Effect of osteoarthritis in the lumbar spine and hip on bone mineral density and diagnosis of osteoporosis in elderly men and women

To determine in the elderly the effect of osteoarthritis on bone mineral density (BMD) and on diagnosis of osteoporosis, lumbar spine and hip were radiographed and BMD measured by dual-energy X-ray absorptiometry (DXA) in 120 men and 314 women, aged 60–99 years. Prevalence and severity of osteoarthritis were scored on osteophytes, joint space narrowing and bone sclerosis. Ultrasound measurements were also made at the heel to examine whether osteoarthritis at hip or lumbar spine influence bone at this remote site. Osteophytes were the commonest feature, with men having a higher prevalence than women, and lumbar spine having more disease than hip. Lumbar spine osteophytes affected 75% of men and 61.1% of women, and hip osteophytes affected 31.7% of men and 27.4% of women. Stepwise multiple regression analysis using age, weight, height, osteophytes, sclerosis and joint space narrowing indicated that lumbar osteophytes explained 16.6% of variation in lumbar spine BMD in women, and 22.4% in men. Hip osteophytes had a minimal effect on hip BMD, accounting for only 2.2% of variation in women, and none in men. Sclerosis and joint narrowing had little effect on BMD at lumbar spine or hip. Indirect effects of osteoarthritis on BMD were small and inconsistent across genders. Lumbar spine osteophytes in men explained 3.1% of hip BMD variation and 6% of variation in speed of sound at the heel, whereas hip osteophytes in women explained 2.2% of lumbar spine BMD variation. Osteoporosis at the hip, defined as BMD <2.5 SD of the young normal mean, was present in 33.1% of women and 25.8% of men, whereas, at the lumbar spine it was present in only 24.2% of women and 4.2% of men. However, in women and men free of spinal osteoarthritis, 37.7% of women and 10% of men had osteoporosis. We conclude that lumbar spine ostoephytes affect most subjects over the age of 60 years, and contribute substantially to lumbar spine BMD measured in the anteroposterior position by DXA. The effect is largely direct by virtue of osteophytes being included in the BMD measurement. However, a small indirect effect on remote skeletal sites is also present. Diagnosis of osteoporosis and assessment of osteoporotic fracture risk in the elderly should be based on hip BMD and not on anteroposterior lumbar spine, unless spinal osteoarthritis has been excluded.     

Study of bone mineral density in lumbar spine and femoral neck in a Spanish population

The aim of this study was to generate standard curves for bone mineral density (BMD) in a Spanish population using dual-energy X-ray absorptiometry (DXA), at both lumbar spine and femoral neck sites. The total sample size was 2442 subjects of both sexes aged 20–80 years, stratified according to survival rates, demographic distribution by local regions and sex ratio in the Spanish population. Subjects with suspected conditions affecting bone metabolism or receiving any treatment affecting bone mineralization were excluded. The study was carried out in 14 hospitals and bone density measurements were performed, using a QDR/1000 Hologic device. In the female population, the highest value for lumbar spine BMD was found within the 30–39 years age group, being significantly lower after the age of 49 years. In the male population, the highest values for lumbar spine BMD are found one decade earlier than in the female population and become significantly lower after the age of 69 years. The highest values for femoral neck BMD in men and women was found in the 20–29 year age group. Values for femoral neck BMD in the female population become statistically lower after the age of 49 years, while in the male population this effect was seen after the age of 69 years. Values for femoral neck BMD were higher in men than women at all ages.Others investigators of the Multicentre Research Project on Osteoporosis: Drs Torrijos, Aguado, Espinosa (H. La Paz, Madrid); Drs Lozano, Gonzalez (H. Clínico San Carlos, Madrid); Drs Yagüe, López Gavilanes (F. Jimenez Díaz, Madrid); Drs Portugal, Del Pino, Martín (H. Clínico Univ., Salamanda); Drs Roig, Nolla (Ciudad Sanitaria Bellvitge, Barcelona); Drs Farrerons, Lopez Navidad, Yoldi (H. Sta. Creu i San Pau, Barcelona); Drs Diez Pérez, Kanterewicz, Martínez Izquierdo, H. de la Esperanza, Barcelona); Drs. Romeu, Edo, Monzó (H. La Fe, Valencia); Drs Moruno, Vazquez (H. Clínico Univesitario, Sevilla); Drs Escobar, Muñoz Torres, Raya, Salvatierra (H. Clínico Universitario, Granada); Drs Cannata, Gómez Alonso, Virgós (H. Central de Asturias); Drs Ferrer, Peguero (H. Miguel Servet, Zaragoza); Drs Ganoza, Barrios (Clinica Universitaria, Pamplona); Drs Betancor, Sosa Henríquez, Hernandez Hernandez (H. Insular Las Palmas).     

