Warming L, Hassager C, Christiansen C
Center for Clinical and Basic Research, Ballerup, Denmark.
Osteoporos Int. 2002;13(2):105-12. doi: 10.1007/s001980200001.
We performed a prospective study to evaluate the normal changes in bone mineral density (BMD) in the forearm, hip, spine and total body, and to study the agreement between changes in BMD estimated from cross-sectional data and the actual longitudinal changes. Six hundred and twenty subjects (398 women, 222 men; age 20-89 years) without diseases or medication known to affect bone metabolism undertook baseline evaluations, and 525 (336 women, 189 men) completed the study. BMD was measured twice 2 years apart by dual-energy X-ray absorptiometry. From cross-sectional evaluations the only premenopausal bone loss (<0.003 g/cm2/year) was found in the hip. In women after menopause and in men an age-related bone loss (0.002-0.006 g/cm2/year) was found at all sites. The data from the longitudinal evaluation showed a small bone loss in women before menopause at the hip and lumbar spine (<0.4%/year (<0.004 g/cm2/year)); this bone loss nearly tripled in the early postmenopausal years (<10 years since menopause), and thereafter decreased to the premenopausal rate for the hip, and to zero for the lumbar spine. The most pronounced bone loss after menopause occurred in the forearm (1.2%/year (0.006 g/ cm2/year)), and it remained constant throughout life. In men there was a small longitudinal bone loss in the hip throughout life, and a small bone loss in the distal forearm after the age of 50 years. In all groups, except for the early postmenopausal women, we found a small increase in total body BMD with age. When comparing the changes in BMD estimated from cross-sectional data with the longitudinal changes, only the hip and forearm generally displayed agreement, whereas the changes in the total body and spine generally were incongruous. In conclusion, the hip and forearm appear to be the sites with the best agreement between the cross-sectional estimated and the longitudinal age-related changes in BMD.
我们开展了一项前瞻性研究，以评估前臂、髋部、脊柱和全身的骨密度（BMD）正常变化情况，并研究根据横断面数据估算的BMD变化与实际纵向变化之间的一致性。620名受试者（398名女性，222名男性；年龄20 - 89岁），无已知影响骨代谢的疾病或药物治疗史，进行了基线评估，525名（336名女性，189名男性）完成了研究。采用双能X线吸收法，在间隔2年的时间里对BMD进行了两次测量。横断面评估发现，仅绝经前髋部存在骨质流失（<0.003 g/cm²/年）。绝经后女性和男性在所有部位均出现与年龄相关的骨质流失（0.002 - 0.006 g/cm²/年）。纵向评估数据显示，绝经前女性髋部和腰椎存在少量骨质流失（<0.4%/年（<0.004 g/cm²/年））；绝经后早期（绝经后<10年），这种骨质流失几乎增加了两倍，此后髋部降至绝经前水平，腰椎骨质流失降至零。绝经后最明显的骨质流失发生在前臂（1.2%/年（0.006 g/cm²/年）），且终生保持不变。男性一生中髋部存在少量纵向骨质流失，50岁后远端前臂存在少量骨质流失。在所有组中，除绝经后早期女性外，我们发现全身BMD随年龄略有增加。当比较根据横断面数据估算的BMD变化与纵向变化时，只有髋部和前臂总体上显示出一致性，而全身和脊柱的变化总体上不一致。总之，髋部和前臂似乎是横断面估算的与纵向年龄相关BMD变化之间一致性最佳的部位。
