Cheung Catherine Siu King, Lee Warren Tak Keung, Tse Yee Kit, Lee Kwong Man, Guo Xia, Qin Ling, Cheng Jack Chun Yiu
Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin.
Spine (Phila Pa 1976). 2006 Feb 1;31(3):330-8. doi: 10.1097/01.brs.0000197410.92525.10.
A cross-sectional study in girls with adolescent idiopathic scoliosis (AIS) and healthy counterparts of similar age.
To study the association of bone mass with anthropometric parameters, bone turnover, and calcium intake in 621 girls with AIS, aged 11-6-years, and compare the results with 300 healthy girls of similar age.
Generalized low bone mass has been documented in AIS, yet the cause of low bone mineral density in AIS is unknown.
Corrected height and arm span, bone mineral density and bone mineral content of proximal femur, lumbar spine, and distal tibia, and bone turnover markers (bone alkaline phosphatase [bALP] and deoxypyridinoline) were evaluated.
From age 13 years and older, the AIS group had longer anthropometric parameters (P < 0.05), generalized lower bone mass (P < 0.035), and 38.6% higher in bALP (P < 0.004) when compared with controls. A stronger inverse correlation between bALP and bone mass was noted in the AIS group. The bALP was positively correlated with bone area of tibia (P = 0.013) in the AIS group only. Deoxypyridonine of the AIS group was not different from the controls until age 15 years. The mean calcium intake of the AIS group was very low (only 361 mg/day), and calcium intake was significantly associated with bone mass in the AIS group. Low bone mass in AIS could be explained by faster anthropometric bone growth, higher bone turnover, and lower calcium intake in multiple regression analysis.
Results from the current study showed that an abnormally faster growth rate and higher bone turnover in the patient with AIS might lead to increased bone dimensions. Calcium intake in patients with AIS was very low and likely to be insufficient for normal bone mineralization. Therefore, low bone mass in AIS may result from abnormal bone mineralization qualitatively and quantitatively and, thus, fails to catch up with increased bone growth during the peripubertal period.
一项针对青少年特发性脊柱侧凸（AIS）女孩及年龄相仿的健康对照者的横断面研究。
研究621名年龄在11至16岁的AIS女孩的骨量与人体测量参数、骨转换及钙摄入量之间的关联，并将结果与300名年龄相仿的健康女孩进行比较。
AIS患者中已证实存在全身性低骨量，但AIS患者骨密度降低的原因尚不清楚。
评估校正身高和臂展、股骨近端、腰椎和胫骨远端的骨密度及骨矿物质含量，以及骨转换标志物（骨碱性磷酸酶[bALP]和脱氧吡啶啉）。
与对照组相比，13岁及以上的AIS组人体测量参数更长（P<0.05），全身性骨量更低（P<0.035），bALP高38.6%（P<0.004）。AIS组中bALP与骨量之间的负相关性更强。仅在AIS组中，bALP与胫骨骨面积呈正相关（P=0.013）。AIS组的脱氧吡啶啉在15岁之前与对照组无差异。AIS组的平均钙摄入量非常低（仅361毫克/天），且钙摄入量与AIS组的骨量显著相关。在多元回归分析中，AIS患者的低骨量可通过人体测量骨生长更快、骨转换更高和钙摄入量更低来解释。
本研究结果表明，AIS患者异常更快的生长速度和更高的骨转换可能导致骨尺寸增加。AIS患者的钙摄入量非常低，可能不足以实现正常的骨矿化。因此，AIS患者的低骨量可能在质和量上都源于异常的骨矿化，从而在青春期前未能跟上骨生长增加的速度。
