecular and cortical bone assessed by peripheral quantitative computed tomography (pQCT)
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DOI：
10.1259/bjr.73.865.10721315
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发表时间：
2000-01-01
影响因子：
2.6
通讯作者：
Hayashi, K
中科院分区：
文献类型：
--
作者：
Tsurusaki, K;Ito, M;Hayashi, K
目的探讨外周定量计算机断层扫描（pQCT）对代谢性骨疾病（包括骨质疏松症）的诊断价值，特别是对骨小梁和皮质部分的不同诊断价值。研究对象为460名年龄在20 ~ 86岁的日本女性，其中健康志愿者318人，骨质疏松合并骨折患者58人，闭经、类固醇性骨质疏松患者84人。肾性骨营养不良（ROD）和原发性甲状旁腺功能亢进。对74名健康志愿者的骨密度（BMD）进行了4年多的测量。采用脊柱QCT、脊柱、桡骨和足跟双x线吸收仪（DXA）和桡骨和胫骨pQCT测量骨密度。获得了高分辨率的半径几何图像。桡骨pQCT与桡骨DXA的相关性高于脊柱QCT，脊柱QCT与脊柱DXA的相关性高于桡骨pQCT。在轴骨和尾骨中，骨小梁部位的年骨质流失速率都加快了。在骨折研究中，桡骨pQCT显示出比桡骨DXA更高的优势比（OR=4.4），皮质面积比似乎是骨折风险的一个很好的预测因子（OR=5.2）。闭经和类固醇性骨质疏松主要影响小梁骨，ROD主要影响皮质骨，甲状旁腺功能亢进影响两者，尤其是皮质骨。pQCT可用于评估骨小梁和皮质骨，提供代谢性骨病中个体骨变化的信息，并估计骨折的风险。
The usefulness of peripheral quantitative computed tomography (pQCT) was investigated in the diagnosis of metabolic bone diseases, including osteoporosis, and especially in the different diagnostic values in trabecular and cortical components, The subjects were 460 Japanese women aged 20-86 years, including 318 healthy volunteers, 58 osteoporotics with fracture and 84 patients with diseases including amenorrhoea, steroid-induced osteoporosis, renal osteodystrophy (ROD) and primary hyperparathyroidism. Bone mineral density (BMD) was measured for more than 4 years in 74 of the healthy volunteers. BMD was measured by spinal QCT, dual X-ray absorptiometry (DXA) of the spine, radius, and heel, and pQCT of the radius and tibia. High resolution images were obtained for geometry of the radius. Radial pQCT showed a higher correlation with radial DXA than with spinal QCT, and spinal QCT showed a higher correlation with spinal DXA than with radial pQCT. The annual bone loss rates at predominantly trabecular bone sites were accelerated in both the axial and appendicular skeleton. In the fracture study, radial pQCT showed a higher odds ratio (OR=4.4) than radial DXA, and cortical area ratio seemed to be a good predictor of fracture risk (OR=5.2). Amenorrhoea and steroid-induced osteoporosis predominantly affected trabecular bone, ROD predominantly affected cortical bone and hyperparathyroidism affected both components, especially the cortical component. pQCT is useful for assessing both trabecular and cortical bone, to provide information on individual bone changes in metabolic bone disease and to estimate the risk of fracture.