Rubin Mishaela R, Dempster David W, Zhou Hua, Shane Elizabeth, Nickolas Thomas, Sliney James, Silverberg Shonni J, Bilezikian John P
College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
J Bone Miner Res. 2008 Dec;23(12):2018-24. doi: 10.1359/jbmr.080803.
Hypoparathyroidism, a disorder in which PTH is absent, is associated with BMD that is above average. We studied associated structural and dynamic properties of the skeleton in hypoparathyroidism. Thirty-three subjects with hypoparathyroidism and 33 age- and sex-matched control subjects with no known metabolic diseases underwent percutaneous iliac crest bone biopsies after double-labeling with tetracycline. The main outcome was histomorphometric assessment of structural and dynamic skeletal parameters. Subjects with hypoparathyroidism had greater cancellous bone volume (mean +/- SD; BV/TV: 23.5 +/- 8 versus 19.7 +/- 5%, p = 0.02), trabecular width (Tb.Wi: 136.1 +/- 37 versus 119.3 +/- 21 microm, p = 0.03), and cortical width (Ct.Wi: 923.4 +/- 420 versus 753.5 +/- 246 microm, p = 0.05) than control subjects. Dynamic skeletal indices, including mineralizing surface (MS: 0.85 +/- 1.58 versus 4.27 +/- 3.32%, p < 0.0001) and bone formation rate (BFR/BS: 0.006 +/- 0.014 versus 0.032 +/- 0.028 microm(3)/microm(2)/d, p < 0.0001), were profoundly suppressed in the hypoparathyroid subjects. We conclude that hypoparathyroidism is characterized by markedly unusual structural and dynamic properties of bone.
甲状旁腺功能减退症是一种甲状旁腺激素缺乏的疾病，与高于平均水平的骨密度相关。我们研究了甲状旁腺功能减退症患者骨骼的相关结构和动态特性。33例甲状旁腺功能减退症患者和33例年龄及性别匹配、无已知代谢疾病的对照受试者，在使用四环素进行双重标记后，接受了经皮髂嵴骨活检。主要观察指标是对骨骼结构和动态参数进行组织形态计量学评估。甲状旁腺功能减退症患者的骨小梁体积更大（均值±标准差；骨小梁体积/总体积：23.5±8%对19.7±5%，p = 0.02）、骨小梁宽度更大（Tb.Wi：136.1±37对119.3±21微米，p = 0.03）以及皮质宽度更大（Ct.Wi：923.4±420对753.5±246微米，p = 0.05）。与对照受试者相比，甲状旁腺功能减退症患者的动态骨骼指标，包括矿化表面（MS：0.85±1.58%对4.27±3.32%，p < 0.0001）和骨形成率（BFR/BS：0.006±0.014对0.032±0.028立方微米/平方微米/天，p < 0.0001）受到显著抑制。我们得出结论，甲状旁腺功能减退症的特征是骨骼具有明显异常的结构和动态特性。
