Lauretani Fulvio, Bandinelli Stefania, Griswold Michael E, Maggio Marcello, Semba Richard, Guralnik Jack M, Ferrucci Luigi
Tuscany Regional Health Agency, Florence, Italy.
J Bone Miner Res. 2008 Mar;23(3):400-8. doi: 10.1359/jbmr.071103.
We prospectively examined vBMD and structural bone parameters assessed by QCT among participants of the InCHIANTI study over a 6-yr follow-up. Periosteal apposition occurred both in men and women. Endocortical resorption causes bone loss in older women despite periosteal apposition.
To address the hypothesis that age-related changes in BMD and bone geometry may be different in men and women, we prospectively examined volumetric BMD (vBMD) and structural bone parameters assessed by QCT among participants of the InCHIANTI study over a 6-yr follow-up.
Three hundred forty-five men and 464 women 21-102 yr of age from the InCHIANTI study, a population-based study in Tuscany, Italy, were included. Tibial QCT bone parameters were measured at enrollment (1998-2000) and at 3- (2001-2003) and 6-yr (2004-2006) follow-ups.
Periosteal apposition occurred both in men and women. The annual rate of bone periosteal apposition was higher in younger than in older men, whereas in women, the rate of apposition was homogenous across age groups. The age-related medullary expansion, expression of endocortical resorption, was significantly higher in women compared with men. In women, but not in men, accelerated endocortical resorption not sufficiently balanced by periosteal apposition caused accelerated loss in cortical bone mass. The cross-sectional moment of inertia decreased progressively over the life span in both sexes.
Endocortical resorption causes bone loss in older women despite periosteal apposition. Obtaining a balance between endocortical resorption and periosteal apposition should be the target for interventions aimed to decrease bone loss and prevent osteoporosis in older women.
我们对基安蒂研究（InCHIANTI study）的参与者进行了为期6年的随访，前瞻性地研究了通过定量CT（QCT）评估的体积骨密度（vBMD）和骨结构参数。男性和女性均出现骨膜增生。尽管有骨膜增生，但内皮质吸收仍导致老年女性骨质流失。
为了验证男性和女性与年龄相关的骨密度和骨几何结构变化可能不同这一假设，我们对基安蒂研究的参与者进行了为期6年的随访，前瞻性地研究了通过定量CT（QCT）评估的体积骨密度（vBMD）和骨结构参数。
纳入了来自意大利托斯卡纳地区一项基于人群的基安蒂研究中的345名年龄在21至102岁之间的男性和464名女性。在入组时（1998 - 2000年）以及3年（2001 - 2003年）和6年（2004 - 2006年）随访时测量胫骨QCT骨参数。
男性和女性均出现骨膜增生。年轻男性的骨膜年增生率高于老年男性，而在女性中，各年龄组的增生率相同。与男性相比，女性与年龄相关的骨髓腔扩大，即内皮质吸收的表现更为明显。在女性中，而非男性中，内皮质吸收加速且未被骨膜增生充分平衡，导致皮质骨量加速流失。两性的截面惯性矩在整个生命周期中均逐渐降低。
尽管有骨膜增生，但内皮质吸收仍导致老年女性骨质流失。在内皮质吸收和骨膜增生之间取得平衡应成为旨在减少老年女性骨质流失和预防骨质疏松症的干预目标。
