Carnevale V, Dicembrino F, Frusciante V, Chiodini I, Minisola S, Scillitani A
Department of Internal Medicine, Istituto di Ricovero e Cura a Carattere Scientifico Casa Sollievo della Sofferenza, San Giovanni Rotondo Foggia, Italy.
J Nucl Med. 2000 Sep;41(9):1478-83.
Bone turnover changes with age have been shown by both histomorphometric and scintimetric methods; fewer studies have been performed on the regional differences of bone remodeling in the aging skeleton. To noninvasively investigate this issue, we evaluated the age-related patterns of global and regional bone uptake of 99mTc-methylene diphosphonate (MDP) in a large sample of healthy women.
In a group of 84 healthy women (33 pre- and 51 postmenopausal), the uptake of 99mTcMDP was semiquantitatively measured in 5 regions of interest. Total-body digital scans (TBDSs) were acquired at 5 min and at 4 h. Five regions of interest were drawn on the skeleton as a whole, on the lumbar spine, on the iliac wing, on the femoral neck, and on the femoral diaphysis of the 4-h TBDS. Regional skeletal uptake of the lumbar spine (LS-RSU), of the iliac wing (IL-RSU), of the femoral neck (FN-RSU), and of the femoral diaphysis (FD-RSU) was calculated as percentage injected dose retained in these skeletal segments at 4 h.
As expected, in postmenopausal women the global skeletal uptake (GSU) values were higher than those in premenopausal women (40.7 +/- 5.9 percentage injected dose [%ID] versus 35.1 +/- 4.2 %ID; P < 0.0001). GSU correlated positively with age (r = 0.70; P < 0.001), but the addition of years since menopause to the regression model did not ameliorate the regression. On the other hand, LS-RSU (r = -0.55; P < 0.0001), IL-RSU (r = -0.45; P < 0.0001), and FN-RSU (r = -0.22; P < 0.005) decreased significantly, whereas FD-RSU increased significantly (r = 0.39; P < 0.001) with age; the same regressions were not influenced significantly by the addition of menopausal duration to the regression model. The strongest correlation among the different RSUs was that found between LS-RSU and IL-RSU (r = 0.63; P < 0.001). Moreover, the linear regression coefficients of the various RSUs with age were all significantly different from each other (P < 0.001).
Our data show that the GSU of 99mTc-MDP increases with age, whereas different skeletal segments display a variable degree of turnover activation at different ages. This could ultimately induce the different rates of bone loss of different skeletal segments at various ages and, consequently, their variable propensity to fracture.
组织形态计量学和闪烁扫描法均已表明骨转换随年龄而变化；针对衰老骨骼中骨重塑的区域差异所开展的研究较少。为了以非侵入性方式研究此问题，我们在一大群健康女性中评估了99m锝-亚甲基二膦酸盐（MDP）的全身及局部骨摄取的年龄相关模式。
在一组84名健康女性（33名绝经前和51名绝经后）中，在5个感兴趣区域对99m锝-MDP的摄取进行半定量测量。在5分钟和4小时时进行全身数字扫描（TBDS）。在4小时的TBDS上，在整个骨骼、腰椎、髂骨翼、股骨颈和股骨干上绘制5个感兴趣区域。腰椎（LS-RSU）、髂骨翼（IL-RSU）、股骨颈（FN-RSU）和股骨干（FD-RSU）的局部骨骼摄取量计算为4小时时保留在这些骨骼节段中的注射剂量百分比。
正如预期的那样，绝经后女性的全身骨骼摄取（GSU）值高于绝经前女性（40.7±5.9注射剂量百分比 [%ID] 对35.1±4.2 %ID；P<0.0001）。GSU与年龄呈正相关（r = 0.70；P<0.001），但将绝经后的年限添加到回归模型中并未改善回归效果。另一方面，LS-RSU（r = -0.55；P<0.0001）、IL-RSU（r = -0.45；P<0.0001）和FN-RSU（r = -0.22；P<0.005）随年龄显著下降，而FD-RSU随年龄显著增加（r = 0.39；P<0.001）；将绝经持续时间添加到回归模型中对相同的回归没有显著影响。不同RSU之间最强的相关性是在LS-RSU和IL-RSU之间发现的（r = 0.63；P<0.001）。此外，各RSU与年龄的线性回归系数彼此均有显著差异（P<0.001）。
我们的数据表明，99m锝-MDP的GSU随年龄增加，而不同的骨骼节段在不同年龄表现出不同程度的转换激活。这最终可能导致不同骨骼节段在不同年龄有不同的骨质流失率，从而导致它们不同的骨折倾向。
