Mass Examination for Osteofluorosis and Osteoporosis,Using Dual-Energy X-ray Absorptiometry

为了预防氟骨症(骨硬化症)和骨质疏松症(由于工业化和老龄化导致的骨质疏松症的发病率迅速上升)，我们建立了一种使用骨密度计对两种骨病进行集体检查的方法。基础研究是使用Norland XR-26(美国)双能X射线吸收法(DEXA)系统进行的；从灵敏度、准确性、测量时间和非侵入性的角度来看，该系统被认为是最适合测量骨矿物质含量的系统。该方法体外测量的波动系数小于1%，体内测量的波动系数小于2%，具有良好的精密度。在测量精度方面，定量计算机断层扫描(QCT)标准体模的测量值与标称值之间存在线性关系。此外，在使用热释光剂量计进行的测量中，基本上没有散射辐射。…在确定最适合进行集体检查的区域时，对身体的不同区域进行了评估，发现腰椎前后方向(L_2-L_4)在所需时间、准确性和易测性方面是最佳的检查位置。正常成人骨密度(BMD)常高于1.000g/cm~2，男性BMD基本不随年龄变化，但女性在40多岁和50多岁有快速下降的趋势。在氟骨症方面，对生活在饮用水氟含量高的地区的居民进行了骨密度测量，这些地区散布在北九州的霍曼河流域。测量结果表明，高氟水的消耗量与骨密度的增加之间存在一定的相关性。诊断系统安装在检查车上，我们在现场进行了大规模检查。腰椎前后方向的测量每人大约需要10分钟，因此每天检查40人是可能的。通过对约300名骨质疏松患者的测量，发现16.1%的成年女性骨密度值比我们所设定的值低1SD。此外，在调查期间对人们进行的行为采访显示，在低骨密度人群中发现了传统上报告的骨质疏松症风险因素，如缺乏钙摄入量或缺乏锻炼。本研究建立了一种使用DEXA和车载骨密度仪对氟骨症和骨质疏松症进行大规模检查的方法，并发现该方法在预防骨病方面是有效的。较少

In response to efforts to prevent osteofluorosis (osteosclerosis) and osteoporosis, the incidence of which is rapidly increasing due to industrialization and aging of the society, we established a mass examination method using a bone densitometer to test for two types of osteopathies. Basic studies were conducted using a Norland XR-26 (USA) system for dual-energy X-ray absorptiometry (DEXA); this system is considered to be the most suitable for measurement of bone mineral content from the standpoint of sensitivity, accuracy, measurement time, and noninvasive properties. The fluctuation coefficients of measurements were less than 1% in vitro and less than 2% in vivo with good precision. Regarding the accuracy of measurements, a linear relationship between measured values of standard phantoms of quantitative computed tomography (QCT) and nominal values was found. Furthermore, there was essentially no scattering radiation in the measurements performed with a thermoluminescence dosimeter. … More Various regions of the body were evaluated in the determination of the most appropriate region for mass examination, and the anterior-posterior direction of the lumbar spine (L_2-L_4) was found to be optimum for examination in terms of required time, accuracy, and ease of measurement. The bone mineral density (BMD) of the region in normal adults is often higher than 1.000g/cm^2; although essentially no change in BMD with age was found in males, a tendency toward rapid decrease was observed in females in their 40s and 50s. With respect to osteofluorosis, BMD was measured in residents living in areas where the fluoride content in drinking water is high--areas scattered throughout the Homan river Basin in North Kyushu. The results of measurements indicated a certain correlation between consumption of water containing a high level of fluoride and an increase in BMD. The diagnostic system was mounted on an examination vehicle, and we conducted mass examinations in the field. Measurements made in the anterior- posterior direction on the lumbar spine required approximately 10min.per person; thus examination of 40 persons per day was possible. From the measurements of approximately 300 persons for osteoporosis the value of BMD was found to be 1SD lower than a set value established by us in 16.1% of female adults. Also, behavioral interviews carried out on people during the investigation revealed that conventionally reported risk factors for osteoporosis, trends such as lack of calcium intake or lack of exercise, were found among low-BMD individuals. In the present study, a method using DEXA and a vehicle-mounted bone densitometer for mass examination of osteofluorosis and osteoporosis has been established and found to be effective in the prevention of osteopathies. Less