Montemurro L, Fraioli P, Rizzato G
Sarcoidosis Clinic, Niguarda Hospital, Milan, Italy.
Sarcoidosis. 1991 Mar;8(1):29-34.
The introduction of new techniques for the study of Bone Mineral Content (BMC) has not yet been extensively applied to sarcoidosis. Using Quantitative Computed Tomography (QCT) in a long-term prednisone-treated sarcoid population we have shown in 1988 [1] that Bone Mineral Loss is more frequent than elsewhere reported with other techniques on patients with different diseases. It was not clear if this difference was due to the sarcoidosis itself or to the better sensitivity of QCT compared to former techniques [2]. Thus we have now studied QCT in a group of 36 untreated patients with active, histologically proven sarcoidosis, chronic in most cases, to clarify the action of sarcoidosis itself over the BMC. For each patient Vertebral Cancellous Mineral Content (VCMC) has been expressed in terms of Z score (i.e. the number of Standard Deviations (SD) above or below the normal value) in order to overcome the differences due to age and sex. In the whole group, mean value of Z score was -0.41 +/- 0.30 (P > 0.05 vs. 190 normals). Nevertheless VCMC was below the normal range in 13 out of 36 patients; in five of them, all with longstanding sarcoidosis for at least 2 years, VCMC was more than two SD below the normal; four out of 36 had a VCMC lower than 110 mg/cm3 K2HPO4 eq, that is considered the threshold level under which the risk of fracture begins (but three of them were postmenopausal females).(ABSTRACT TRUNCATED AT 250 WORDS)
骨矿物质含量(BMC)研究新技术的引入尚未广泛应用于结节病。1988年我们在长期接受泼尼松治疗的结节病患者群体中使用定量计算机断层扫描(QCT)[1]发现,骨矿物质流失比其他技术在不同疾病患者中报道的更为常见。尚不清楚这种差异是由于结节病本身,还是由于QCT比以前的技术具有更高的敏感性[2]。因此,我们现在对一组36例未经治疗的、组织学确诊为活动性结节病(大多数为慢性)的患者进行了QCT研究,以阐明结节病本身对BMC的影响。为了克服年龄和性别差异,对每位患者的椎体松质骨矿物质含量(VCMC)用Z评分表示(即高于或低于正常值的标准差(SD)数)。在整个组中,Z评分的平均值为-0.41±0.30(与190名正常人相比,P>0.05)。然而,36例患者中有13例的VCMC低于正常范围;其中5例,均患有至少2年的长期结节病,VCMC比正常低两个以上标准差;36例中有4例的VCMC低于110mg/cm³K₂HPO₄当量,这被认为是骨折风险开始的阈值水平(但其中3例是绝经后女性)。(摘要截断于250字)