Oishi Y, Shimizu K, Katoh T, Nakao H, Yamaura M, Furuko T, Narusawa K, Nakamura T
Department of Orthopedic Surgery, Keihai Rosai Hospital, 632 Takatoku, Fujiwaramachi, Shioyagun, Tochigi 321-2523, Japan.
Bone. 2003 Apr;32(4):405-11. doi: 10.1016/s8756-3282(03)00031-0.
Our study was designed to assess the contributions of the physical and constitutional factors to osteophyte formation, disc degeneration, and bone mineral density (BMD) in lumbar vertebrae of elderly postmenopausal women. A total of 126 Japanese women with back pain, aged over 60 years, were invited to participate in the study. Then 80 subjects with a full set of data for physical examinations, radiographs, MRI, and DXA were examined. TaqI polymorphism of vitamin D receptor (VDR) gene was examined in 60 subjects. Prevalence rates of osteophytes (on radiographs) and disc degeneration (on MRI) were 61 and 68%, respectively. Body weight and BMI correlated significantly with anteroposterior (AP) and lateral (LAT) BMD (r = 0.354 for weight, r = 0.347 for BMI) and mean osteophyte area (r = 0.557 for weight, r = 0.486 for BMI), and body weight also correlated with number of discs with osteophytes. However, these did not correlate with the disc area or the number of degenerated discs. Stepwise regression analysis revealed that body weight and LAT-BMD values independently related to the osteophyte area. Disc area (r = 0.386 for AP view) and osteophyte area (r = 0.384 for AP view) significantly correlated with BMD. However, disc area and osteophyte area did not correlate with each other (r = 0.056). The proportion of degenerated discs was higher in the lower lumbar discs, but not the proportion of discs with osteophytes. Frequencies of T and t alleles of VDR did not correlate with disc degeneration, osteophyte formation, or osteoporosis. Our data showed that increases in osteophyte formation and BMD in the lumbar vertebrae are influenced by body weight and BMI, but did not correlate with disc area, which correlated inversely with BMD. Disc degeneration and osteophyte formation seem to represent two different factors that affect lumbar spine in elderly women.
我们的研究旨在评估身体因素和体质因素对老年绝经后女性腰椎骨赘形成、椎间盘退变及骨密度（BMD）的影响。共有126名60岁以上有背痛症状的日本女性受邀参与本研究。随后，对80名具备体格检查、X光片、核磁共振成像（MRI）及双能X线吸收法（DXA）全套数据的受试者进行了检查。在60名受试者中检测了维生素D受体（VDR）基因的TaqI多态性。骨赘（X光片所示）和椎间盘退变（MRI所示）的患病率分别为61%和68%。体重和体重指数（BMI）与前后位（AP）及侧位（LAT）骨密度显著相关（体重r = 0.354，BMI r = 0.347）以及平均骨赘面积（体重r = 0.557，BMI r = 0.486），体重还与有骨赘的椎间盘数量相关。然而，这些因素与椎间盘面积或退变椎间盘数量无关。逐步回归分析显示，体重和LAT - BMD值独立与骨赘面积相关。椎间盘面积（AP位视图r = 0.386）和骨赘面积（AP位视图r = 0.384）与骨密度显著相关。然而，椎间盘面积和骨赘面积彼此不相关（r = 0.056）。退变椎间盘在下腰椎的比例较高，但有骨赘的椎间盘比例并非如此。VDR的T和t等位基因频率与椎间盘退变、骨赘形成或骨质疏松均无关联。我们的数据表明，腰椎骨赘形成和骨密度的增加受体重和BMI影响，但与椎间盘面积无关，而椎间盘面积与骨密度呈负相关。椎间盘退变和骨赘形成似乎代表影响老年女性腰椎的两个不同因素。
