Magnetic resonance imaging of normal and osteoarthritic trabecular bone structure in the human knee

OBJECTIVE: To use high-resolution magnetic resonance imaging (MRI) to evaluate the trabecular bone structure in the distal femur and the proximal tibia and its to correlate the findings with different stages of osteoarthritis (OA) of the human knee. METHODS: Axial images of the distal femur and proximal tibia were obtained at 1.5 T in patients without and with mild OA and with severe OA. The spatial resolution was 195 x 195 microm(2) with a 1-mm slice thickness. Apparent measures of trabecular bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular separation (Tb.Sp), and trabecular thickness (Tb.Th) were calculated. RESULTS: Significant differences existed in the trabecular bone structure of the femur and tibia. Differences in trabecular bone structure between the tibia and the femur decreased with the degree of OA. The apparent BV/TV, Tb.N, and Tb.Sp in the femoral condyles could be used to differentiate healthy patients or patients with mild OA from patients with severe OA (P < 0.05). Among individuals, the structural variation of the lateral and medial femoral condyle was indicative of the extent of the disease. CONCLUSION: High-resolution MRI of the knee joint can provide a noninvasive assessment of trabecular bone structure. Trabecular bone structure, determined by high-resolution MRI, shows significant variation in patients with varying degrees of OA. The impact of OA on trabecular bone is different in the tibia than in the femur, and this difference depends on the extent of the disease.     

Bone histomorphometry in 50 normal tunisian subjects

Summary Quantitative bone histomorphometry was done on undecalcified sections of iliac crest bone specimens obtained at autopsy from 50 normal subjects (24 males and 26 females). The following parameters were measured: cortical thickness (Ct.Th), trabecular bone volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), osteoid volume (OV/BV), osteoid surfaces (OS/BS), osteoid thickness (O.Th) and eroded surfaces (ES/BS). There was a significant age-related decrease in BV/TV in both sexes which followed a x³ polynomial regression. A significant decrease of Tb.Th was noted in males after the fifth decade. In males, bone loss was 1.5% per decade, but in females it was 0.36% before menopausal period and 2% after. Other parameters were unrelated to age and sex.     

雄性ApoE基因敲除小鼠不同时期骨密度和骨微结构的改变

目的 观察ApoE基因敲除(ApoE-/-)小鼠的骨微结构、骨密度、骨矿含量(BMC)的变化,探讨ApoE在骨重建中的作用.方法 15、28和40周龄雄性ApoE-/-纯合子小鼠以及同性别、同周龄的野生型小鼠共48只,应用显微CT测定小鼠右侧股骨远端松质骨和皮质骨的骨微结构参数,双能X线骨密度仪(DXA)测定左侧股骨骨密度.并分析骨微结构、骨密度、BMC相关性.结果 与野生鼠相比,不同时期ApoE-/-鼠的股骨松质骨体积骨密度(vBMD)、组织骨密度、BMC、骨体积分数(BV/TV)、骨小梁数量(Tb.N)、骨小梁厚度(Tb.Th)明显增加(P<0.05),骨面积分数(BS/BV)、骨小梁间隔(Tb.SP)和结构模型指数明显减低(P<0.05).股骨皮质骨内径周长、皮质骨外径周长、皮质骨面积、骨髓腔面积、截面总面积和截面惯性矩增加,而皮质骨骨密度、皮质骨BMC和皮质骨厚度变化不明显.DXA测定显示28周龄ApoE-/-鼠的总体骨密度明显高于野生型鼠(P<0.05),15和40周龄ApoE-/-鼠总体骨密度与对照组相比,无统计学差异.28周龄ApoE-/-鼠vBMD与BMC、BV/TV、Tb.Th、BS/BV和皮质骨BMC明显相关,相关系数分别为0.955、0.944、0.834、0.923和0.903,而与其他参数不相关.结论 ApoE-/-鼠表现出骨量增加,提示ApoE在骨重建中起重要作用.     