腰椎旋转角度对骨密度测量值影响的定量研究

目的定量分析腰椎旋转角度对双能X线法(Dual-energy X-ray absorptiometry,DXA)测量腰椎骨密度值(Bone mineral density,BMD)的影响,并提出校正方法。方法模拟腰椎BMD标准测量方法,将5具成年男性腰椎标本放于特制的可旋转模具上。以5°为增加量,将标本从0°(标准前后位)逐渐旋转至45°,测量不同旋转角度状态下的腰椎BMD。同时,对标本进行X线摄片,根据Nash-Moe法评估椎体的旋转程度,并与DXA获得的图像进行比较。结果随着腰椎旋转角度增加,腰椎的投射面积逐渐增加,骨矿含量无显著性变化,骨密度值逐渐降低。相关性分析表明,腰椎旋转角度与投射面积呈正性相关,与BMD呈负性相关。当旋转度数至15°时,测量BMD值与0°值之间有显著性差异(P=0.001)。当旋转至45°时,BMD降低达21%。根据Nash-Moe法判断腰椎旋转程度,DXA法与X线法的符合率为90%。结论椎体旋转角度对腰椎骨密度值具有显著性影响,可以导致测量值较真实值偏低。对于存在腰椎旋转畸形患者,应当根据旋转角度校正骨密度,以避免过高估计患者骨质疏松严重程度。     

Failure load of thoracic vertebrae correlates with lumbar bone mineral density measured by DXA

Fractures of the thoracic spine account for a large portion of vertebral fractures in the elderly, yet noninvasive measurements of bone mineral properties are limited to the L2–L4 vertebral bodies. The purpose of this investigation was to determine whether bone mineral properties of the umbar spine correlate with the failure properties of thoracic ertebrae. Cadaveric lumbar segments were scanned using dual-energy x-ray absorptiometry (DXA) from both the latcrol and anteroposterior projections. Three-body segments L1–L3 and T10–T12 were then compressed to create crush tractures in the L2 and T11 vertebral bodies, and linear corelation analyses were performed to compare each DXA measure with the failure properties of L2 and T11. Lumbar BMD from the lateral view correlated significantly with T11 altimate load (r=0.94, P<0.001), as did lumbar BMD from the anteroposterior projection (r=0.83, P=0.001). Significant correlations were also found between both lumbar BMD and BMC and the stiffness and energy to failure of I'll. Furthermore, BMD and BMC measured at L2 correlated significantly with L2 ultimate load, stiffness, and energy to failure. We conclude that bone mineral properties measured at the lumbar spine provide a valid assessment of the compressive strength of both thoracic and lumbar vertebrae. Lumbar BMD may therefore be used to derive an index for the prediction of thoracolumbar fractures to aid in the early intervention of vertebral fractures.Portions of this work were presented at the 40th Annual Meeting of the Orthopaedic Research Society and appeared in abstract form in the conference proceedings.     

乌鲁木齐地区2711例骨密度调查研究

目的了解新疆乌鲁木齐地区正常汉族人群骨密度(BMD)的变化规律和骨质疏松症(OP) 的患病率。方法应用法国DMS公司生产的CHALLENGER型双能X线骨密度仪对乌鲁木齐地区汉族人群共2711名20～80岁居民进行腰椎2～4及股骨近端的骨密度测定。结果乌鲁木齐地区汉族人群男性、女性的腰椎及股骨近端的BMD峰值均出现在20～29岁年龄组,峰值后随着年龄的增长,而骨密度BMD降低,女性在50～59岁明显加速下降,男性没有加速下降现象。乌鲁木齐地区40岁以后OP患病率男性28．3％,女性OP患病率45．2％。男女性50～59岁以上,组间患病率有显著差异(P<0．05)。结论通过对乌鲁木齐地区汉族人群的骨密度变化规律及患病率研究, 为乌鲁木齐地区汉族人群的骨质疏松症诊断及治疗提供客观有效的依据。     

