Pluskiewicz W, Drozdzowska B
Department of Internal and Allergic Diseases, Silesian Academy of Medicine, Katowice, Poland.
Osteoporos Int. 1998;8(4):349-54. doi: 10.1007/s001980050074.
In this cross-sectional study 954 Polish healthy women aged 30-80 years were evaluated (mean age 50.8 +/- 8.9 years). Among them were 460 premenopausal (mean age 44.4 +/- 5.5 years) and 494 postmenopausal women (mean age 56.8 +/- 7.2 years). Women suffering from diseases known to affect bone metabolism and/or treated with drugs that affect bone tissue were excluded. All women were volunteers from six towns in the south of Poland, who underwent bone measurements for screening purposes. Bone status was assessed using an ultrasound device (DBM Sonic 1200, Igea, Italy) that measures amplitude-dependent speed of sound (AD-SoS) in metres per second. Phalanges (II-V) of the non-dominant hand were measured and an average value was computed. In vivo short-term precision was 0.49% for intraobserver, and 0.42% for interobserver measurements. Mean AD-SoS values were: in the whole group, 1974.6 +/- 90.7 m/s; in premenopausal women, 2032.1 +/- 50.0 m/s; and in postmenopausal women, 1921.0 +/- 87.3 m/s (p < 0.0001). The mean decrease in AD-SoS value in the studied population was 6.1 m/s per year. Simple linear regression analysis showed significant, negative correlations between age and AD-SoS: in the whole group r = -0.70 (p < 0.0001); in pre- and postmenopausal women, r = -0.29 (p < 0.0001) and r = -0.58 (p < 0.0001), respectively. Years since menopause (YSM) showed a significant influence on AD-SoS: linear correlation in the whole group resulted in a value of r = -0.59 (p < 0.0001) and in the group of postmenopausal women in a value of r = -0.57 (p < 0.0001). AD-SoS decreased in the first 8 YSM by 5.1% (0.63%/year) and in the next 15 YSM by 5.44% (0.36%/year). In postmenopausal women mean AD-SoS was regressed simultaneously on age and YSM, resulting in AD-SoS = 2181.0 - 4.031 x Age - 3.911 x YSM. In conclusion, ultrasound measurements of proximal phalanges were found to enable detection of age- and YSM-related skeletal changes in a Polish healthy female population. Results obtained in this study showed a premenopausal decrease in the ultrasound parameter (not observed by other authors) and an AD-SoS value lower than those in French, Italian and Spanish populations. The premenopausal decline in AD-SoS, the most important observation, requires further longitudinal investigations to determine factors affecting the skeleton before menopause.
在这项横断面研究中，对954名年龄在30至80岁的波兰健康女性进行了评估（平均年龄50.8±8.9岁）。其中有460名绝经前女性（平均年龄44.4±5.5岁）和494名绝经后女性（平均年龄56.8±7.2岁）。排除患有已知影响骨代谢疾病和/或接受过影响骨组织药物治疗的女性。所有女性均为来自波兰南部六个城镇的志愿者，她们接受骨测量以进行筛查。使用超声设备（DBM Sonic 1200，Igea，意大利）评估骨状态，该设备以米每秒为单位测量与振幅相关的声速（AD-SoS）。测量非优势手的指骨（II-V）并计算平均值。观察者内测量的体内短期精密度为0.49%，观察者间测量的为0.42%。平均AD-SoS值分别为：在整个组中为1974.6±90.7米/秒；绝经前女性为2032.1±50.0米/秒；绝经后女性为1921.0±87.3米/秒（p<0.0001）。研究人群中AD-SoS值的平均下降速度为每年6.1米/秒。简单线性回归分析显示年龄与AD-SoS之间存在显著的负相关：在整个组中r = -0.70（p<0.0001）；在绝经前和绝经后女性中，r分别为-0.29（p<0.0001）和-0.58（p<0.0001）。绝经年限（YSM）对AD-SoS有显著影响：整个组的线性相关值为r = -0.59（p<0.0001），绝经后女性组的为r = -0.57（p<0.0001）。在绝经后的前8年中，AD-SoS下降了5.1%（每年0.63%），在接下来的15年中下降了5.44%（每年0.36%）。在绝经后女性中，平均AD-SoS同时与年龄和YSM进行回归分析，得出AD-SoS = 2181.0 - 4.031×年龄 - 3.911×YSM。总之，发现对近端指骨进行超声测量能够检测波兰健康女性人群中与年龄和YSM相关的骨骼变化。本研究获得的结果显示超声参数在绝经前下降（其他作者未观察到），且AD-SoS值低于法国、意大利和西班牙人群。AD-SoS在绝经前的下降是最重要的观察结果，需要进一步进行纵向研究以确定绝经前影响骨骼的因素。
