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负重长骨干皮质骨矿物质密度的区域差异——一项外周定量计算机断层扫描研究

Regional differences in cortical bone mineral density in the weight-bearing long bone shaft--a pQCT study.

作者信息

Lai Y M, Qin L, Hung V W Y, Chan K M

机构信息

Department of Optometry and Radiography, The Hong Kong Polytechnic University, Hong Kong SAR, PR China.

出版信息

Bone. 2005 Mar;36(3):465-71. doi: 10.1016/j.bone.2004.11.005.

Abstract

This study used a multislice peripheral quantitative computed tomography (pQCT) to measure volumetric BMD (vBMD) and cortical thickness for investigating regional adaptation in lower tibial shaft in 72 healthy postmenopausal women aged 47-60. Tomographic slices were analysed on four distinct cortical regions: the anterior, posterior, medial and lateral cortical wall. One-way analysis of variance (ANOVA) test was used to compare the vBMD in the four regions. The results showed that the posterior cortex had the highest vBMD (1923 +/- 135.3 mg/cm(3)), significantly (P < 0.001) higher than the anterior cortex (1805 +/- 110.6 mg/cm(3)), medial cortex (1863 +/- 103.6 mg/cm(3)) and lateral cortex (1815 +/- 111.6 mg/cm(3)); whereas there was no significant difference (P > 0.05) between the medial and lateral cortices located near the neutral plane of bending. The anterior cortex had the greatest thickness (2.56 +/- 0.47 mm), significantly (P < 0.001) greater than that of the posterior cortex (2.11 +/- 0.27 mm), medial cortex (2.20 +/- 0.39 mm) and lateral cortex (2.03 +/- 0.29 mm). The vBMD of the posterior cortex was a significant 6.5% higher than that of the anterior cortex (P < 0.001); whereas the anterior cortical thickness was a significant 21.3% greater than that of the posterior cortex (P < 0.001). There was no linear relationship found between cortical vBMD and cortical thickness measured at the four cortical regions (r = 0.086, P > 0.05). In conclusion, the regional differences, with higher vBMD found in posterior cortex, might be a result of mechanical adaptation, which caused the posterior cortex to sustain higher compressive loading than the anterior tensile cortex during the landing phase in the gait cycles of individuals. Nevertheless, regional geometric adaptation in anterior cortical thickness might be adapted to accommodate for the reduced vBMD and to reduce the bending stress in this region.

摘要

本研究采用多层外周定量计算机断层扫描(pQCT)测量72名年龄在47 - 60岁的健康绝经后女性胫骨下段的骨体积密度(vBMD)和皮质厚度,以研究区域适应性。对四个不同的皮质区域进行断层扫描分析:前皮质壁、后皮质壁、内侧皮质壁和外侧皮质壁。采用单因素方差分析(ANOVA)测试比较这四个区域的vBMD。结果显示,后皮质的vBMD最高(1923±135.3mg/cm³),显著高于前皮质(1805±110.6mg/cm³)、内侧皮质(1863±103.6mg/cm³)和外侧皮质(1815±111.6mg/cm³)(P < 0.001);而位于弯曲中性平面附近的内侧和外侧皮质之间无显著差异(P > 0.05)。前皮质厚度最大(2.56±0.47mm),显著大于后皮质(2.11±0.27mm)、内侧皮质(2.20±0.39mm)和外侧皮质(2.03±0.29mm)(P < 0.001)。后皮质的vBMD比前皮质显著高6.5%(P < 0.001);而前皮质厚度比后皮质显著大21.3%(P < 0.001)。在四个皮质区域测量的皮质vBMD和皮质厚度之间未发现线性关系(r = 0.086,P > 0.05)。总之,后皮质中较高的vBMD这种区域差异可能是机械适应的结果,这导致在个体步态周期的着地阶段,后皮质比前拉伸皮质承受更高的压缩负荷。然而,前皮质厚度的区域几何适应可能是为了适应vBMD的降低并减少该区域的弯曲应力。

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