Gender differences in bone density at different skeletal sites of acquisition with age in Chinese children and adolescents

Bone mass acquisition from different genders and races of children and adolescents may vary. To explore gender- and age-related differences in bone mineral density (BMD) measurements in Chinese children and adolescents, we used the dual-energy X-ray absorptiometry (DXA) bone densitometer to take BMD measurements at the posteroanterior (PA) and lateral spine, hip, and forearm in 1286 healthy children and adolescents, ranging from 6 to 24 years of age. Our results show a correlation between BMD measurements taken from different skeletal sites and from different ages of subjects. Male data were best fit to a power regression model, yielding the largest determinant coefficients (R ²), whereas S regression was the best fitting model for females. In individuals younger than 17 years of age, the rate of BMD accumulation in the PA spine is more rapid in females than in males, whereas in individuals older than 19 years of age, the converse was found to be true. In children younger than 14 years of age, BMD measurements, taken from the lateral spine, the neck and trochanter of the femur, and the total hip, correlated with age similarly in both genders. Additionally, in measurements taken from the forearm ultradistal and 1/3 region, BMD measurements from similar ages of both genders are similar. With increasing age, BMD measurements in males become significantly higher than those of females. However, volumetric BMD (vBMD) measurements from both genders show good uniformity at the lateral spine with a near overlap of the two models. Our findings suggest that vBMD acquisition measurements in Chinese children and adolescents show no gender differences, with gender differences only demonstrated in areal BMD (aBMD) measurements taken from different skeletal sites.     

Influence of patient's weight on dual-photon absorptiometry and dual-energy X-ray absorptiometry measurements of bone mineral density

Lumbar spine bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) (Hologic QDR 1000) and by¹⁵³Gd dual-photon absorptiometry (DPA) (Novo Lab 22a) in 120 postmenopausal women. Though a high correlation existed between the two techniques, the ratio between DXA and DPA values was not constant. Using DXA we observed a higher dependence of BMD on weight than in the DPA measurements. To investigate the different behaviour of DXA and DPA machines with weight, we analysed the effects of increasing thickness of soft tissue equivalents on the BMD of the Hologic spine phantom and on the BMD equivalent of an aluminium standard tube. Increasing tissue-equivalent thickness caused the phantom BMD measured by DPA to decrease significantly but had not effect on the DXA measurements. The different behaviour of DPA and DXA equipment with regard to the phantoms could account for the differences observed in the relations between BMD and weight in the patients. Using multiple regression we studied the influence of weight and body mass index on the relation between BMD measured by the two techniques. The introduction of either of these variables into the regression resulted in an improvement of the prediction of the DXA values from the DPA values. However, the residual standard error of the estimate was still higher than the combined precision errors of the two methods, so that no simple relation allows a conversion of BMD_DPA into BMD_DXA. Our results confirm that BMD is positively correlated with weight in postmenopausal women; the influence of weight on BMD is blunted when the Novo Lab 22a DPA machine is used for measuring bone mineral.     

人体双髋骨密度分布规律研究

目的 探索人体双髋骨密度(bone mineral density,BMD)的分布规律,为选择髋部感兴趣区提供依据.方法 用GE Lunar Prodigy型双能X线骨密度仪(dual-energy X-ray absorptiometry,DXA)测量受检者双髋BMD,感兴趣区选择股骨颈和全髋部.结果 共检测301例,其中男性135例,左右侧股骨颈BMD差值为(0.004±0.048)g/cm~2,左右侧全髋部BMD差值为(0.006±0.042)g/cm~2,差异均无统计学意义;高低侧股骨颈BMD差值为(0.038±0.029)g/cm~2[95%CI(0.034,0.043)],高低侧全髋部BMD差值为(0.035±0.025)g/cm~2[95%CI(0.030,0.039)].女性166例,左右侧股骨颈BMD差值为(0.006±0.040)g/cm~2,左右侧全髋部BMD差值为(0.003±0.036)g/cm~2,差异均无统计学意义;高低侧股骨颈BMD差值为(0.032±0.025)g/cm~2[95%CI(0.028,0.036)],高低侧全髋部BMD差值为(0.030±0.021)g/cm~2[95%CI(0.027,0.033)].无论男性还是女性,髋部股骨颈BMD与全髋部BMD呈正相关.结论 人体左右侧髋部感兴趣区BMD总体分布基本一致,但个体髋部存在优势侧与非优势侧,建议测量双侧髋部BMD,并报告较低的一侧.     