骨细胞GLP-1受体表达对2型糖尿病大鼠骨微结构的影响

目的观察2型糖尿病大鼠股骨颈骨细胞表达胰高血糖素样肽-1受体(GLP-1R)阳性细胞百分数的变化,探讨骨组织GLP-1R变化对骨微结构的影响。方法雄性Wistar大鼠60只,随机分为实验组(30只)和对照组(30只),实验组采用高糖高脂饲料喂养至12周时加小剂量链脲佐菌素腹腔注射诱导糖尿病模型,对照组采用普通饲料喂养。分别于造模成功时和成模后第12周,处死10只大鼠作为糖尿病0周组(DM0w组,n=10)和糖尿病12周组(DM12w组,n=10),对照组分别于同期各处死10只大鼠作为正常对照(NGT0w组,n=10;NGT12w组,n=10)。经腹主动脉采血测定空腹血糖(FBG)、胆固醇(TC)、三酰甘油(TG)。取近端股骨颈,制备脱钙和不脱钙骨切片,备免疫组化检测GLP-1R阳性的骨细胞,采用Simple软件分析骨小梁形态计量学指标:骨小梁占骨髓腔体积百分比(BV/TV)、骨小梁厚度(Tb.Th)、骨小梁数目(Tb.N)。采用单因素方差分析比较各组大鼠股骨颈表达GLP-1R阳性的骨细胞百分数,BV/TV、Tb.Th、Tb.N的变化,采用Pearson行相关分析。结果与同期对照组相比,DM0w组、DM12w组大鼠FBG、TC、TG升高(均P0.05);与同期对照组相比,DM0w组、DM12w组大鼠股骨颈表达GLP-1R阳性骨细胞百分数和BV/TV、Tb.Th均减少(均P0.05);与DM0组相比,DM12组大鼠股骨颈表达GLP-1R阳性的骨细胞百分数、BV/TV、Tb.Th、Tb.N均减少(均P0.05);Pearson相关分析显示大鼠股骨颈GLP-1R阳性骨细胞百分数与股骨颈BV/TV、Tb.Th、Tb.N均呈正相关,相关系数分别为r=0.803,P0.05;r=0.545,P0.05;r=0.771,P0.05。结论糖尿病大鼠股骨颈骨细胞GLP-1R的表达减少,同时BV/TV、Tb.N减少,Tb.Th变薄,骨细胞GLP-1R的表达可能是影响2型糖尿病骨微结构的因素之一。     

去卵巢大鼠椎体松质骨骨小梁微结构改变及其对生物力学的影响

目的观察骨质疏松和正常状态下椎体松质骨的微观结构改变,分析其对骨生物力学的影响。方法将12只4月龄雌性Lewis大鼠随机分为去卵巢组(OVX)组和假手术组(Sham),每组各6只。OVX组行双侧卵巢切除术,假手术组仅显露双侧卵巢。术后6个月处死动物,取尾椎(L_(4-7))行Micro-CT分析及生物力学测试。结果去卵巢6个月后,OVX组大鼠体积骨密度(vBMD)和组织骨密度(tBMD)较Sham组显著降低,松质骨骨小梁的骨体积分数(BV/TV)和数目(TB.N)都明显低于Sham组,骨小粱表面积密度(BS/BV)、结构模拟指数(SMI)和间距(Tb.Sp)显著高于Sham组,差异有统计学意义。但2组间骨小梁厚度(Tb.Th)差异无统计学意义。生物力学测试结果表明,去势6个月后,OVX组大鼠骨质生物力学性能显著下降。骨小梁力学性能与骨小梁体积分数(Adjusted R~2=0.750和数目(Adjusted R~2=0.861)呈正线性相关,而与结构模拟指数(Adjusted R~2=0.716)和骨小梁间距(Adjusted R~2=0.830)呈负线性相关。结论松质骨骨小梁微观结构的改变可影响骨质的生物力学性能,二者之间具有一定的线性关系。     

