Bouxsein Mary L
Orthopedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Nat Clin Pract Rheumatol. 2008 Jun;4(6):310-8. doi: 10.1038/ncprheum0798. Epub 2008 Apr 22.
Fractures that result from osteoporosis are an enormous and growing concern for public health systems; as the population ages, the number of fractures worldwide will double or triple in the next 50 years. The ability of a bone to resist fracture depends not only on the amount of bone present, but also on the spatial distribution of the bone mass, the cortical and trabecular microarchitecture, and the intrinsic properties of the materials that comprise the bone. Although low bone mineral density is one of the strongest risk factors for fracture, a number of clinical studies have demonstrated the limitations of using measurements of areal bone mineral density by dual-energy X-ray absorptiometry to assess fracture risk and to monitor responses to therapy. As a result, new, noninvasive imaging techniques that are capable of assessing various components of bone strength are being developed. These techniques include three-dimensional assessments of bone density, geometry and microarchitecture, as well as integrated measurements of bone strength by engineering analyses. Although they show strong potential, further development and validation of these techniques is needed to define their role in the clinical management of individuals with osteoporosis.
骨质疏松导致的骨折是公共卫生系统日益关注的重大问题；随着人口老龄化，全球骨折数量在未来50年内将增加一倍或两倍。骨骼抵抗骨折的能力不仅取决于现有骨量，还取决于骨质量的空间分布、皮质和小梁微结构以及构成骨骼的材料的固有特性。虽然低骨密度是骨折的最强危险因素之一，但多项临床研究表明，使用双能X线吸收法测量面积骨密度来评估骨折风险和监测治疗反应存在局限性。因此，正在开发能够评估骨强度各个组成部分的新型非侵入性成像技术。这些技术包括对骨密度、几何形状和微结构的三维评估，以及通过工程分析对骨强度进行综合测量。尽管它们具有很大潜力，但仍需要进一步开发和验证这些技术，以确定它们在骨质疏松症患者临床管理中的作用。
