Study of the etiology of spinal and hip fractures due to osteoporesis

骨质疏松引起的脊柱和髋部骨折的病因学研究

• 批准号: 09670966
• 负责人: FUKUNAGA Masao
• 金额: $ 1.98万
• 依托单位: KAWASAKI MEDICAL SCHOOL
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1999
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09670966/
• 关键词: osteoporosis; spinal fracture; hip fracture; bone mass measurement; bone marker; bone architecture; 脊髄骨折; 大腿骨頚部骨折

To clarify the etiology of spinal and hip fractures complicated with osteoporosis, the bone mineral density (BMD) and bone geometry or bone metabolic state were studied.The BMDs were measured with dual-energy X-ray absorptiometry (DXA) equipment ; the DCS-600 for midradius, and the QDR-2000 for the second to fourth lumbar vertebrae, and proximal femur. As bone markers, The levels of pyridinoline (Pyr), deoxypyridinoline (D-Pyr), and NTx were measured. This study was conducted on women. Spinal fracture was judged by employing the diagnostic criteria for primary osteoporosis, after morphometry of anterior, central, and posterior vertebral height on lateral X-ray films of the thoracic and lumbar spines. For the geometry of the proximal femur, femur axis length (FAL) and neck width were measured.With respect to spinal fracture ; (1) The radial, lumbar, and femoral BMDs in the fractured cases (N=41) were significantly lower (p<0.0001-0.0062) than those in the non-fractured cases (N=118-125) … More . (2) Pyr levels in the fractured cases tended to be higher. (3) The fractured cases showed a significantly (p=0.0092-0.0188) higher incidence of not only increased levels of both Pyr and D-Pyr (more than 33.2 pmol/mmol/Cr and 6.4 pmol/mmol/Cr, respectively), but also decreased BMD levels, less than 70% of the young adult mean, in both the radius and lumbar vertebrae, compared with the non-fractured cases.With respect to hip fracture ; (1) Femoral neck BMDs were significantly lower(p<0.0001) in the fractured cases (N=76). (2) The increased odds ratio of hip fracture, which is calculated from logistic regression analysis, ageadjusted, was 3.40 (p<0.0001) for a decrease in the ISD of femoral neck BMD, and 1.48 (p=0.0320) for a decrease of 10kg of body weight. (3) The threshold value of femoral neck BMD of hip fractures was 0.516 g/cmィイD12ィエD1, and (4) from a study of fractured cases (N37) and non-fractured cases (N=161) of more than 70 years old, a significantly longer neck width was noted in the fractured cases than in the non-fractured cases, while there were no differences in FAL between the two groups.Thus, it was suspected that spinal fracture is related to both a low BMD and the increased bone turnover, but hip fracture is related to geometry, as well as a low BMD. Less

为明确脊柱骨折和髋部骨折合并骨质疏松症的病因，采用双能X线骨密度仪（DXA）测量桡骨中段骨密度，QDR-2000测量第2 ~ 4腰椎和股骨近端骨密度，并对骨形态和骨代谢状态进行研究。作为骨标志物，测定吡啶啉（Pyr）、脱氧吡啶啉（D-Pyr）和NTx的水平。这项研究是在女性身上进行的。采用原发性骨质疏松症的诊断标准，在胸椎和腰椎侧位X线片上进行前、中、后椎体高度的形态测量后，判断脊柱骨折。对于股骨近端的几何形状，测量股骨轴长（FAL）和股骨颈宽度。关于脊柱骨折：（1）骨折病例（N=41）的桡骨、腰椎和股骨BMD显著低于非骨折病例（N=118-125）（p<0.0001-0.0062）。 ...更多信息 . (2)骨折病例的Pyr水平往往较高。(3)骨折病例显示出明显的（p=0.0092-0.0188）不仅Pyr和D-Pyr水平升高，（分别超过33.2 pmol/mmol/Cr和6.4 pmol/mmol/Cr），但也降低了桡骨和腰椎的BMD水平，低于年轻成人平均值的70%，在髋部骨折方面：（1）骨折组（N=76）股骨颈BMD明显低于非骨折组（P<0.0001）。(2)根据Logistic回归分析计算，年龄调整后，股骨颈BMD的ISD降低，髋部骨折的增加优势比为3.40（p<0.0001），体重降低10 kg，髋部骨折的增加优势比为1.48（p=0.0320）。(3)髋部骨折的股骨颈BMD阈值为0.516 g/cm × D12 × D1;（4）对70岁以上骨折病例（N = 37）和非骨折病例（N=161）的研究发现，骨折病例的股骨颈宽度明显长于非骨折病例，而两组之间的FAL没有差异。人们怀疑脊柱骨折与低BMD和骨转换增加有关，但髋部骨折与几何形状以及低BMD有关。少

项目成果

Masao Fukunaga, et al: "The present state and future prospects for bone mass measurement. In Mechanical Loading of Bone and Joints, ed. By Tkahashi HE"Springer-Verlag, Tokyo. 13-23 (1999)

Masao Fukunaga 等人：“骨量测量的现状和未来前景。骨骼和关节的机械负载，Tkahashi HE 编辑”Springer-Verlag，东京。

福永仁夫: "骨代謝マーカー"産科と婦人科. 66. 1754-1761 (1999)

Nio Fukunaga：“骨转换标记”妇产科 66。1754-1761（1999）。

Masao Fukunaga: "The present state and future prospects for bone mass measuremet. In Mechanical Loading of Bones and Joints"Springer-Verlag, Tokyo. 11 (1999)

Masao Fukunaga：“骨量测量的现状和未来前景。骨骼和关节的机械负载”Springer-Verlag，东京。

Masao Fukunaga: ""The present state and future prospects for bone mass measurement" Mechanical Loading of Bones and Joints"Springer-Verlag,Tokyo. 11 (1999)

Masao Fukunaga：“骨量测量的现状和未来前景”骨骼和关节的机械载荷”施普林格出版社，东京。