氟对大鼠腰椎骨组织形态计量学的影响

目的 观察氟对大鼠腰椎的骨组织形态计量学影响.方法 90只2月龄SPF级SD大鼠,雌雄各半,按体质量随机分成9组,其中对照组分为幼年(CS)、成年(AS)、长期(NS)组,用药组分为幼年高氟(CHS)、幼年低氟(CIS)、成年高氟(AHS)、成年低氟(ALS)、幼年长期高氟(CLHS)、幼年长期低氟(CLLS)组.对照组生理盐水灌胃,用药组分别按相应时间给予不同剂量的氟化钠灌胃.实验验结束后,取腰椎制成不脱钙骨切片,行骨组织形态计量学测量.包括骨小粱面积百分数(Tb.Ar)、骨小梁厚度(Tb.Th)、骨小梁数量(Tb.N)、骨小梁分离度(Tb.Sp)、单位骨小梁面积破骨细胞数(Oc.N)、破骨细胞周长百分数(%Oc.Pm)、荧光周长百分率(%L.Pm)、骨矿化沉积率(MAR)、骨小梁周长形成率(BFR/BS)、骨小梁面积形成率(BFR/BV)、骨组织总面积形成率(BFR/TV)、成骨细胞周长(Ob.PM).结果 [1]CHS组的%Tb.Ar、Tb.Th、Tb.N、%L.Pm、MAR、BFR/BS、BFR/BV、和BFR/TV[(50.63±7.44)%,(150.26±27.51)μm,(3.44±0.47)N/mm,(50.63±7.44)%,(0.85±0.03)μm/d、(8.45±2.36)μm/d×100、(381.16±41.62)%/year、(75.07±4.81)%/year]均高于CS组[(29.71±9.32%)、(1 10.93±28.19)μm、(2.68±0.34)N/mm、(24.00±1.22)%、(0.65±0.03)μm/d、(5.43±0.18)μm/d×100、(141.32±9.29)%/year、(58.14±2.3)%/year,P<0.05].CLS组的%Tb.A、Tb.Th、%L.Pm、MAR、BFR/BS、BFR/BV、BFR/TV和Ob.PM[(40.76±6.43)%、(164.25±45.65)μm、(42.02±6.12)%、(0.85±0.04)μm/d、(8.95±3.73)μm/d×100、(378.73±35.39)%/year、(73.52±8.71)%/year、(1.41±0.05)μm]均高于CS组(P均<0.05).[2]AHS组的%Tb.Ar、Oc.N、%Oc.Pm、%L.Pm、MAR、BFR/BS、BFR/BV和BFR/TV[(50.62±5.76)%、(0.51±0.05)N/mm、(1.13±0.05)%、(42.3±7.02)%、(1.28±0.09)μm/d、(12.91±1.52)μm/d×100、(390.12±43.56)%/year、(65.21±22.13)%/year]均高于AS组[(42.73±5.22)%、(0.41±0.17)N/mm、(0.77±0.52)%、(28.43±6.93)%、(0.80±0.03)μm/d、(9.83±1.44)μm/d ×100、(324.43±53.44)%/year和(48.35±9.36)%/year,P均<0.05].A15组的%Tb.Ar、Oc.N、%Oc.Pm、%L.Pm、MAR、BFR/BS、BFR/BV和BFR/TV[(51.14±6.22)%、(O.49±0.61)N/mm、(1.17±0.11)%、(45.06±6.92)%、(1.39 ±0.08)μm/d、(12.87±1.35)μm/d × 100、(394.6±50.23)%/year和(66.31±18.93)%/year]均高于AS组(P均<0.05).[3]CLHS组的Ob.PM、Oc.N和%Oc.Pm[(1.47±0.27)μm、(0.58±0.13)N/mm、(1.14±0.07)%]均高于NS组[(0.82±1.2)μm、(0.42±0.25)N/mm和(0.75±0.64)%,P均<0.05)].结论 短期染氟导致幼年、成年大鼠的腰椎成骨活动增强;长期染氟虽然增加成骨细胞数目,但是腰椎骨量增加不明显,有促进骨吸收,降低骨质量的可能,随着氟化钠使用时间的延长,逐渐表现出对生长期大鼠骨代谢和骨质量的负作用.     

Trabecular bone microarchitecture in mild primary hyperparathyroidism

Primary hyperparathyroidism (PHPT) is a common endocrine disease. High levels of PTH cause demineralization of bone and increased risk of fracture. On the other hand, the effect of PHPT on bone structure is more ambiguous. The aim of this study was to evaluate the effect of PHPT on cancellous bone volume, structure, and microarchitecture. Thirteen transiliac biopsy specimens taken in untreated post-menopausal women aged 65+/-5 yr with primary hyperparathyroidism were compared with 13 biopsies taken in normal women aged 66+/-6 yr. None of the patients presented any other disorder affecting bone metabolism. In these samples we evaluated the direct and indirect histomorphometric parameters of bone microarchitecture using an image analysis system consisting of an epifluorescent microscope (Leica DMR) connected to an analogic 3 CCD camera (Sony DXC 390P) and a computer equipped with specific software for histomorphometric analyses. No significant differences between PHPT patients and controls in cancellous bone volume, trabecular thickness, and number were found. Two-dimensional parameters showed a preserved microarchitecture in PHPT patients. On the other hand, indirect parameters of microarchitecture [Marrow Star Volume (MSV) and Trabecular Bone Pattern Factor (TBPf)] showed a significant compromising of microarchitecture in these patients. PHPT patients have similar structural parameters to normal subjects. Concerning microarchitecture, indirect approach by MSV and TBPf shows a significant compromising of connectivity. These results can explain trabecular fragility observed in clinical studies on PHPT.     

Early changes in biochemical markers of bone formation correlate with improvements in bone structure during teriparatide therapy