脊柱退行性疾病对腰椎前后位骨密度的影响分析

双能X线骨密度仪检测骨密度是诊断骨质疏松症的"金标准",学者推荐50岁以上人群采用腰椎前后位进行测量。然而骨质疏松症发病率较高的老年人群,常常合并罹患多种脊柱退行性疾病,例如腰椎间盘突出、退行性侧凸、骨赘增生等,这些病理改变可导致腰椎前后位骨密度值准确性降低。因此,提高腰椎骨密度测量准确性,对于骨质疏松症的诊断和治疗具有重要意义。本文就常见的脊柱退行性疾病对腰椎前后位骨密度的影响作一综述,以期帮助临床医生全面评估和诊断骨质疏松症。     

The prevalence of significant left-right differences in hip bone mineral density

Introduction We determined the prevalence of left-right differences in hip bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA) and the resultant consequence, namely: the frequency at which patients would be classified differently if lumbar spine and only one hip (rather than both hips) were measured.Methods This was a retrospective DXA scan reanalysis of 3012 white women ≥50 yrs who had scans of both hips using Hologic DXA systems. The difference between left and right hips was considered significant if it exceeded the least significant change (LSC) for any of three hip subregions (total hip, femoral neck, trochanter). The number of women with osteoporosis in both hips, the left hip only, or the right hip only was determined by lowest T-score from total hip, femoral neck, or trochanter.Results Despite high left-right correlations of subregion BMD, significant left-right differences in BMD were common: the difference exceeded the LSC for 47% of women at total hip, 31% at femoral neck, and 56% at trochanter. Left-right differences in BMD that exceeded the LSC affected the percent agreement of left-right hip classification: for all women irrespective of spine status, there was 77% classification (diagnostic) agreement in hip pairs in which the left-right hip BMD difference exceeded the LSC versus 87% agreement in which LSC was not exceeded (significant difference in proportions, P<0.0001). The greatest risk of different classification would occur in women with normal spines as the diagnosis might be determined by hip T-scores. Using L1-4 lumbar spine T-scores, 1229 women were normal at the spine. Twenty-four (2%) were osteoporotic at both hips. However, 12 women (1%) were osteoporotic only in the left hip (significantly different from zero, P<0.001) and 11 (1%) only in the right hip (P<0.001); of these 23 women, the difference in BMD between the osteoporotic hip and the contralateral hip exceeded the LSC in 16 (70% of those with osteoporosis in only one hip). Using L1-4 lumbar spine T-scores, 1159 women were osteopenic at the spine. Of these, 126 (11%) were osteoporotic at both hips, 54 (5%) only in the left hip (P<0.001), and 42 (4%) only in the right hip (P<0.001); of these 96 women, the difference in BMD between the osteoporotic hip and the contralateral hip exceeded the LSC in 56 (58% of those with osteoporosis in only one hip).Conclusions A statistically significant number of women with osteoporosis are potentially classified differently when scanning only one hip as a result of the high prevalence of left-right differences in BMD. Although the percentages are low, the total number of women affected may be large. From a public health perspective, the practice of scanning both hips could potentially identify more women with osteoporosis and may help prevent future hip fractures.     

Effects of unilateral strength training and detraining on bone mineral density and content in young women: A study of mechanical loading and deloading on human bones

This study assessed the effect of unilateral strength training at 80% one repetition maximum and of detraining on bone mineral density (BMD, g/cm^-2) and bone mineral content (BMC, g) in young women. Twelve female physiotherapy students trained their left limb by leg press an average of four times per week for 1 year followed by 3 months of detraining. Twelve students served as controls. Repeated bone measurements were performed by dual energy X-ray absorptiometry of the lumbar spine, femoral neck, distal femur, patella, proximal tibia, and calcaneus. The training increased the muscle strength of the trained limb, and the BMD of the same limb showed a nonsignificant but systematic increase in distal femur, patella, and proximal tibia, and in BMC of the five measured limb sites (considered an index of the total osteogenic effectiveness of the training). Simultaneously, the muscle strength increased in the untrained limb as an evidence of cross-training effect. A corresponding small but systematic increase was also seen in BMD of this limb as well as in BMC. After the cessation of training, leg extension strength was retained but BMD and BMC of the trained and untrained limbs declined towards baseline values in 3 months. The BMD and BMC values in the control group showed an increasing tendency during the follow-up but the changes were less than 1%. The differences of the changes in BMD and BMC between the left and right limb in the control group, as well as between the same limb in the training and control groups were nonsignificant. The findings of this study indicate that unidirectional strength training, intensive enough to induce substantial strength gain, is not an effective stimulus to increase BMD and BMC in young, physically active women. The unilateral training model turned out to be feasible in these subjects, producing a definite cross-training effect in muscle strength and a trend of similar effect in BMD. Further development of the unilateral training model, and studies to test if training produces adaptation in nonloaded bones (i.e., a crosstraining effect), are also warranted.     

