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Low bone volume--a risk factor for coronary calcifications in hemodialysis patients.低骨量——血液透析患者冠状动脉钙化的一个危险因素。
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Peripheral dual-energy X-ray absorptiometry in the management of osteoporosis: the 2007 ISCD Official Positions.外周双能X线吸收法在骨质疏松症管理中的应用：2007年国际临床骨密度学会官方立场
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Mineral metabolism, bone histomorphometry and vascular calcification in alternate night nocturnal haemodialysis.隔日夜间血液透析中的矿物质代谢、骨组织形态计量学与血管钙化
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Timing of peak bone mass: discrepancies between CT and DXA.峰值骨量的时间：CT与DXA之间的差异。
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Incidence and risk factors for hip or other bone fractures among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study.透析预后与实践模式研究中血液透析患者髋部或其他骨折的发生率及危险因素
Kidney Int. 2006 Oct;70(7):1358-66. doi: 10.1038/sj.ki.5001754. Epub 2006 Aug 23.
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PTH and the risks for hip, vertebral, and pelvic fractures among patients on dialysis.甲状旁腺激素与透析患者髋部、脊椎和骨盆骨折风险
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血液透析患者的股骨骨密度反映了组织学确定的皮质骨体积。

Femoral bone mineral density reflects histologically determined cortical bone volume in hemodialysis patients.

机构信息

Nephrology Department, Santa Cruz Hospital, Lisbon, Portugal.

出版信息

Osteoporos Int. 2010 Apr;21(4):619-25. doi: 10.1007/s00198-009-0988-9. Epub 2009 Jun 25.

DOI:10.1007/s00198-009-0988-9
PMID:19554246
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4501027/
Abstract

UNLABELLED

We evaluated the associations between dual energy X-ray absorptiometry (DXA) and histologically determined cancellous and cortical bone volume by controlling for vascular calcifications and demographic variables in hemodialysis (HD) patients. Femoral bone mineral density (f-BMD) was associated with cortical porosity.

INTRODUCTION

Assessment of bone mass in chronic kidney disease patients is of clinical importance because of the association between low bone volume, fractures, and vascular calcifications. DXA is used for noninvasive assessment of bone mass whereby vertebral results reflect mainly cancellous bone and femoral results reflect mainly cortical bone. Bone histology allows direct measurements of cancellous and cortical bone volume. The present study evaluates the association between DXA and histologically determined cancellous and cortical bone volumes in HD patients.

METHODS

In 38 HD patients, DXA was performed for assessment of bone mass, anterior iliac crest bone biopsies for bone volume, and multislice computed tomography for vascular calcifications.

RESULTS

While lumbar bone mineral density (l-BMD) by DXA was not associated with histologically measured cancellous bone volume, coronary Agatson score showed a borderline statistically significant association (P = 0.055). When controlled for age and dialysis duration, f-BMD by DXA was associated with cortical porosity determined by histology (P = 0.005).

CONCLUSIONS

The usefulness of l-BMD for predicting bone volume is limited most probably because of interference by soft tissue calcifications. In contrast, f-BMD shows significant association with cortical porosity.

摘要

目的

通过控制血液透析（HD）患者的血管钙化和人口统计学变量，评估双能 X 射线吸收法（DXA）与组织学确定的松质骨和皮质骨体积之间的相关性。股骨骨密度（f-BMD）与皮质骨孔隙率相关。

背景

在慢性肾脏病患者中评估骨量具有临床重要性，因为骨量低、骨折和血管钙化之间存在关联。DXA 用于非侵入性评估骨量，其中椎体结果主要反映松质骨，股骨结果主要反映皮质骨。骨组织学允许直接测量松质骨和皮质骨体积。本研究评估了 DXA 与 HD 患者组织学确定的松质骨和皮质骨体积之间的相关性。

方法

在 38 名 HD 患者中，进行 DXA 评估骨密度，在前髂嵴骨活检评估骨体积，以及多层计算机断层扫描评估血管钙化。

结果

尽管 DXA 测定的腰椎骨密度（l-BMD）与组织学测量的松质骨体积无关，但冠状动脉 Agatson 评分显示出有统计学意义的边缘相关性（P=0.055）。当控制年龄和透析时间时，DXA 测定的 f-BMD 与组织学确定的皮质骨孔隙率相关（P=0.005）。

结论

l-BMD 预测骨体积的有用性是有限的，这很可能是由于软组织钙化的干扰。相比之下，f-BMD 与皮质骨孔隙率显著相关。