CONTEXT: Biochemical markers of bone turnover may reflect bone structure during anabolic treatment. OBJECTIVE: The objective was to evaluate associations between changes in biochemical markers and structural and dynamic bone parameters during teriparatide treatment. DESIGN: This study was a randomized, multicenter, double-blind, placebo-controlled fracture prevention trial, with 20-month median treatment duration for biopsy subset. SETTING: The trial was conducted at 11 clinical study sites. PATIENTS: Sixty-one postmenopausal women with osteoporosis who had paired transiliac biopsy specimens participated in the study. INTERVENTIONS: Once-daily sc injections of either placebo or teriparatide (20 or 40 microg) were administered. MAIN OUTCOME MEASURES: The study measured: 1) serum and urinary biochemical markers of bone formation [bone alkaline phosphatase and procollagen I C-terminal propeptide (PICP)] and resorption (N-telopeptide and deoxypyridinoline); and 2) structural and dynamic analyses of bone biopsies, including two-dimensional (2D) histomorphometry and three-dimensional (3D) micro-computed tomography evaluations measured at baseline (n = 57) and 12 (n = 21) or 22 (n = 36) months. RESULTS: U-N-telopeptide/creatinine and serum-PICP correlated with bone structure and dynamic indices at baseline, respectively. Changes in bone alkaline phosphatase at 1 month correlated with changes at 22 months in 2D wall thickness (r = 0.73; P = 0.001), trabecular bone volume (trabecular bone volume per total volume, BV/TV) (r = 0.58; P < 0.05), marrow star volume (r = -0.51; P = 0.05); 3D trabecular thickness (r = 0.49; P < 0.05), and BV/TV (r = 0.54; P < 0.05). Changes in PICP at 1 month correlated with changes in wall thickness (r = 0.60; P = 0.01), and 2D BV/TV (r = 0.51; P < 0.05) at 22 months. Changes in markers at 6 or 12 months were not associated with changes in structural or dynamic parameters. CONCLUSIONS: Early (1-month) changes in biochemical markers of bone formation, but not resorption, correlated with improvements in bone structure after 22 months of teriparatide therapy.     

Serum osteocalcin is increased in patients with osteomalacia: correlations with biochemical and histomorphometric findings.

The synthesis of osteocalcin or bone gla protein by osteoblasts is markedly stimulated by 1,25-(OH)2D, a key hormone in the regulation of bone mineralization. The circulating levels of osteocalcin have been shown to reflect both the osteoid matrix production and the formation rate of mineralized bone in several metabolic bone diseases (osteoporosis, thyrotoxicosis, primary hyperparathyroidism) in which both mechanisms are tightly coupled because of the absence of mineralization defect. In this study, we measured in 12 patients (7 women, 5 men, 56 +/- 15 yr old) with untreated osteomalacia serum osteocalcin and vitamin D metabolites (25OHD and 1,25-(OH)2D). The results were correlated with biochemical and histomorphometric assessment of bone remodeling. Osteomalacia was due to vitamin D deficiency (5 cases), to vitamin D malabsorption (6 cases), and to hypophosphataemia in 1 case. When compared to control values, serum osteocalcin was increased in patients with osteomalacia (7.4 +/- 4 vs. 3.7 +/- 1.3 ng/mL; P less than 0.001) and was positively correlated with serum alkaline phosphatase (r = 0.65; P = 0.03) and negatively with 25 OHD (r = -0.61; P = 0.04). Serum osteocalcin was not correlated with 1,25-(OH)2D [r = -0.45; not significant (NS)] even after exclusion of the patient with hypophosphataemia. Serum osteocalcin was positively correlated with the osteoid volume and osteoid perimeter (r = 0.71 and 0.69 respectively; P less than 0.01) but not with any of the tetracycline-based parameter of bone mineralization at the tissue level (r ranging from -0.41 to +0.42, NS). Serum 25 OHD, but not 1,25-(OH)2D, was positively correlated with the mineralization rate (r = 0.59; P less than 0.05 and r = 0.54; NS). We conclude that in patients with osteomalacia, a condition which is characterized by an increased osteoid accumulation due to a decreased mineralization rate, the increased level of serum osteocalcin reflects the increased osteoid synthesis but not the mineralization defect. In this disease, serum osteocalcin is inversely correlated to the severity of vitamin D deficiency reflected by serum 25 OHD, but not to the serum levels of 1,25-(OH)2D.     

Bone remodelling in monoclonal gammopathies of uncertain significance,symptomatic and nonsymptomatic myeloma

Summary In order to characterize the abnormalities of bone remodelling in the various stages of plasma cell disorders, we studied 60 patients (29 monoclonal gammopathies of uncertain significance (MGUS), 13 stage I myeloma, 18 stage III myeloma). We carried out histomorphometric study of bone biopsies in 34 patients and measurement of osteocalcin and the calciuria/creatinine ratio.Bone remodelling was approximately normal (BV/TV: 21.2±7, ES: 4.1±2, OS: 16.5±10) in MGUS. Stage I myeloma was characterised by parallel increases in resorption surfaces and osteoid surfaces (BV/TV: 18±5, ES/BS: 7.4±3.5, OS/BS: 24.8±11.5), of the ca/cr ratio and osteocalcin. In stage III myeloma, resorption surfaces and the ca/cr ratio showed an even greater increase while osteoid surfaces, osteocalcin and trabecular bone volume decreased (BV/TV 13.6±6, ES/BS: 12.1±6, OS/BS: 13.6±8.3). Osteocalcin and osteoid surfaces were correlated (r=0.5). There was a positive correlation between osteocalcin and the number of plasmocytes in stage 1 myeloma (r=0.64) and a negative correlation in stage III myeloma (r=0.9).Bone remodeling was normal in MGUS; bone remodelling grew with a parallel increase of formation and resorption in stage I; bone resorption increased while bone formation decreased in stage III myeloma.     