Lumbar spine bone density in argentine children

It has been demonstrated that bone mineral density (BMD) in children and adolescents is influenced by individual height. The aim of the present work was to introduce a formula to include height in the BMD analysis. Postero-anterior (PA) (L2–L4) and lateral (L2–L3) lumbar BMD was assessed by dual X-ray absorptiometry (DXA) in 433 and 393, respectively, healthy Caucasian females from 2 to 20 years of age. A complete medical examination including weight, height, and Tanner puberal stage was performed in all the subjects. Bone age was assessed by left wrist radiographs and analyzed by the TW2 method to insure that it was within 1 year of chronological age. Bone mineral density adjusted for height (BMD_corr=BMC/projected area × height), was calculated for each individual. As analyzed by Tanner stage, both PA and lateral BMD increased up to stage 3, and there were no significant differences among stages 3–5. Results of BMD_corr variations related to Tanner stage suggested that the increase in lateral BMD before puberty might be related to height. PA BMD_corr increased up to Tanner stage 3, and there were no differences among stages 3–5. The BMD_CORR approach can be used to get a more reliable analysis of BMD studies in children and adolescents. This study was presented in part at the 16th Annual Meeting of the American Society for Bone and Mineral Research, Kansas City, Missouri, September, 1994 This study has been supported by a grant from the Metabolic Research Foundation, Buenos Aires, Argentina     

Relationship between bone mineral density of the proximal femur and lumbar spine and quadriceps and hamstrings torque in healthy Japanese subjects

The purpose of this study was to examine the corelations between the muscle torque of the leg extensors (quadriceps femoris) and leg flexors (Hamstrings) and the bone mineral density (BMD) of the proximal femur and lumbar spine. To investigate the decline in BMD of proximal femur and lumbar spine, we examined the relative importance of muscle torque, age, and body weight in the prediction of BMD in 340 healthy volunteers (109 males, and 231 females). Age and body weight were independent predictors of femoral BMD in men. Body weight and quadriceps torque were independent predictors of femoral BMD in premenopausal women. Body weight and years after menopause were independent predictors of BMD in postmenopausal women. The BMD was greatly affected by menopause, whereas the muscle torque was independent of the menopause, and showed the negative relationship to age. These results suggest that muscle-building exercise may have the potentiality to elevate the BMD in the proximal femur in premenopausal women.     

Menopause-related changes in bone mineral density in Japanese women: A longitudinal study on lumbar spine and proximal femur

We investigated 2-year longitudinal changes of bone mineral density (BMD) in lumbar spine and proximal femur in 64 Japanese women aged 38–67. Forty subjects were premenopausal (mean age 44.9) and 24 postmenopausal (mean age 54.6) at enrollment of the study. Six subjects experienced menopause during the 2-year study period and were defined as the perimenopausal group. Measurements of BMD were performed using dual-energy X-ray absorptiometry at L2–4, femoral neck, greater trochanter, and Ward's triangle. Paired t test revealed no significant decrease in BMD at any site in the premenopausal group. Significant annual decrease in BMD was observed in the perimenopausal group at L2–4, femoral neck, and greater trochanter. A similar tendency was observed in Ward's triangle, but did not reach statistical significance. In the postmenopausal group, significant decrease in BMD was found at the proximal femur, but not at L2–4. Significant inverse correlation between age and change rate of BMD was found at L2–4, but not at the proximal femur, in premenopausal women. In postmenopausal women, there was a significant association between body weight (BW) change and change rate in BMD at L2–4, femoral neck, or greater trochanter. This association was not found in the premenopausal group. These results suggest that effect of menopause on BMD may be different in individuals and sites of the skeleton. BW change may affect change in BMD in postmenopausal women. However, the limited variability in both BW and BMD changes among premenopausal women in this study may explain the poor association between change in BW and change in BMD in the premenopausal group. As individual differences in each group is considerably large, annual measurements of BMD may be necessary to find possible candidates for early intervention.     

