Partanen Juha, Heikkinen Jorma, Jämsä Timo, Jalovaara Pekka
Department of Orthopaedic and Trauma Surgery, University of Oulu, P.O. Box 5000, Finland.
J Bone Miner Metab. 2002;20(6):367-75. doi: 10.1007/s007740200053.
Seventy-four postmenopausal women with nonpathological hip fracture were recruited to a study in which they were compared for lifetime factors, some biochemical measurements of bone metabolism, and bone mineral density (BMD), with 40 age-adjusted controls without fracture. The fracture patients were less independent; their walking ability was weaker; their vision was poorer; they had more general diseases (strokes, diabetes, malignant diseases, heart and vascular diseases); more of them had had deliveries; and they were using significantly more loop diuretics, and antidepressant, neuroleptic, and diabetes drugs than the controls. Thirty-seven patients and 19 controls were excluded from the statistical comparison of BMD and the biochemical measurements of bone metabolism because they had had treatments with calcium, vitamin D, bisphosphonates, estrogens, calcitonin, or corticosteroids, and one fracture patient was excluded for primary hyperparathyroidism. The BMD of the upper femur was significantly lower in the fracture group compared with the control group. Serum total calcium (S-Ca) and serum vitamin D (S-25-(OH)-D) were significantly lower and the levels of calcitonin (S-CT) significantly higher in the fracture group than in the control group, but none of the bone formation markers showed significant differences between the study groups. A comparison of patients with cervical and trochanteric fractures showed BMD to be significantly lower in the upper femur in the trochanteric fracture group. There were no significant differences in the biochemical measurements (with the exception that S-CT was higher in the cervical fracture group), nor in the lifetime factors between the fracture types. In conclusion, some lifetime factors and low S-Ca, low S-25-(OH)-D, high S-CT, and low BMD of the upper femur seem to be related to the risk of hip fracture, and low BMD and low S-CT seem to be related to the trochanteric fracture type in postmenopausal women.
74名非病理性髋部骨折的绝经后女性被纳入一项研究，在该研究中，将她们的终身因素、一些骨代谢的生化指标以及骨密度（BMD）与40名年龄匹配的无骨折对照者进行比较。骨折患者的独立性较差；行走能力较弱；视力较差；患有更多的全身性疾病（中风、糖尿病、恶性疾病、心脏和血管疾病）；更多人有分娩史；并且他们使用袢利尿剂、抗抑郁药、抗精神病药和糖尿病药物的剂量明显高于对照组。37名患者和19名对照者被排除在骨密度和骨代谢生化指标的统计比较之外，因为他们曾接受过钙、维生素D、双膦酸盐、雌激素、降钙素或皮质类固醇治疗，一名骨折患者因原发性甲状旁腺功能亢进被排除。与对照组相比，骨折组股骨上段的骨密度明显较低。骨折组的血清总钙（S-Ca）和血清维生素D（S-25-(OH)-D）明显较低，而降钙素（S-CT）水平明显高于对照组，但各研究组之间的骨形成标志物均无显著差异。对颈椎骨折和转子间骨折患者的比较显示，转子间骨折组股骨上段的骨密度明显较低。骨折类型之间的生化指标（颈椎骨折组S-CT较高除外）和终身因素均无显著差异。总之，一些终身因素以及股骨上段低S-Ca、低S-25-(OH)-D、高S-CT和低骨密度似乎与髋部骨折风险有关，而低骨密度和低S-CT似乎与绝经后女性的转子间骨折类型有关。
