Gerdhem P, Obrant K J
Department of Orthopaedics, Malmö University Hospital, Malmö, Sweden.
Osteoporos Int. 2002 Dec;13(12):932-6. doi: 10.1007/s001980200130.
In order to elucidate the influence of nicotine smoking on bone mass in elderly women, bone mass was cross-sectionally assessed by dual energy X-ray absorptiometry (DXA) in total body, hip and lumbar spine, as well as with ultrasound of calcaneus and phalanges of the hand. Subjects were 1,042, 75-year old women, recruited on a population basis (Osteoporosis Prospective Risk Assessment (OPRA) study). We found bone mineral density (BMD) to be lower in hip (0.71 vs. 0.76 g/cm2, p<0.0001 for femoral neck) and total body (0.96 vs. 1.02 g/cm2, p<0.0001) in current smokers compared to never-smokers. There was no difference in BMD of the lumbar spine between current smokers and never-smokers. Bone mass as assessed by ultrasound of the calcaneus was lower for speed of sound ( p<0.01), broadband ultrasound attenuation ( p<0.0001) and stiffness ( p<0.0001) in current smokers than in never-smokers. No differences were found for ultrasound measurements of the phalanges between smokers and never-smokers. Also, weight and current physical activity as assessed by a questionnaire differed significantly between current smokers and never-smokers. There was no evident difference between former smokers and never-smokers in any of the skeletal regions assessed by DXA or ultrasound. After correcting for differences in weight and physical activity, current smokers had lower BMD in all hip sites ( p<0.05) and total body ( p<0.01) compared to never-smokers. Ultrasound and BMD spine did not differ between these two groups after correction for weight and physical activity. We conclude that nicotine smoking has a negative influence on bone mass independent of differences in weight and physical activity. This difference is detected by DXA but not by ultrasound measurements of the calcaneus or the phalanges. The present data are encouraging since no bone mass differences were found between former and never-smokers.
为了阐明吸烟对老年女性骨量的影响，采用双能X线吸收法（DXA）对全身、髋部和腰椎的骨量进行了横断面评估，并对手部跟骨和指骨进行了超声检查。研究对象为1042名75岁的女性，她们是基于人群招募的（骨质疏松症前瞻性风险评估（OPRA）研究）。我们发现，与从不吸烟者相比，当前吸烟者的髋部（股骨颈骨密度0.71 vs. 0.76 g/cm²，p<0.0001）和全身（骨密度0.96 vs. 1.02 g/cm²，p<0.0001）骨矿物质密度（BMD）较低。当前吸烟者和从不吸烟者的腰椎BMD没有差异。与从不吸烟者相比，当前吸烟者跟骨超声评估的骨量在声速（p<0.01）、宽带超声衰减（p<0.0001）和硬度（p<0.0001）方面较低。吸烟者和从不吸烟者的指骨超声测量结果没有差异。此外，通过问卷调查评估的体重和当前身体活动在当前吸烟者和从不吸烟者之间也有显著差异。在DXA或超声评估的任何骨骼区域，既往吸烟者和从不吸烟者之间没有明显差异。在校正体重和身体活动差异后，与从不吸烟者相比，当前吸烟者在所有髋部部位（p<0.05）和全身（p<0.01）的BMD较低。在校正体重和身体活动后，这两组之间的超声和腰椎BMD没有差异。我们得出结论，吸烟对骨量有负面影响，且与体重和身体活动差异无关。这种差异可通过DXA检测到，但跟骨或指骨的超声测量未检测到。目前的数据令人鼓舞，因为既往吸烟者和从不吸烟者之间未发现骨量差异。