On the mechanism of cancellous bone preservation in postmenopausal women with mild primary hyperparathyroidism.

Several studies have demonstrated that cancellous bone mass and architecture are preserved in postmenopausal women with primary hyperparathyroidism (PHPT). To investigate the mechanism(s) that could account for this observation, we analyzed features of bone formation in 19 postmenopausal women with PHPT by bone histomorphometry. The results were compared with those from a comparable group of 34 healthy, postmenopausal women. Patients with PHPT were similar to control subjects in cancellous bone area as well as in trabecular width, separation, and number. However, in PHPT, elevations were observed in indexes of bone turnover, such as eroded surface, osteoid surface, mineralizing surface, bone formation rate at the tissue level, and activation frequency. At the level of the bone-remodeling unit, women with PHPT had significantly higher values for the wall width of trabecular bone packets (40.26 +/- 0.36 vs. 34.58 +/- 0.45 mm), the adjusted apposition rate (0.40 +/- 0.04 vs. 0.29 +/- 0.03 mm/day), and the active formation period (67.8 +/- 5.1 vs. 57.3 +/- 2.3 days). These findings are consistent with a stimulatory action of elevated PTH levels on the duration of the active bone formation phase in individual remodeling units and may account at least in part for the preservation of cancellous bone in postmenopausal women with mild PHPT.     

旋转中心偏移对显微CT松质骨定量分析的影响

目的观察旋转中心微小偏移对显微CT测量参数的影响。方法20只7月龄sD大鼠随机分为去卵巢组（OVX）和假手术组（SHAM）。手术后3周处死,应用显微cT扫描胫骨近干骺端。手动校正以获取每次扫描的最佳旋转中心,分析各旋转中心在偏移±0．5、±1．0、±1．5和±2．0像素条件下的密度及微结构参数。结果一般线性模型分析结果显示OVX组与SHAM组比较,表观骨密度、组织骨密度、骨体积分数、骨小梁数量和联接密度明显下降,骨小梁间隔明显增宽（P〈0．05）。组织骨密度、各向异性度、骨小梁面积密度和联接密度随旋转中心的偏移下降,骨体积分数和骨小梁厚度随偏移幅度的加大逐渐升高。旋转中心偏移±1．5像素内,对组织骨密度、骨体积分数、各向异性度和联接密度的测量无影响。而骨小梁厚度和骨小梁面积密度在旋转中心偏移±1．0像素内影响较小。OVX组与SHAM组各参数随旋转中心偏移的变化趋势基本一致。各参数随旋转中心偏移服从二次回归方程趋势。通过二次回归方程拟合,可以获得实际旋转中心。以该中心获取的图像质量高,并能确保定量分析数据的准确。实际旋转中心与人为校正的最佳旋转中心之间存在微小差异。结论旋转中心的微小偏移对表观骨密度、结构模型指数、骨小梁间隔和数量的测量无明显影响。组织骨密度、骨小梁厚度、骨小梁面积密度、骨体积分数、各向异性度和联接密度受旋转中心偏移影响较大。通过二次曲线方程拟合能找到正确的旋转中心,该中心与人为校正获取的最佳旋转中心存在一定误差。     

Risedronate prevents the loss of microarchitecture in glucocorticoid-induced osteoporosis in rats

Osteoporosis is a severe complication of glucocorticoid treatment. Bisphosphonates are a powerful therapeutic option to prevent osteoporotic fractures. The aims of this study were: a) to determine bone alterations induced by therapy with glucocorticoids (GC); b) to establish the efficacy of risedronate (Ris) in the prevention of these effects. We studied 40 female Sprague-Dawley rats randomly divided into 4 groups of treatment, administered 3 times a week sc: 1. Control: vehicle of methylprednisolone (GC) + vehicle of Ris; 2. Ris: Ris 5 mug/kg body weight vehicle of GC; 3. GC: GC 7 mg/kg + vehicle of Ris; 4. GC+Ris: GC 7 mg/kg, Ris 5 microg/kg. Animals were treated for 30 days and then were sacrificed. Densitometry was performed at baseline and at the end of the treatment. Right tibiae were removed for histomorphometric analyses. The GC group showed a 7% decrease in bone density vs controls (p<0.05), while the GC+Ris group was associated with a 3.5% increase in bone density vs controls (p<0.05). In the GC group, histomorphometric evaluations showed reduced bone volume (BV/TV) and thinning of trabeculae (Tb.Th) vs controls (BV/TV: 31+/-1 vs 35+/-1%, p<0.05; Tb.Th: 43+/-2 vs 50+/-3 microm, p<0.01; Ac.f: 1.8+/-0.2 vs 1.6+/-0.3 N/yr). The GC+Ris group had increased BV/TV and Tb.Th, and reduced Ac.f vs the GC group. Ris also maintained trabecular microarchitecture. At the histological level, glucocorticoid-induced osteoporosis was characterized by decreased bone volume, reduced osteoblastic activity, and deterioration of microarchitecture. Ris counteracted these effects both by prolonging osteoblast activity, and by maintaining bone microarchitecture.     