Bone mineral density of the spine in normal Japanese subjects using dual-energy X-ray absorptiometry: Effect of obesity and menopausal status

Summary Bone mineral density (BMD) of the lumbar spine was measured to determine normal Japanese values and to examine the effect of obesity and menopausal status on BMD. Normal Japanese subjects (N=1,296, 1,048 women and 248 men) were examined using dual-energy X-ray absorptiometry. BMD for men peaked between age 20 and 29. For women, there was abrupt bone loss after age 50. Obese women within the same age bracket had a higher BMD than thin women after age 40–49. We determined that BMD began to decline during the irregular menstruation period before the onset of menopause. We conclude that there is a positive correlation between obesity and BMD, particularly in postmenopausal women. In addition, we found that bone loss related to menopause begins during the irregular menstruation period before menopause.     

A longitudinal study of supine lateral DXA of the lumbar spine: A comparison with posteroanterior spine,hip and total-body DXA

We report a study to assess whether supine lateral dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine provide better data for monitoring response to treatment than alternative measurement sites such as the posteroanterior (PA) spine, hip and total body. The study population was 152 women enrolled in a placebo-controlled clinical trial of cyclical etidronate therapy. All subjects were 1–10 years after the menopause with bone mineral density (BMD) between 0 and –2 SD of age-matched normal women. Paired PA and lateral spine, left hip and total-body DXA scans were performed at baseline, 1 year and 2 years on a Hologic QDR-2000. One hundred and thirty-one subjects completed the study. Mean percentage change from baseline at 2 years in the treated (n=61) and control (n=70) groups was calculated for vertebral body, width-adjusted (WA) vertebral body, mid-vertebral body and WA mid-vertebral body BMD measurements on the lateral scans and compared with the percentage changes in PA spine, femoral neck, trochanter, Ward's triangle and total-body BMD. The long-term precision for each BMD measurement site was obtained by linear regression analysis in subjects taking placebo. Overall treatment effect, defined as the difference in the percentage change in BMD in the two treatment groups at 2 years, was divided by long-term precision to give an index of the ability of each site to monitor response to treatment. Results (and standard errors) normalized to the ratio of treatment effect/precision for PA spine BMD were as follows: PA spine, 1.00; vertebral body, 0.89 (0.14); WA vertebral body, 0.78 (0.14); mid-vertebral body, 0.65 (0.14); WA mid-vertebral body, 0.60 (0.13); femoral neck, 0.35 (0.15); trochanter, 0.45 (0.15); Ward's triangle, 0.59 (0.22); total body, 0.52 (0.19). Although treatment effect was larger for lateral than for PA spine BMD, this advantage was offset by the greater precision errors. PA spine BMD remains the optimum measurement for longitudinal studies in recently postmenopausal women.     

Dual-energy X-ray absorptiometry at the lumbar spine in German men and women: A cross-sectional study

A cross-sectional, population-based study of 238 randomly selected females and 224 males with German ethnic background (aged 20–80 years) was carried out to establish lumbar spine bone mineral density (BMD) values, using dual X-ray absorptiometry (DXA), for a German population. Comparison was made to the reference range provided by the manufacturer of the DXA equipment. No sex difference in peak spine BMD was found in our study (1.091±0.114 g/cm² for males versus 1.070±0.113 g/cm² for females, n.s.). Different patterns of bone loss could be detected in both sexes. In premenopausal women there was no significant correlation between age and BMD (y = 1.044 + 0.00047x, r=0.03, P=0.73) whereas reduction of female BMD at the spine was demonstrated in postmenopausal women (y = 1.189–0.0041x, r=-0.28, P=0.01), underscoring the important role of the menopause for later manifestation of spinal osteoporosis in women. In contrast, in males we found no significant change of BMD with aging (y = 1.071–0.0007x, r=-0.08, P=0.25). Employing commonly used exclusion criteria, BMD values of the study subjects were found mostly within the normal range of BMD. The major finding of our study was good concordance between female data of our study population and the reference data provided by the manufacturer. Clinically significant discrepancies between our data and the Hologic reference range for males could be detected. Our data on males (30–39 years of age) were up to 7% lower than those provided by the manufacturer, probably due to differences in sampling procedures.     

