Qin L, Au S K, Chan K M, Lau M C, Woo J, Dambacher M A, Leung P C
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong.
Calcif Tissue Int. 2000 Jul;67(1):29-36. doi: 10.1007/s00223001092.
The aim of this cross-sectional study was to use a newly available precise and multislice pQCT (Densiscan 2000) for establishing reference data of volumetric bone mineral density (vBMD) of the distal radius. vBMD of the nondominant wrist was measured in 118 healthy Hong Kong Chinese women aged 41-60. Anthropometric parameters, menstrual status, and handgrip strength were also measured. Results showed that there was a significant age-related decline in trabecular BMD (tBMD), integral BMD (iBMD), and cortical BMD (cBMD), with correlation coefficients ranging from -0.401 to -0.547 (P < 0.001). The annual decline of vBMD was 2.22%, 1.79%, and 0.88% in tBMD, iBMD, and cBMD, respectively. When subjects were divided into premenopausal and postmenopausal groups, we found an age-related decline in tBMD and iBMD, but not in cBMD in both groups. The vBMD values interpreted in mg/cm3 in premenopausal women were 238.4 +/- 57.2 in tBMD, 604.6 +/- 82.9 in iBMD, 1415.5 +/- 129.9 in cBMD, and declined significantly (all P < 0.001) to 193.7 +/-54.7 in tBMD, 500.0 +/- 90.3 in iBMD, and 1306.7 +/- 153.5 in cBMD in the postmenopausal women. On average, 16.7% of the subjects showed their vBMDs to be below-1 SD and only 1.7% of them lower than -2 SD. Linear regression showed that the annual decline of vBMD was faster in postmenopausal women with 2.42% in tBMD, 1.90% in iBMD, and 0.88% in cBMD compared with 1.91% in tBMD, 0.98% in iBMD, and 0.55% in cBMD in the premenopausal women. After adjustment for age, only the iBMD with dominant trabecular elements showed a significantly accelerated decrease after the onset of menopause (P = 0.008). Weak or no association was found among vBMDs with anthropometric parameters, years since menopause, or handgrip strength. In conclusion, we found a significant age-related decline of vBMDs in Hong Kong Chinese women aged 41-60 years, characterized by the early reduction of metabolically active trabecular bone after entering the fourth decade of life, with an accelerated decline after the onset of menopause.
这项横断面研究的目的是使用新获得的精确多层外周定量CT（Densiscan 2000）来建立桡骨远端骨体积密度（vBMD）的参考数据。对118名年龄在41至60岁的健康中国香港女性非优势手腕的vBMD进行了测量。还测量了人体测量参数、月经状况和握力。结果显示，小梁骨密度（tBMD）、整体骨密度（iBMD）和皮质骨密度（cBMD）均有显著的年龄相关性下降，相关系数在-0.401至-0.547之间（P<0.001）。tBMD、iBMD和cBMD的vBMD年下降率分别为2.22%、1.79%和0.88%。当将受试者分为绝经前和绝经后组时，我们发现两组的tBMD和iBMD均有年龄相关性下降，但cBMD没有。绝经前女性以mg/cm³表示的vBMD值，tBMD为238.4±57.2，iBMD为604.6±82.9，cBMD为1415.5±129.9，而绝经后女性则显著下降（均P<0.001），tBMD为193.7±54.7，iBMD为500.0±90.3，cBMD为1306.7±153.5。平均而言，16.7%的受试者vBMD低于-1标准差，只有1.7%低于-2标准差。线性回归显示，绝经后女性的vBMD年下降速度更快，tBMD为2.42%，iBMD为1.90%，cBMD为0.88%，而绝经前女性tBMD为1.91%，iBMD为0.98%，cBMD为0.55%。在调整年龄后，只有具有主要小梁成分的iBMD在绝经后下降显著加速（P = 0.008）。vBMD与人体测量参数、绝经年限或握力之间的关联较弱或无关联。总之，我们发现41至60岁的中国香港女性vBMD有显著的年龄相关性下降，其特征是进入生命的第四个十年后代谢活跃的小梁骨早期减少，绝经后下降加速。