Segmental variations in trabecular bone density and microstructure of the spine in senescence-accelerated mouse (SAMP6): a murine model for senile osteoporosis

The senescence-accelerated mouse strain P6 (SAMP6) is a model of senile osteoporosis, which possesses many features of senile osteoporosis in humans. So far, little is known about the systemic bone microstructural changes that occur at the cervical, thoracic, and lumbar vertebrae. In this study, we therefore investigated segmental variations of vertebral trabecular bone mineral density (BMD) and three-dimensional microstructure in SAMP6 and the normal control mouse (SAMR1) at 12 months of age using quantitative micro computed tomography (micro-CT) and image analysis software. The vertebral height and vertebral cross-sectional area (CSA) increased, while vertebral trabecular BMD and trabecular bone volume fraction (BV/TV) decreased from the cervical to lumbar spine both in SAMR1 and SAMP6. As compared with SAMR1, the thoracic vertebral CSA had a tendency to be low and the lumbar vertebral CSA was significantly declined in SAMP6. The vertebral trabecular BMD, BV/TV, trabecular thickness (Tb.Th), and trabecular number (Tb.N) significantly decreased in cervical, thoracic and lumbar spine of SAMP6. Trabecular bone pattern factor (TBPf) was higher at the lumbar spine and the structure model index (SMI) of the lower thoracic and lumbar spine was higher in SAMP6. These results indicate that vertebral trabecular bone microstructures are remarkably heterogeneous throughout the spine in both SAMR1 and SAMP6. The decrease of vertebral trabecular bone density in SAMP6 advanced faster caudally than cranially within the spine, similar phenomena were observed in humans. These findings highlight the relevance of SAMP6 for studies of vertebral fragility associated with senile osteoporosis.     

大鼠去卵巢后不同时期骨微结构和力学性能的变化特征

目的揭示大鼠在去卵巢后不同时期腰椎松质骨微结构退变的变化特征,探讨骨整体力学性能下降的同时可能存在的各种适应性代偿性变化。方法50只7月龄SD大鼠随机分为基线、去卵巢组（OVX组）和假手术组（SHAM）。基线组10只,其余每组均20只。实验开始时先将基线组10只处死,OVX组和SHAM组分别在手术后3周、15周各处死10只,留取动脉血清及腰椎标本,骨微结构、力学和生化指标的测定。结果去卵巢后3周时OVX组表观骨密度、骨体积分数、骨小梁厚度和骨小梁数量均较SHAM和基线降低（P〈0．05）,各向异性度较基线下降（P〈0．05）而与SHAM组无统计学差异。骨小梁面积密度、骨小梁间隔和结构模型指数均较SHAM和基线组增加（P〈0．05）。去卵巢后3周时OVX组最大应力、弹性模量、血清TRAP-5b和骨细胞密度均低于基线（P〈0．05）而与SHAM组无统计学差异。去卵巢后15周时OVX组表观骨密度、骨体积分数、骨小梁数量和联接密度、最大应力、TRAP-Sb和骨细胞密度均较SHAM和基线组降低（P〈0.05）,骨小梁结构模型指数、骨小梁间隔和各向异性度均较SHAM和基线组增加（P〈0．05）,骨小梁面积密度和厚度均与SHAM和基线组无统计学差异。结论大鼠去卵巢后腰椎骨量快速丢失,骨微结构逐渐退变,而血清TRAP-5b水平下降及骨细胞密度、骨小梁各向异性度和厚度的适应性增加,可能在一定程度上代偿骨力学性能的下降,有利于维持骨结构的完整性。     

Bone turnover and balance evaluated by a combined calcium balance and calcium kinetic study and dynamic histomorphometry