Characteristics of regional bone mineral density and soft tissue composition in patients with atraumatic vertebral fractures

To clarify the characteristics of total body and regional bone mineral density (BMD) and soft tissue composition in patients with atraumatic vertebral fractures (AVF), we measured total body and regional BMD, lean mass, and fat mass using dual-energy X-ray absorptiometry. Sixty-four women, aged 55–75 years, were divided into two groups: women with AVF (fracture group, n = 30) and women without AVF (nonfracture group, n = 34). Mean BMD of the second to fourth lumbar vertebrae (L2–4BMD), regional BMD, and soft tissue mass were measured. Regional BMD was measured in the head, arms, legs, ribs, thoracic vertebrae, lumbar vertebrae, and pelvis. Lean mass and fat mass of head, arms, legs, and trunk were measured. L2–4BMD, total body BMD, and BMD of the lumbar spine, thoracic spine, and pelvis of the fracture group were significantly lower than those of the nonfracture group (P < 0.001). Total lean and fat mass of the fracture group tended to be lower than that of the nonfracture group. The results suggest that BMD of weight-bearing bones, except for that of the bones of the legs of the fracture group, is significantly lower than that of the nonfracture group, and that total body lean and fat mass may be a predictor for AVF. Received: September 27, 1999 / Accepted: January 7, 2000     

体重、身高对成都地区青壮年腰椎、髋部骨量的影响

目的　研究体重、身高对青壮年腰椎、髋部骨量的影响。方法　随机抽取成都地区年龄在 2 0～ 39岁 ,排除心肝肺肾、内分泌等慢性病、骨代谢疾病及脊椎畸形者 2 37名 (其中男性 10 8名 ,女性 12 9名 ) ,采用美国Lunar公司生产DPX L型双能X线骨密度仪测定受试者腰椎和髋部的骨矿含量 (BMC)、面积 (AREA)、骨密度 (BMD)。全部资料输入微机 ,用SPSS软件进行统计学处理。结果　体重、身高、体重指数 (BMI)与腰椎、髋部的BMC、Area、BMD呈正相关 ,其中体重与腰椎、髋部的BMC、Area中等程度相关 (r=0 39～ 0 5 5 ,P <0 0 1) ,身高与腰椎 (L2 - 4)AREA相关性最好 (r=0 75 8,P <0 0 1) ,体重、身高与BMD相关性差 (r=0 15 2～ 0 2 2 5 ,P <0 0 5 )。男性腰椎及髋部的BMC、AREA均明显高于同年龄组女性 (P <0 0 1) ,男、女L2 - 4BMD无显著性差异 (P >0 0 5 ) ,男性略低于女性。L2 - 4BMC与体重比值及L2 - 4AREA与体重比值 ,男、女无显著性差异 (P >0 0 5 )。L2 - 4Area与身高比值男性明显高于女性 (P <0 0 1)。结论　体重对青壮年BMC的影响大于身高 ,身高对L2 - 4AREA影响最大 ,男、女体重、身高的差异决定了峰值骨量的差异。BMC、Area、BMD 3项指标中 ,BMC更能反映体重、身高的差异 ,用BMC诊断骨质疏松     

长期强的松治疗对绝经前SLE患者骨密度的影响

目的探讨长期强的松治疗对绝经前系统性红斑狼疮(SLE)患者骨密度的影响。方法142例SLE患者均为绝经前女性,年龄12~40岁(平均29·5岁)。正常对照78例女性,年龄15~39岁(平均28·9岁),排除影响骨代谢的各种急慢性疾病。应用HOLOGIC QDR4500双能量X线骨密度仪检测腰椎和股骨近端的骨密度值,测定血清雌二醇、雌三醇。结果①绝经前SLE患者骨量减少、骨质疏松发生率分别为42·96%、14·79%,均显著高于正常对照组(P值均<0·01);②骨质疏松和骨量减少患者服用强的松的时间、总剂量均显著高于骨量正常患者(P值均<0·01);③绝经前患者雌二醇与正常对照无显著差异,而雌三醇明显升高(P<0·01)。结论①长期服用强的松的绝经前SLE患者骨量减少和骨质疏松发生率均显著增高;②SLE患者骨量减少和骨质疏松的发生与使用强的松的时间和总剂量有关;③绝经前SLE患者雌三醇产生增多,可能对骨密度具有保护作用。