Byers R J, Denton J, Hoyland J A, Freemont A J
University of Manchester Bone Disease Research Centre, Department of Pathological Sciences, UK.
J Clin Pathol. 1999 Jan;52(1):23-8. doi: 10.1136/jcp.52.1.23.
To investigate the level of bone formation in the different bone compartments in cases of established osteoporosis, as previous work has concentrated on trabecular bone alone.
Bone formation rates were measured histomorphometrically, in the periosteal (P), cortical (C), subcortical (SC), and trabecular (T) compartments in iliac crest biopsies from 159 patients with established osteoporosis. The values were standardised using age and sex matched control data and patterns of differential change determined by analysis of parametric status (increased, normal, reduced).
Mean bone formation was reduced in all four compartments. This was more marked (4.4/4.1 standard deviations below the mean in C/T, v 2.3/0.9 in P/SC) and more frequent (reduced in 81.5%/78.3% in T/C, v 43.3%/44% in P/SC) in the trabecular and cortical compartments than in the periosteal or subcortical bone. Parametric status was equal in trabecular and cortical bone in 85.4% of cases, and in periosteal and subcortical bone in 65.7%, but in all four compartments in only 35.1%, indicating differential alteration of bone formation in the two sets of compartments (T/C v P/SC).
Altered trabecular bone formation is important in osteoporosis, but there are differential patterns of alteration in the other three compartments, emphasising the presence of different microenvironments in bone; thus the effect on the cortical compartment was similar to that on the trabecular, while the subcortical and periosteal compartments also showed linkage. The linkage between the two pairs was divergent, indicating different control of bone formation, with resultant different patterns of perturbation in osteoporosis.
既往研究仅关注小梁骨，本研究旨在调查已确诊骨质疏松症患者不同骨区域的骨形成水平。
对159例已确诊骨质疏松症患者的髂嵴活检组织中的骨膜（P）、皮质（C）、皮质下（SC）和小梁（T）区域进行组织形态计量学测量骨形成率。使用年龄和性别匹配的对照数据对这些值进行标准化，并通过参数状态分析（增加、正常、降低）确定差异变化模式。
所有四个区域的平均骨形成均降低。小梁和皮质区域的这种情况更为明显（C/T区域比平均值低4.4/4.1个标准差，而P/SC区域为2.3/0.9）且更频繁（T/C区域中81.5%/78.3%降低，而P/SC区域为43.3%/44%），高于骨膜或皮质下骨。在85.4%的病例中，小梁骨和皮质骨的参数状态相同，在65.7%的病例中骨膜和皮质下骨的参数状态相同，但在所有四个区域中仅35.1%相同，表明两组区域（T/C与P/SC）的骨形成存在差异改变。
小梁骨形成改变在骨质疏松症中很重要，但其他三个区域存在不同的改变模式，强调了骨中存在不同的微环境；因此，对皮质区域的影响与对小梁区域的影响相似，而皮质下和骨膜区域也显示出关联。两对区域之间的关联是不同的，表明骨形成的控制不同，导致骨质疏松症中出现不同的扰动模式。
