Does hip strength analysis explain the lower incidence of hip fracture in the People's Republic of China?
Does hip strength analysis explain the lower incidence of hip fracture in the People's Republic of China?
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DOI：
10.1016/j.bone.2003.12.005
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发表时间：
2004-03-01
期刊：
影响因子：
4.1
通讯作者：
Prentice, A
中科院分区：
文献类型：
--
作者：
Yan, L;Crabtree, NJ;Prentice, A
为了探讨计算的髋部力量是否存在种族差异，从而解释中国髋部骨折的低发生率，我们使用 Lunar DPX“β”版髋部力量分析 (HAS) 和髋轴长度 (HAL) 程序来比较沉阳中国受试者与参加欧洲前瞻性骨质疏松症研究 (EPOS) 的奥斯陆和鲁汶白人受试者的髋部几何形状、计算强度和密度值。受试者包括 210 名中国人和 403 名白人男性和女性，年龄在 53 至 77 岁之间。研究的参数包括骨密度（BMD）、骨矿物质含量（BMC）、骨面积（BA）、横截面惯性矩（CSMI）和截面模量（均表示股骨颈的强度和刚度）、HAL、颈长（NL）、颈直径、拉应力（Tstress）和压应力（Cstress）（分别表示步行或标准跌倒时股骨颈最弱横截面处的应力）、安全系数（SF，表示行走时产生的力的抗骨折能力）和跌倒指数（FI，表示大转子跌倒时产生的力的抗骨折能力）。中国男性和女性的身高和体重显着低于白人（P < 0.01），并且 BMD、BMC 和股骨颈 BA 显着较低（P < 0.01）。调整 BA、体重和身高后，BMC 中任一性别均不存在显着的种族差异。中国男性和女性的 CSMI 和截面模数显着较低，HAL、NL 和颈径显着较短（P < 0.01）。在调整体重和身高后，这些差异仍然存在。各性别族群之间的 Tstress、Cstress、SF 和 FI 均无显着差异。中国受试者的大部分髋部力量计算参数与白人受试者相似或更差。没有证据表明沉阳人具有优越的 BMD 或 BMC 或更好的计算髋部力量。然而，人群的 HAL 和 NL 较短可能是导致髋部骨折发生率较低的一个独立因素。 (C) 2004 Elsevier Inc. 保留所有权利。
To explore whether there are ethnic differences in calculated hip strength that might explain the low incidence of hip fracture in China, we used Lunar DPX 'beta' version of hip strength analysis (HAS) and hip axis length (HAL) programs to compare hip geometry, calculated strength and densitometric values from Chinese subjects in Shenyang to those of Caucasian subjects in Oslo and Leuven participating in the European Prospective Osteoporosis Study (EPOS). Subjects were 210 Chinese and 403 Caucasian men and women aged 53-77 years. Parameters investigated included bone mineral density (BMD), bone mineral content (BMC), bone area (BA), cross-sectional moment of inertia (CSMI) and section modulus (both indicating strength and rigidity of the femoral neck), HAL, neck length (NL), neck diameter, tensile stress (Tstress) and compressive stress (Cstress) (indicating the stress in the femoral neck at its weakest cross section arising from walking or a standard fall, respectively), safety factor (SF, indicating the resistance to fracture for forces generated during walking) and fall index (FI, indicating the resistance to fracture from force generated during a fall in the greater trochanter). The Chinese men and women were significantly shorter and lighter than their Caucasian counterparts (P < 0.01) and had significantly lower BMD, BMC and BA of the femoral neck (P < 0.01). After adjusting for BA, weight and height, there was no significant ethnic difference in either gender in BMC. CSMI and section modulus were significantly lower, and HAL, NL and neck diameter were significantly shorter in the Chinese men and women (P < 0.01). These differences all remained after adjusting for weight and height. There were no significant differences in Tstress, Cstress, SF and FI between ethnic groups in either gender. Most of the parameters of calculated hip strength in the Chinese subjects were similar to or poorer than those in the Caucasian subjects. There was no evidence to indicate that Shenyang Chinese have superior BMD or BMC or better calculated hip strength. The short HAL and NL of the population, however, could be an independent factor contributing to the low incidence of hip fracture. (C) 2004 Elsevier Inc. All rights reserved.