Bone resorption and formation rates were evaluated at the organ level using calcium kinetic methods and at the trabecular bone tissue level using dynamic histomorphometry in 20 patients with various metabolic bone diseases (primary hyperparathyroidism (N = 9), hyperthyroidism (N = 6), and hypothyroidism (N = 5). Highly significant correlations were demonstrated between resorption and formation rates at organ level (r = .90, P less than .001) and at tissue level (volume referent) (r = .93, P less than .001), indicating a high degree of coupling between resorption and formation within the three disease states. Tissue level resorption rates (surface referent, as well as volume referent) both correlated significantly (P less than .01) to organ level resorption rate (r = .60 and r = .63, respectively). Fractional active resorption surface and cellular level resorption rate did not reveal significant correlations to calcium kinetic estimates. No correlation could be demonstrated between organ level mineralization rate and formative or labeled trabecular surfaces. However, all tetracycline based tissue level formation rates revealed highly significant correlations (P less than .01) to organ level mineralization rate (calcification rate, r = .71; surface referent bone formation rate, r = .59; volume referent bone formation rate, r = .68). Based on histomorphometric parameters for resorption and formation, actual and predicted tissue level trabecular bone balances were calculated. Both the actual and predicted bone balance correlated significantly to the organ level calcium balance (P less than .05). Correction for skeletal size based on BMC measurements did not improve any of the correlations significantly.(ABSTRACT TRUNCATED AT 250 WORDS)     

Fluoride therapy for osteoporosis: characterization of the skeletal response by serial measurements of serum alkaline phosphatase activity

Optimum use of fluoride therapy for osteoporosis requires a sensitive and convenient index of the skeletal response to fluoride. Since previous studies had shown that serum alkaline phosphatase activity (SALP) was increased in response to fluoride therapy, we examined serial measurements of SALP in 53 osteoporotics treated with 66 to 110 mg of sodium fluoride (NaF) for 12 to 91 months. SALP was increased in 87% of the subjects during therapy with fluoride. The increase in SALP was thought to reflect the osteogenic action of fluoride based on the findings that SALP correlated with both trabecular bone area (r = .81, P less than .001) and osteoid length (r = .67, P less than .01) in iliac crest biopsies, predicted increased bone density on spinal radiographs in response to fluoride therapy with an 87% accuracy, and predicted decreased back pain in response to fluoride with a 91% accuracy. In addition, the SALP response to fluoride was seen earlier than other therapeutic responses as indicated by the findings that the tau 1/2 for the SALP response (ie, time for 1/2 of the patients to show a significant response) was significantly less (1.2 +/- 0.3 yr) than that for the pain response (1.6 +/- 0.3 yr, P less than .05) or that for the radiographic response (3.7 +/- 0.5 yr, P less than .001). Although most patients responded to fluoride with an increase in SALP, evaluation of the kinetics of the SALP response to fluoride revealed marked interpatient variation.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of excess endogenous androgens on bone density in young women

To determine whether endogenous androgens influence bone density in young women, we studied 27 normal women and 19 women with androgen excess, as defined by increased serum bioavailable testosterone (bio T) concentrations. The women ranged from 21-48 yr of age. The 2 groups were comparable with respect to age, anthropomorphic measures, nutrition, gynecological history, and serum cortisol and estradiol levels. Trabecular (lumbar) and cortical (radial) bone density were quantitated by computerized tomography and single photon absorptiometry, respectively. Serum obtained during the follicular phase of the cycle was assayed for bio T, total T, dehydroepiandrosterone sulfate, androstenedione (Adione), and 3 alpha-androstanediol glucuronide (3-Adiol-G). Trabecular bone density was significantly higher in the androgen excess group [172 +/- 7 (+/- SE) vs. 153 +/- 5 mg/mL; P = 0.03]; controlling for serum Adione (but not for serum bio T, total T, dehydroepiandrosterone sulfate, or 3 alpha-androstanediol glucuronide, or 3-Adiol-G) abolished this difference. Similarly, serum Adione correlated more strongly than the other androgens with trabecular bone density (r = 0.31; P = 0.03). Average cortical bone density was not higher in the androgen excess group (0.740 +/- 0.014 vs. 0.722 +/- 0.008 g/cm2; P = 0.27). Among the 27 normal women, cortical density was correlated to serum bio T (r = 0.47; P = 0.01) and total T (r = 0.53; P = 0.004), but not to the other androgens. We conclude that supraphysiological levels of endogenous androgens are associated with increased trabecular bone density in young women. Serum Adione appeared to be the best marker for the impact of androgen on trabecular density. Among normal women, cortical bone density was related to serum T.     

