Fracture Site-Specific Deficits in Bone Size and Volumetric Density in Men with Spine or Hip Fractures
作者:Ego Seeman、Yunbo Duan、Christopher Fong、Jan Edmonds
DOI:10.1359/jbmr.2001.16.1.120
日期:——
To study the structural basis of bone fragility in men, we compared bone size and volumetric bone mineral density (vBMD) of the third lumbar vertebra and femoral neck in 95 men with spine fractures, 127 men with hip fractures, and 395 healthy controls using dual‐energy X‐ray absorptiometry (DXA). The results were expressed in absolute terms and age‐specific SD scores (mean ± SEM). In controls, vertebral body and femoral neck width increased across age, being 0.46 ± 0.11 SD and 0.91 ± 0.08 SD higher in elderly men than in young men, respectively (both, p < 0.001). Men with spine fractures had reduced vertebral body width (−0.45 ± 0.10 SD; p < 0.01) but not femoral neck width (−0.15 ± 0.10 SD, NS). Men with hip fractures had reduced femoral neck width (−0.45 ± 0.11 SD; p < 0.01) and vertebral body width (−0.25 ± 0.10 SD; p < 0.05). The deficits in bone volume (BV) exaggerated the deficits in bone mineral content (BMC) by 40% at the vertebrae in men with spine fractures and by 9% at the femoral neck in men with hip fractures. vBMD deficits were greater at the vertebrae in men with spine fractures than in men with hip fractures (−1.37 ± 0.08 SD vs.−0.70 ± 0.10 SD, respectively; p < 0.01) but were similar at the femoral neck (−0.93 ± 0.10 SD and −0.76 ± 0.11 SD, respectively, NS), despite the men with spine fracture being 10 years younger. Bone fragility leading to spine or hip fractures in men may be the result of fracture site‐specific deficits in bone size and vBMD that have their origins in growth, aging, or both.
为了研究男性骨脆弱性的结构基础,我们使用双能X射线吸收法(DXA)比较了95名脊椎骨折男性、127名髋关节骨折男性和395名健康对照的第三个腰椎和股骨颈的骨大小及体积骨密度(vBMD)。结果以绝对值和年龄特异的标准差(SD)分数(均值 ± 标准误)表示。在对照组中,椎体和股骨颈的宽度随年龄增长而增加,老年男性的椎体宽度比年轻男性高出0.46 ± 0.11 SD,股骨颈宽度高出0.91 ± 0.08 SD(均,p < 0.001)。脊椎骨折的男性椎体宽度降低(−0.45 ± 0.10 SD;p < 0.01),但股骨颈宽度没有显著降低(−0.15 ± 0.10 SD,NS)。髋关节骨折的男性股骨颈宽度(−0.45 ± 0.11 SD;p < 0.01)和椎体宽度(−0.25 ± 0.10 SD;p < 0.05)均有减少。骨体积(BV)的亏损在脊椎骨折男性的椎体区域使骨矿物质含量(BMC)的亏损加重了40%,在髋关节骨折男性的股骨颈区域则加重了9%。脊椎骨折男性的vBMD亏损在椎体区域大于髋关节骨折男性(分别为−1.37 ± 0.08 SD与−0.70 ± 0.10 SD;p < 0.01),但在股骨颈区域相似(分别为−0.93 ± 0.10 SD和−0.76 ± 0.11 SD,NS),尽管脊椎骨折的男性年龄比髋关节骨折的男性小10岁。导致男性脊椎或髋关节骨折的骨脆弱性可能源于特定骨折部位的骨大小和vBMD的亏损,这些亏损来源于生长、衰老或两者的结合。