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

To clarify the etiology of spinal and hip fractures complicated with osteoporosis，bone mineral density (BMD) and bone geometry or bone metabolic state were studied.The BMDs weremeasured with dual-energy X-ray absorptiometry (DXA) equipment；the DCS-600 for midradius, and the QDR-2000 for the second to fourth lumbar vertebrae，和proximal femur. As bone markers, The levels of pyridinoline (Pyr), deoxypyridinoline (D-Pyr)，NTx measured. This study was conducted on women. Spinal fracture was judged by employingdiagnostic 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 thegeometry of the proximal femur，femur axis length (FAL) and neck width were measured.With respect to spinal fracture(1) radial, lumbarand femoral BMDs in the fractured cases (N=41) were significantly lower (p<0.0001-0.0062) than thosein the non-fractured cases （N=118-125）(2) Pyr levels in the fractured cases tended to be higher. (3) the fractured casesshowed a significantly (p=0.0092-0.0188) higher incidence of not increased levels of both Pyrand 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 meanin both the radius and lumbar vertebraecompared with the non-fractured cases.With respect to hip fracture；(1) Femoral neck BMDs were significantly low (p<0.0001) in the fractured cases (N=76). (2) theincreased odds ratio of hip fracture，其中是calculated from logistic regression分析，ageadjusted, was 3.40 (p<0.0001) for a decrease in the ISD of femoral neck BMD，1.48 (p=0.0320) for a decrease of 10kg of body weight. (3) The threshold value of femoral neckBMD of hip fractures was 0.516 g/cmand (4) from a study of fractured cases (N37) and non-fractured cases (N=161) of more than 70 yearsold,a significantly longer neck width was noted in the fractured cases than in the non-fractured caseswhile there no differences in FAL between the two groups.Thus，这是支持spinal fracture is related to both a low BMD and the increased bone turnover，但hip fracture是与地理相关的，因为它是一个低BMD. Less

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