Parathyroid hormone deficiency and excess: similar effects on trabecular bone but differing effects on cortical bone

Parathyroid hormone (PTH) may be anabolic at trabecular bone and catabolic in cortical bone. As many regions of the skeleton contain both types of bone, the effects of PTH deficiency or excess may be difficult to evaluate using bone densitometry, a technique that integrates the cortical and trabecular compartments of bone. We asked the following questions: 1) Is the higher bone mineral density (BMD) in postsurgical hypoparathyroidism due to higher cortical, not trabecular, bone? 2) Is age-related bone loss slowed in patients with postsurgical hypoparathyroidism? 3) Is lower BMD in primary hyperparathyroidism the result of deficits in cortical, not trabecular, bone? BMD of the lumbar spine, proximal femur, distal radius, and femoral midshaft was measured by postero-anterior (PA) scanning, while bone mineral content (BMC) of the third lumbar vertebra was measured by lateral scanning using dual x-ray absorptiometry in 10 women, ages 64.6 +/- 3.2 yr, with postsurgical hypoparathyroidism and in 25 women, ages 68.7 +/- 1.6 yr, with primary hyperparathyroidism. Measurements were repeated 4.7 +/- 0.6 yr later in 8 patients with hypoparathyroidism and 4.0 +/- 0.4 yr later in 20 age-matched controls. Data were expressed as z scores (SD, mean +/- sem) derived from 405 postmenopausal women. In patients with hypoparathyroidism, bone mass z score of the third lumbar vertebra (vertebral body plus posterior processes) was higher than zero by PA scanning (1.26 +/- 0.58 SD, P < 0.05) and lateral scanning (1.04 +/- 0.60 SD, P = 0.1), and higher at the trabecular-rich vertebral body (1.02 +/- 0.47 SD, P = 0.07) and predominantly cortical posterior processes (0.98 +/- 0.66 SD, P = 0.1) determined by lateral scanning. The BMD z scores were higher than zero at the femoral neck (0.89 +/- 0.48 SD, P = 0.09), but not at the femoral midshaft (0.45 +/- 0.60, NS) and distal radius (0.04 +/- 0.51, NS). During follow-up, femoral neck BMD decreased in controls but not in patients with hypoparathyroidism (slope, -0.00818 +/- 0.00496 g/cm2/year vs. 0.00907 +/- 0.00583 g/cm2/year, respectively, P = 0.06). There was no change in lumbar spine BMD in either group. In 25 women with primary hyperparathyroidism, there were no deficits in BMD at the third lumbar vertebra (vertebral body plus posterior processes) by PA or lateral scanning. By lateral scanning, BMC was increased at the vertebral body (0.64 +/- 0.31 SD, P < 0.01) and reduced at the posterior processes (-0.65 +/- 0.26 SD, P < 0.05). BMD was lower at the midshaft of the femur (-0.82 +/- 0.37 SD, P < 0.05) and at the distal radius (-0.68 +/- 0.20 SD, P < 0.01), but not at the femoral neck (-0.08 +/- 0.20 SD, NS). Longitudinal data were unavailable in hyperparathyroid patients. In summary, trabecular bone is increased by both PTH deficiency and excess. Cortical bone loss is slowed by PTH deficiency and accelerated by PTH excess so that suppression of PTH may reduce age-related bone loss and the risk of fracture. Assessment of BMD in PTH deficiency and excess requires the separate study of cortical and trabecular bone.     

Influence of age at menarche on forearm bone microstructure in healthy young women

BACKGROUND: Shorter estrogen exposure from puberty onset to peak bone mass attainment may explain how late menarche is a risk factor for osteoporosis. The influence of menarcheal age (MENA) on peak bone mass, cortical, and trabecular microstructure was studied in 124 healthy women aged 20.4 +/- 0.6 (sd) yr. METHODS: At distal radius, areal bone mineral density (aBMD) was measured by dual-energy x-ray absorptiometry, and volumetric bone mineral density (BMD) and microstructure were measured by high-resolution peripheral computerized tomography, including: total, cortical, and trabecular volumetric BMD and fraction; trabecular number, thickness, and spacing; cortical thickness (CTh); and cross-sectional area (CSA). RESULTS: Median MENA was 12.9 yr. Mean aBMD T score of the whole cohort was slightly positive. aBMD was inversely correlated to MENA for total radius (R = -0.21; P = 0.018), diaphysis (R = -0.18; P = 0.043), and metaphysis (R = -0.19; P = 0.031). Subjects with MENA more than the median [LATER: 14.0 +/- 0.7 (+/-sd) yr] had lower aBMD than those with MENA less than the median (EARLIER: 12.1 +/- 0.7 yr) in total radius (P = 0.026), diaphysis (P = 0.042), and metaphysis (P = 0.046). LATER vs. EARLIER displayed lower total volumetric BMD (315 +/- 54 vs. 341 +/- 56 mg HA/cm(3); P = 0.010), cortical volumetric BMD (874 +/- 49 vs. 901 +/- 44 mg HA/cm(3); P = 0.003), and CTh (774 +/- 170 vs. 849 +/- 191 microm; P = 0.023). CTh was inversely related to CSA (R = -0.46; P < 0.001). In LATER reduced CTh was associated with 5% increased CSA. CONCLUSIONS: In healthy young adult women, a 1.9-yr difference in mean MENA was associated with lower radial aBMD T score, lower CTh without reduced CSA, a finding compatible with less endocortical accrual. It may explain how late menarche is a risk factor for forearm osteoporosis.